CPMSM EXAM QUESTIONS AND
ANSWERS 100% CORRECT
Why it is important to check that the practitioner is not currently excluded suspended the
board or in eligible to participate in federal healthcare programs - ANSWER-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 - ANSWER-
Licensure
According to NCQA standards and organization that discovers sanction information
complaints or adverse events regarding a practitioner must take what action -
ANSWER-Determine 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 healthcare quality
improvement act of 1986 to restrict the ability of incompetent physicians Dennis and
other healthcare practitioners to move from state to state without disclosure or discovery
a previous medical malpractice payment and adverse action history - ANSWER-The
national practitioner data Bank
When developing clinical privileging criteria which of the following is important to
evaluate - ANSWER-Establish standards of practice such a specialty board
recommendations
What is the main reason for periodically assessing appropriateness of clinical privileges
for each specialty - ANSWER-To protect patient safety by ensuring current competency
relevance to the facility and excepted standards of care
Which of the following specialist is most likely to perform a PTCA - ANSWER-An
interventional cardiologist
The joint commission hospital standards require the clinical privileges or hospital
specific and - ANSWER-Based on the individuals demonstrate occur in confidence and
the procedures the hospital can support
Which of the following would be routinely performed by a cardiologist - ANSWER-
Transesophageal echocardiography
Which NCQA required committee makes recommendations regarding credentialing
decisions - ANSWER-Credentialing committee
, HFAP standards require three medical staff committees to be delineated in the medical
staff structure two of them or the medical executive committee and the utilization of
osteopathic methods and concepts committee required for hospitals with 10 or more
DO's who admit patients and provide direct patient care what is the other required
medical staff committee - ANSWER-Utilization review committee
If you needed to find out about what the federal government requires in regards to
antitrust issues what law would you consult - ANSWER-Sherman antitrust act
According to NCQA standards the application attestation statement must affirm that the
application is - ANSWER-Correct and complete
According to the joint commission standards medical staff bylaws should define -
ANSWER-The structure of the medical staff
According to the joint commission hospital standards professional criteria for the
granting of clinical privileges must include at least - ANSWER-Relevant training or
experience ability to perform privileges requested current licensure and competence
The joint commission hospital standards require medical staff bylaws to include -
ANSWER-A mechanism for selection and removal of officers
According to NCQA standards which of the following is an approved source for
verification of board certification - ANSWER-State licensing agency if state agency
conducts primary verification of bored status
According to the joint commission hospital standards which of the following is a required
component of the reappointment process - ANSWER-Documentation of the applicants
health status
Pier references should be obtained from - ANSWER-Practitioners who have referred
patients to the provider
Patrick versus Burgett is an important case because it - ANSWER-Illustrates the
potential for anti-trust liability arising out of peer review activities
If the medical staff member has privileges and or medical staff appointment revote here
she must be - ANSWER-Reported immediately to the national practitioner data Bank
Access to credentials file should be - ANSWER-Describe fully in an access policy
Which of the following bodies approves clinical privileges - ANSWER-Governing body or
Board
What primary source verification is required by NCQA prior to provisional credentialing -
ANSWER-Licensure and five-year malpractice history or NPDD
ANSWERS 100% CORRECT
Why it is important to check that the practitioner is not currently excluded suspended the
board or in eligible to participate in federal healthcare programs - ANSWER-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 - ANSWER-
Licensure
According to NCQA standards and organization that discovers sanction information
complaints or adverse events regarding a practitioner must take what action -
ANSWER-Determine 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 healthcare quality
improvement act of 1986 to restrict the ability of incompetent physicians Dennis and
other healthcare practitioners to move from state to state without disclosure or discovery
a previous medical malpractice payment and adverse action history - ANSWER-The
national practitioner data Bank
When developing clinical privileging criteria which of the following is important to
evaluate - ANSWER-Establish standards of practice such a specialty board
recommendations
What is the main reason for periodically assessing appropriateness of clinical privileges
for each specialty - ANSWER-To protect patient safety by ensuring current competency
relevance to the facility and excepted standards of care
Which of the following specialist is most likely to perform a PTCA - ANSWER-An
interventional cardiologist
The joint commission hospital standards require the clinical privileges or hospital
specific and - ANSWER-Based on the individuals demonstrate occur in confidence and
the procedures the hospital can support
Which of the following would be routinely performed by a cardiologist - ANSWER-
Transesophageal echocardiography
Which NCQA required committee makes recommendations regarding credentialing
decisions - ANSWER-Credentialing committee
, HFAP standards require three medical staff committees to be delineated in the medical
staff structure two of them or the medical executive committee and the utilization of
osteopathic methods and concepts committee required for hospitals with 10 or more
DO's who admit patients and provide direct patient care what is the other required
medical staff committee - ANSWER-Utilization review committee
If you needed to find out about what the federal government requires in regards to
antitrust issues what law would you consult - ANSWER-Sherman antitrust act
According to NCQA standards the application attestation statement must affirm that the
application is - ANSWER-Correct and complete
According to the joint commission standards medical staff bylaws should define -
ANSWER-The structure of the medical staff
According to the joint commission hospital standards professional criteria for the
granting of clinical privileges must include at least - ANSWER-Relevant training or
experience ability to perform privileges requested current licensure and competence
The joint commission hospital standards require medical staff bylaws to include -
ANSWER-A mechanism for selection and removal of officers
According to NCQA standards which of the following is an approved source for
verification of board certification - ANSWER-State licensing agency if state agency
conducts primary verification of bored status
According to the joint commission hospital standards which of the following is a required
component of the reappointment process - ANSWER-Documentation of the applicants
health status
Pier references should be obtained from - ANSWER-Practitioners who have referred
patients to the provider
Patrick versus Burgett is an important case because it - ANSWER-Illustrates the
potential for anti-trust liability arising out of peer review activities
If the medical staff member has privileges and or medical staff appointment revote here
she must be - ANSWER-Reported immediately to the national practitioner data Bank
Access to credentials file should be - ANSWER-Describe fully in an access policy
Which of the following bodies approves clinical privileges - ANSWER-Governing body or
Board
What primary source verification is required by NCQA prior to provisional credentialing -
ANSWER-Licensure and five-year malpractice history or NPDD
