CPCS Study Guide Questions And Answers From GHMSS Study Group 2023

CPCS Study Guide Questions And Answers From GHMSS Study Group 2023 Why is it important to check that the practitioner is not currently excluded, suspended, debarred, or ineligible to participate in Federal health care programs? - ANS-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? a. Medical school b. Post graduate education c. Closed medical malpractice claims d. Licensure - ANS-Licensure According to NCQA standards, an organization that discovers sanction information, complaints, or adverse events regarding a practitioner must take what action? - ANSDetermine 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 Health Care Quality Improvement Act of 1986 to restrict the ability of incompetent physicians, dentists, and other healthcare practitioners to move from state to state without disclosure or discovery of previous medical malpractice payment and adverse action history? - ANS-The National Practitioner Databank When developing clinical privileging criteria, which of the following is important to evaluate? a. How many providers are in that specialty b. Established standards of practice such as, specialty board recommendations c. Whether or not the quality department can support the FPPE process d. The average cost to the patient - ANS-Established standards of practice such as, specialty board recommendations What is the main reason for periodically assessing appropriateness of clinical privileges for each specialty? - ANS-To protect patient safety by ensuring current competency, relevance to the facility, and accepted standards of care Which of the following specialists is most likely to perform at PTCA? a. General Surgeon b. ObGyn c. Urologist d. Interventional Cardiologist - ANS-Interventional Cardiologist The Joint Commission hospital standards require that clinical privileges are hospital specific and ___ a. Based on the individual's demonstrated current competence and the procedures the hospital can support b. Based on board certification c. Based on the privileges the individual is currently approved to perform at other hospitals d. Posted in a place that is accessible to all hospital employees - ANS-Based on the individual's demonstrated current competence and the procedures the hospital can support Which of the following would be routinely performed by a cardiologist? a. Hysterectomy b. Trans-esophageal Echocardiography c. Urethral dilation d. Renal dialysis - ANS-Trans-esophageal Echocardiography Which NCQA required committee makes recommendations regarding credentialing decisions? - ANS-Credentials Committee HFAP standards require three medical staff committees to be delineated in the medical staff structure. Two of them are the Medical Executive Committee and the Utilization of Osteopathic Methods & Concepts Committee. What is the other required medical staff committee? -ANS- Continues...