CPMSM Exams Questions with Correct Answers 2023 Latest with assured success, Exams of Psychiatry

Download CPMSM Exams Questions with Correct Answers 2023 Latest with assured success and more Exams Psychiatry in PDF only on Docsity! CPMSM Exams Questions with Correct Answers 2023 Latest with assured success 1. Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - ✔✔️Y️es organization have in place to obtain approval to enter into a delegated agreement? - ✔✔️C️redentialing policies 6. How often does the OIG report to the NPDB? - ✔✔️M️onthly 7. Hospitals must query the NPDB when: - ✔✔️I️nitial appt, granting of privileges, every two years 8. NCQA requires verifications must be less than how many days old? - ✔✔️1️80 days 9. What is the verification time limit on malpractice history according to the NCQA? - ✔✔️1️80 days 10.Time limited credential must be verified by the CVO within how many days prior to submission to the client? - ✔✔️1️20 days 13.Who is required to query the NPDB? - ✔✔️H️ospitals 14. Is disciplinary action taken against the license of a dentist reportable to the NPDB? - ✔✔️Y️es 15.Under HCQIA, a hospital failure to report an adverse privilege action lasting longer than 30 days may cause the organization to lose HCQIA immunity for how many years? - ✔✔️3️ years 16.According to NCQA, verification of Medicare/Medicaid sanctions can be queried by any of what sources? - ✔✔️A️MA, FSMB, HIPDB, OIG, Sanctions Report, NPDB, Sate Agency 17.According to NCQA, how often must an organization conduct an audit of the credentialing 20.What accreditation bodies require privileges to be distributed to essential department personnel? - ✔✔️J️oint Commission/CMS 21.T/F - The Joint Commission and NCQA do not require criminal background checks. - ✔✔️T️rue - the only organization that requires background checks is HFAP. 22. Is a payment made by an insurance company reportable to the NPDB? - ✔✔️Y️es 23.Who is the best person to consult when releasing adverse information in a verification request from another organization? - ✔✔️L️egal Counsel 24.According to CMS, who in the organization may 29.5. Describes the process by which the organization evaluates the delegated entities performance 30.6. Describes remedies available to the organization if the delegated entity does not fulfil its obligations including revocation of delegated agreement 31.According to NCQA, what providers are NOT required to be credentialed when working in an independent relationship? - ✔✔️L️ocums Tenens, Hospital based practitioners (i.e. Anesthesia, Pathology, Radiology, etc.) 32.How many peer references does HFAP require at initial appointment? - ✔✔️1️ ✔✔️M️edical School, AMA, ECFMG, AOA 36.According to NCQA, practitioners must be notified of credentialing decision within how many days? - ✔✔️6️0 days 37.The DHHS mails a copy of the NPDB report to the names provider. If the provider wishes to dispute the reports accuracy, the provider has how many days to do so? - ✔✔️6️0 days 38.According to URAQ, within how many days must the practitioner be notified of credentialing decisions? - ✔✔️1️0 days 39.How many days does a practitioner have to dispute an NPDB report accuracy? - ✔✔️6️0 days 43.T/F - Only the highest of training must be verified according to the NCQA. - ✔✔️T️rue 44.According to the Joint Commission, a peer recommendation should address what six competencies? - ✔✔️M️edical knowledge, technical and clinical skills, clinical judgment, interpersonal skills, communication skills, and professionalism. 45.Telemedicine - according to TJC what two options are available for credentialing at the originating site? - ✔✔️F️ull credentialing, use of the distant sites credentialing 46.According to TJC, what is included in the process of planning and implementing privileges? - reportable to the NPDB? - ✔✔️N️o 53.A hospital that does not query the databank as required by HCQIA is: - ✔✔️L️egally liable for knowledge of any information reported. 54.According to TJC, OPPE should be performed on whom? - ✔✔️A️ll privileges practitioners 55.According to TJC who can provide confirmation of an applicant's health status - ✔✔️D️irector of post graduate training program, chief of another hospital where applicant holds privileges. 56.According to NCQA any gap in personal history greater than __ must be clarified in writing. - ✔✔️O️ne year organizations minimum credentialing criteria? - ✔✔️P️re-application 60.Name an essential source when developing a peer review policy? - ✔✔️H️CQIA 61.According to NCQA what requires ongoing monitoring between credentialing cycles? - ✔✔️L️icense sanctions 62.The HCQIA was passed into law in what year? - ✔✔️1️986 63.HCQIA peer review protections apply to peer review of: - ✔✔️P️hysicians, Dentists 64.According to URAQ the credentialing application must include what? - ✔✔️R️elease of information of the initial visit? - ✔✔️6️ months 68. If the physician is notified of an adverse recommendation and requests a hearing what is required in the notice? - ✔✔️1️. Place, time, date 69.2. Hearing date within 30 days from date of notice 70.3. List of witnesses 71.What is the time limit on PSV of current licensure according to NCQA? - ✔✔️1️80 days 72.When an applicant for membership or privileges with a clean application is awaiting approval of MEC and the governing board, temporary privileges may be granted for a limited time not to exceed how many days? - ✔✔️1️20 days ✔✔️S️tate licensure, highest level of education 77.According to TJC who has the ultimate authority in credentialing decisions? - ✔✔️G️overning body 78.According to NCQA, a provisional period is granted for no longer than __ days? - ✔✔️6️0 days 79.According to NCQA what verification is required before provisional credentialing is permitted? - ✔✔️C️urrent license, 5 year malpractice history 80.NCQA requires an attestation of good health and competence to perform essential functions. How is this achieved? - ✔✔️S️igned attestation 81.Within how many days must a medical work history valid? - ✔✔️1️80 days 84.What came first? HIPD or NPDB - ✔✔️N️PDB, which was established through HCQIA and began in 1990. HIPDB was established in 1996 and began operations in 2000. 85.According to NCQA, how long is the signature on the attestation good for? How long for CVOs? - ✔✔️3️65/305 86.How often does AAAHC require recredentialing? - ✔✔️A️t least every 3 years 87.According to URAC, who should oversee the clinical aspects of the credentialing program within the organization? - ✔✔️S️enior clinical staff person of malpractice insurance. - ✔✔️T️rue 92.What six criteria are observed in an initial site visit by NCQA? - ✔✔️1️. Physical accessibility 93.2. Physical appearance 94.3. Adequacy of waiting and exam rooms 95.4. Appointment availability 96.5. Adequacy of treatment 97.6. Record keeping processes 98.According to TJC which of the following should be used to verify current competence? Board Certification, malpractice face sheet, hospital verification, or patient complaint record - ✔✔️H️ospital verification 99.According to NCQA, who has ultimate authority in credentialing decisions? 106. 6. System based practice 107. Do TJC or NCQA require date stamping? - ✔✔️N️o however NCQA states organizations must demonstrate the credentialing information was present and current at the time of the credentialing decision. 108. Name 7 sources for verifications of highest level of education of an MD or DO according to NCQA. - ✔✔️1️. Medical School 109. 2. AMA 110. 3. AOA 111. 4. ECFMG 112. 5. Assoc of schools for HC providers 113. 6. State licensing board 114. 7. ABMS if board certified 118. NCQA requires PSV of board certification. What sources can be used? How long is the verification good for? - ✔✔️1️. ABMS, AOA, AMA, Specialty board, state licensing board. 119. 2. 180 days 120. What are some sources that can be used to determine which procedures should be performed by which specialty? - ✔✔️S️pecialty board, white papers 121. Malpractice payors must report adverse actions or payouts within how many days? - ✔✔️3️0 days 122. State licensing board must report adverse actions or payouts within how many days? - ✔✔️3️0 days 126. Adverse actions affecting clinical privileges for a period longer than __ days must be reported to the NPDB. Report should be submitted to the state and NPDB within __ days of the action. - ✔✔️3️0, 15 127. Within how many days of a licensure disciplinary action, based on reasons related to professional conduct, must the licensing board report to the NPDB? - ✔✔️3️0 days 128. An organization has sent a request for information regarding a physician on staff who has exhibited behavioral issues at a facility. What release form should the facility obtain prior to releasing this information to the requesting POTENTIAL - NO MEDICAL USE 131. 2) II - HIGH ABUSE POTENTIAL WITH DEPENDANCE LIABILITY 132. 3) III - LESS ABUSE POTENTIAL,MODERATE DEPENDENCE 133. 4) IV - LESS ABUSE POTENTIAL, LIMITED DEPENDENCE 134. 5) V - LIMITED ABUSE POTENTIAL 135. Name an organization that can be queried to obtain a copy of a DEA. - ✔✔️N️TIS 136. Which agency requires a Medicare attestation? - ✔✔️C️MS 137. According to TJC rules on credentialing of telemedicine providers, the origination site can use credentialing and ✔✔️W️hen the information provided is false and the person providing the information knew it was false. 141. When preparing for a committee meeting, who would an MSP most likely meet with to coordinate the agenda and meeting packet? - ✔✔️C️ommittee Chairperson 142. NPDB - 143. Peer review protection does not apply in which state? - ✔✔️P️hilippines 144. LEGAL - ANTICOMPETITIVE PEER REVIEW 145. Led to the development of HCQIA - ✔✔️P️atrick v Burget, US Supreme Court 1988 146. LEGAL -NEGLIGENT CREDENTIALING 150. LEGAL - FAILURE TO DISCLOSE 151. Ophthalmologist did not disclose all prior hospital affiliations on application - ✔✔️O️skooi vs Fountain Valley Regional Health Center - California 1996 152. LEGAL - HCQIA 153. Burden on physician to prove bad faith peer review - ✔✔️M️atthews vs Lancaster General Hospital - Tennessee 1996 154. LEGAL - DUTY TO CREDENTIAL 155. Application denied when physician refused to authorize prior hospital to release information - ✔✔️W️ebman vs Little Company of Mary Hospital - California 1995 156. LEGAL - DISRUPTIVE BEHAVIOR recommendation to reinstate call panel membership - ✔✔️H️ongsathavig vs Queen of angels Hollywood Presbyterian - California 1998 162. LEGAL - 163. The managed care organization in this case was not held liable for negligent credentialing because state law granted immunity to not-for-profit health plans - ✔✔️H️arrell vs Total Health Care - 1989 164. LEGAL 165. MD brought anti-trust suit against the hospital after his application was 166. denied - ✔✔️R️obinson vs Magovern - 1981 167. LEGAL 168. Doctrine of Corporate Negligence