CPMSM - Study Guide Material Exam
2026 Questions and Answers
What are four models of HMOs? - Answer -Staff Model
Group Model
Network Model
Independent Practice Association (IPA)
What are the four types of committees? - Answer -Standing
Ad hoc
Task force
Continuous quality improvement team
How many medical staff members comprise a Bylaws Committee? - Answer -5
At least five active medical staff
How many medical staff members comprise a Credentials Committee? - Answer -5
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,At least five active medical staff
How many medical staff members must serve on an Infection Control Committee?
- Answer -3
At least three active medical staff
How many medical staff members must serve on a Medical Records Committee? -
Answer -1
At least one active medical staff
How often should the Medical Records committee meet? - Answer -At least
quarterly
How many medical staff members must serve on a Pharmacy & Therapeutics
Committee? - Answer -5
At least five active medical staff
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,How often should the Pharmacy & Therapeutics committee meet? - Answer -At
least quarterly
How many medical staff members must serve on a Utilization Review Committee?
- Answer -1
At least one active medical staff
How often should the Utilization Review Committee meet? - Answer -Every other
month
What is the process of obtaining, verifying, and assessing the qualifications of a
health care practitioner who seeks to provide patient care services in or for a
hospital? - Answer -Credentialing
What are the three reasons for credentialing? - Answer -Patient Safety
Risk Management
Required by agencies
Which three accreditors have been granted "deemed status"? - Answer -TJC,
HFAP, DNV
Which two organizations offer accreditation for managed care organizations? -
Answer -NCQA, URAC
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, Who is the main accreditor for ambulatory care facilities? - Answer -AAAHC
Physicians who are employees of a facility as hospitalists and who are not listed in
the provider directory are not included in the scope of the credentialing standards
with this accreditation? - Answer -URAC
For which accreditation, do the following practitioners need *not* to be
credentialed including:
-exclusively in the inpatient setting caring for organization members only in the
hospital setting
-practice exclusively in free-standing setting for members directed to facility
-pharmacists working for a PBM (pharmacy benefits management) organization
for UM functions
-locum tenens working less than 90 days
-rental network practitioners providing out of area care - Answer -NCQA
What are Medicare CoP's minimum criteria for appointment to the medical
staff/granting of medical staff privileges? - Answer -CCJET
character
competence
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
2026 Questions and Answers
What are four models of HMOs? - Answer -Staff Model
Group Model
Network Model
Independent Practice Association (IPA)
What are the four types of committees? - Answer -Standing
Ad hoc
Task force
Continuous quality improvement team
How many medical staff members comprise a Bylaws Committee? - Answer -5
At least five active medical staff
How many medical staff members comprise a Credentials Committee? - Answer -5
©COPYRIGHT 2025, ALL RIGHTS RESERVED 1
,At least five active medical staff
How many medical staff members must serve on an Infection Control Committee?
- Answer -3
At least three active medical staff
How many medical staff members must serve on a Medical Records Committee? -
Answer -1
At least one active medical staff
How often should the Medical Records committee meet? - Answer -At least
quarterly
How many medical staff members must serve on a Pharmacy & Therapeutics
Committee? - Answer -5
At least five active medical staff
©COPYRIGHT 2025, ALL RIGHTS RESERVED 2
,How often should the Pharmacy & Therapeutics committee meet? - Answer -At
least quarterly
How many medical staff members must serve on a Utilization Review Committee?
- Answer -1
At least one active medical staff
How often should the Utilization Review Committee meet? - Answer -Every other
month
What is the process of obtaining, verifying, and assessing the qualifications of a
health care practitioner who seeks to provide patient care services in or for a
hospital? - Answer -Credentialing
What are the three reasons for credentialing? - Answer -Patient Safety
Risk Management
Required by agencies
Which three accreditors have been granted "deemed status"? - Answer -TJC,
HFAP, DNV
Which two organizations offer accreditation for managed care organizations? -
Answer -NCQA, URAC
©COPYRIGHT 2025, ALL RIGHTS RESERVED 3
, Who is the main accreditor for ambulatory care facilities? - Answer -AAAHC
Physicians who are employees of a facility as hospitalists and who are not listed in
the provider directory are not included in the scope of the credentialing standards
with this accreditation? - Answer -URAC
For which accreditation, do the following practitioners need *not* to be
credentialed including:
-exclusively in the inpatient setting caring for organization members only in the
hospital setting
-practice exclusively in free-standing setting for members directed to facility
-pharmacists working for a PBM (pharmacy benefits management) organization
for UM functions
-locum tenens working less than 90 days
-rental network practitioners providing out of area care - Answer -NCQA
What are Medicare CoP's minimum criteria for appointment to the medical
staff/granting of medical staff privileges? - Answer -CCJET
character
competence
©COPYRIGHT 2025, ALL RIGHTS RESERVED 4
