CPCS - Certified Provider Credentialing Specialist

CPCS - Certified Provider Credentialing Specialist Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - ANS-Yes According to TJC, who may amend the medical staff bylaws? - ANS-Governing body/board. Failure to meet the established qualifications and criteria for appointment should be reported to whom? - ANS-The applicant NCQA requires the MCO to obtain a minimum of how may years of work history? - ANS-Five years According to the NCQA what policy must an organization have in place to obtain approval to enter into a delegated agreement? - ANS-Credentialing policies How often does the OIG report to the NPDB? - ANS-Monthly When must hospitals query the NPDB? - ANS-Initial appointment, granting of privileges, every two years. NCQA requires verifications must be less than how many days old? - ANS-180 days What is the verification time limit on malpractice history according to the NCQA? - ANS180 days Time limited credential must be verified by the CVO with how may days prior to submission to the client? - ANS-120 days According the AAAHC, for initial appointments, in addition to licensure and education, what verification is required? - ANS-Experience and hospital affiliations. What accreditation body states "The NPDB is an acceptable source for sanctions or limitations on licensure, Medicaid/ Medicare sanctions and malpractice history? - ANSNCQA Who is required to query the NPDB? - ANS-Hospitals Is disciplinary action taken against the license of a dentist reportable to the NPDB? - ANS- Continues...