CPMSM EXAM QUESTIONS & ANSWERS
Why it is important to check that the practitioner is not currently excluded suspended the
board or in eligible to participate in federal healthcare programs - Answers :The facility
won't get paid for treating patients unless service is provided by authorized provider
Which of the following credentials must be tracked on an ongoing basis - Answers
:Licensure
According to NCQA standards and organization that discovers sanction information
complaints or adverse events regarding a practitioner must take what action - Answers
:Determine if there is evidence of poor quality that could affect the health and safety of
its members
What is the name of the entity that was established through the healthcare quality
improvement act of 1986 to restrict the ability of incompetent physicians Dennis and
other healthcare practitioners to move from state to state without disclosure or discovery
a previous medical malpractice payment and adverse action history - Answers :The
national practitioner data Bank
Pier references should be obtained from - Answers :Practitioners who have referred
patients to the provider
Patrick versus Burgett is an important case because it - Answers :Illustrates the
potential for anti-trust liability arising out of peer review activities
If the medical staff member has privileges and or medical staff appointment revote here
she must be - Answers :Reported immediately to the national practitioner data Bank
Access to credentials file should be - Answers :Describe fully in an access policy
Which of the following bodies approves clinical privileges - Answers :Governing body or
Board
What primary source verification is required by NCQA prior to provisional credentialing -
Answers :Licensure and five-year malpractice history or NPDD
According to joint commission standards initial appointments to the medical staff are
made for a period of - Answers :Not to exceed two years
According to the joint commission standards temporary privileges may be generated by
- Answers :The CEO on the recommendation of the medical staff president or author
rise designee
, According to the joint commission standards which of the following items must be
verified with a primary source - Answers :Licensure training experience and
competence
According to NCQA standards a copy of which of the following is except a bowl
verification of the document - Answers :DEA certificate
When developing clinical privileging criteria which of the following is important to
evaluate - Answers :Establish standards of practice such a specialty board
recommendations
What is the main reason for periodically assessing appropriateness of clinical privileges
for each specialty - Answers :To protect patient safety by ensuring current competency
relevance to the facility and excepted standards of care
Which of the following specialist is most likely to perform a PTCA - Answers :An
interventional cardiologist
The joint commission hospital standards require the clinical privileges or hospital
specific and - Answers :Based on the individuals demonstrate occur in confidence and
the procedures the hospital can support
Which of the following would be routinely performed by a cardiologist - Answers
:Transesophageal echocardiography
Which NCQA required committee makes recommendations regarding credentialing
decisions - Answers :Credentialing committee
HFAP standards require three medical staff committees to be delineated in the medical
staff structure two of them or the medical executive committee and the utilization of
osteopathic methods and concepts committee required for hospitals with 10 or more
DO's who admit patients and provide direct patient care what is the other required
medical staff committee - Answers :Utilization review committee
If you needed to find out about what the federal government requires in regards to
antitrust issues what law would you consult - Answers :Sherman antitrust act
According to NCQA standards which is an acceptable source for primary source
verification of Medicare and Medicaid sanction activity against positions - Answers
:Federation of state medical board's
According to joint commission standards which of the following is considered a
designated equivalence source for verification of board certification - Answers :The
American Board of medical specialties
Why it is important to check that the practitioner is not currently excluded suspended the
board or in eligible to participate in federal healthcare programs - Answers :The facility
won't get paid for treating patients unless service is provided by authorized provider
Which of the following credentials must be tracked on an ongoing basis - Answers
:Licensure
According to NCQA standards and organization that discovers sanction information
complaints or adverse events regarding a practitioner must take what action - Answers
:Determine if there is evidence of poor quality that could affect the health and safety of
its members
What is the name of the entity that was established through the healthcare quality
improvement act of 1986 to restrict the ability of incompetent physicians Dennis and
other healthcare practitioners to move from state to state without disclosure or discovery
a previous medical malpractice payment and adverse action history - Answers :The
national practitioner data Bank
Pier references should be obtained from - Answers :Practitioners who have referred
patients to the provider
Patrick versus Burgett is an important case because it - Answers :Illustrates the
potential for anti-trust liability arising out of peer review activities
If the medical staff member has privileges and or medical staff appointment revote here
she must be - Answers :Reported immediately to the national practitioner data Bank
Access to credentials file should be - Answers :Describe fully in an access policy
Which of the following bodies approves clinical privileges - Answers :Governing body or
Board
What primary source verification is required by NCQA prior to provisional credentialing -
Answers :Licensure and five-year malpractice history or NPDD
According to joint commission standards initial appointments to the medical staff are
made for a period of - Answers :Not to exceed two years
According to the joint commission standards temporary privileges may be generated by
- Answers :The CEO on the recommendation of the medical staff president or author
rise designee
, According to the joint commission standards which of the following items must be
verified with a primary source - Answers :Licensure training experience and
competence
According to NCQA standards a copy of which of the following is except a bowl
verification of the document - Answers :DEA certificate
When developing clinical privileging criteria which of the following is important to
evaluate - Answers :Establish standards of practice such a specialty board
recommendations
What is the main reason for periodically assessing appropriateness of clinical privileges
for each specialty - Answers :To protect patient safety by ensuring current competency
relevance to the facility and excepted standards of care
Which of the following specialist is most likely to perform a PTCA - Answers :An
interventional cardiologist
The joint commission hospital standards require the clinical privileges or hospital
specific and - Answers :Based on the individuals demonstrate occur in confidence and
the procedures the hospital can support
Which of the following would be routinely performed by a cardiologist - Answers
:Transesophageal echocardiography
Which NCQA required committee makes recommendations regarding credentialing
decisions - Answers :Credentialing committee
HFAP standards require three medical staff committees to be delineated in the medical
staff structure two of them or the medical executive committee and the utilization of
osteopathic methods and concepts committee required for hospitals with 10 or more
DO's who admit patients and provide direct patient care what is the other required
medical staff committee - Answers :Utilization review committee
If you needed to find out about what the federal government requires in regards to
antitrust issues what law would you consult - Answers :Sherman antitrust act
According to NCQA standards which is an acceptable source for primary source
verification of Medicare and Medicaid sanction activity against positions - Answers
:Federation of state medical board's
According to joint commission standards which of the following is considered a
designated equivalence source for verification of board certification - Answers :The
American Board of medical specialties
