CPMSM - Study Guide Material

CPMSM - Study Guide Material What are four models of HMOs? - Staff Model Group Model Network Model Independent Practice Association (IPA) What are the four types of committees? - Standing Ad hoc Task force Continuous quality improvement team How many medical staff members comprise a Bylaws Committee? - 5 At least five active medical staff How many medical staff members comprise a Credentials Committee? - 5 At least five active medical staff How many medical staff members must serve on an Infection Control Committee? - 3 At least three active medical staff How many medical staff members must serve on a Medical Records Committee? - 1 At least one active medical staff How often should the Medical Records committee meet? - At least quarterly How many medical staff members must serve on a Pharmacy & Therapeutics Committee? - 5 At least five active medical staff How often should the Pharmacy & Therapeutics committee meet? - At least quarterly How many medical staff members must serve on a Utilization Review Committee? - 1 At least one active medical staff How often should the Utilization Review Committee meet? - 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? - Credentialing What are the three reasons for credentialing? - Patient Safety Risk Management Required by agencies Which three accreditors have been granted "deemed status"? - TJC, HFAP, DNV Which two organizations offer accreditation for managed care organizations? - NCQA, URAC Who is the main accreditor for ambulatory