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The Joint Commision defines credentialing as? - ✔✔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.
Hospitals Accreditors that have been granted
deemed status are: - ✔✔-The Joint Commission (TJC)
-American Osteopathic Association's Health
Facility Accreditation Program (AOA-HFAP)
-Det Norske Veritas Healthcare, Inc's (DNV GL)
National Integrated Accreditation for Healthcare
Organizations (NIAHO)
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,-The Center for Improvement in Healthcare Quality (CIHQ) is the nation's newest
accreditation provider, approved by CMS to deem ACUTE CARE HOSPITALS as
meeting Medicare COPs. (Received deeming authority in July 2013.)
CVO Credentialing is Driven by: - ✔✔(C.A.P.)
Contract
Policies and Procedures
Accreditation Standards (NCQA, URAC, The Joint Commission, DNV GL, HFAP,
CIQH)
In Ambulatory Care, Medical Office/Surgical Center Credentialing is influenced by: -
✔✔Accreditation Standards (AAAHC, TJC, NCQA, URAC, HFAP)
CMS regulations
State and Federal Law
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, Policies and Procedures
Contractual Agreements
Ambulatory Care Governance Documents (Policies and Procedures and Bylaws)
How often do CMS, TJC and HFAP reappoint? - ✔✔Every 2 years
Per CMS, TJC, HFAP, NCQA Education and Training verifications are acceptable
through? - ✔✔AMA
AOA
ECFMG
TJC requires licensure to be verified with the
primary source at what four times? - ✔✔1. Initial granting
2. Renewal of privileges
3. Revision of privileges
4. At the time of license expiration
According to TJC, the hospital must query the National
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