CPMSM Exams Questions with 100% Correct Answers Verified, Exams of Workplace Safety

Download CPMSM Exams Questions with 100% Correct Answers Verified and more Exams Workplace Safety in PDF only on Docsity! 1 [Date] CPMSM exams Questions with 100% Correct Answers Verified 2023 Latest  Does not specifically addressed in the standards health status and Nondiscrimation  a.TJC  b.HFAP  c.DNV GL  D.NCQA - ✔✔️D️NV GLS 2 [Date]  How many peer references does HFAP require at initial appointment? - ✔✔️1️  According to NCQA what requires ongoing monitoring between recredentialing cycles? - ✔✔️M️edicare/Medicaid sanctions  NCQA requires an attestation of good health and competence to perform essential functions. How is this achieved? - ✔✔️S️igned attestation 5 [Date] not practicing after their temporary privileges have expired?  License  Board certification  Time limit  All of the above privileges to practice for a specified period of time. - ✔✔️T️ime limit  Per TJC, for disaster privileges, PSV of medical licensure must begin as soon as the immediate situation is under control or within ___________ 6 [Date] hours from the time the volunteer LIP begins working at the hospital?  48  72  24  100 - ✔✔️7️2  Which of the following providers is not considered an independent AHP?  Nurse midwife  Physician assistant  Registered nurse 7 [Date]  Nurse practitioner - ✔✔️R️egistered nurse  In telemedicine, the site where the patient is located at the time the service is provided is considered to be ___________ site?  Distant site  Originating site  Telemedicine site  None of the above - ✔✔️O️riginating site 10 [Date]  90 days  120 days - ✔✔️1️20 days  Per NCQA, what is the time limit for provisional credentialing?  60 days  90 days  24 days  120 days - ✔✔️6️0 days  Which accrediting standard requires that before granting privileges, a hospital must determine if it has the resources to support the requested 11 [Date] privilege or if the resources will be available within a specific time  frame?  HFAP  CIHQ  NCQA  TJC - ✔✔️T️JC  Per HFAP, who must grant temporary privileges?  Medical staff president  recommendation of chief/chair of dept or service and the Hospital CEO or their designee 12 [Date]  A and B  Physician can self-grant disaster privileges - ✔✔️B️  T/F The applicant profile is a recap or summary of all the information contained in the application, including dates of verification of information, and any comments related to the application process. - ✔✔️T️rue 15 [Date] information to make a decision, the application is considered incomplete.  If essential information cannot be gained, there is no need to document attempts to obtain clarification  The applicant must be notified of the status of the application and the credentialing process. - ✔✔️a️, b, and d  C is false. If essential information cannot be gained, use of certified, return-receipt requested letters should be utilized—along with 16 [Date] memos documenting various attempts to obtain the needed information.  T/F NCQA standards state that policies and procedures must be in place to allow practitioners to correct wrong information submitted by another source. This means that the practitioner has the right to review references, recommendations, or other peer-review information. - ✔✔️F️alse. The standard does not require the organization to allow a 17 [Date] practitioner to review references, recommendations, or other  peer-review protected information.  Which accreditors specifically address and/or allow the use of a Credentials Committee?  All, including CMS  All, excluding CMS  NCQA and URAC only  CMS only - ✔✔️B️  Note: TJC and AAAHC do not address Credentials Committee in 20 [Date]  Which accreditors require recredentialing at least every 3 years, to the month?  AAAHC and URAC  URAC and NCQA  NCQA and TJC  DNV and URAC - ✔✔️B️  TJC - NTE 2 years  HFAP - no less frequently than every 24 months  DNV - NTE 3 years  AAAHC - NTE 3 years 21 [Date]  Which accreditor requires primary source verification of OIG Medicare/Medicaid Exclusions at reappointment?  AAAHC  NCQA  DNV  HFAP - ✔✔️C️  Which accreditor specifically mentions in the standards that the recredentialing process includes a review of information collected during the OPPE process? 22 [Date]  TJC  HFAP  DNV  AAAHC - ✔✔️A️  T/F Performance Improvement refers to the tracking of results and processes related to improving the quality of care being delivered - ✔✔️T️rue  T/F In regards to enrollment, "providers" are individual professionals that are licensed or 25 [Date] patient that the practitioner or provider has been credentialed by the payer and can be selected to receive healthcare  services.  What is the purpose of CAQH ProView?  It is a program used by Medicare/Medicaid for enrolling a provider.  It is the preferred credentialing software used by NCQA and URAC. 26 [Date]  It is a website used by practitioners and providers to view progress of their enrollment.  It is the primary method used by many commercial payers to collect credentialing application data. - ✔✔️D️  In regards to enrollment, what is a non-delegated practitioner?  A practitioner that has not been credentialed through the organization; credentialing will need to be completed by the commercial payer. 27 [Date]  A practitioner that completes their own credentialing.  A practitioner that has completed credentialing through the organization.  A practitioner that delegates their credentialing to a CVO. - ✔✔️A️  T/F When enrolling a practitioner or provider in Medicare, a Medicare Administrative Contractor or MAC is the main point of contact. A MAC is a private health care insurer that has been awarded a geographic 30 [Date]  T/F When an organization is aware of a practitioner name change, an office location is added or changed, or a practitioner is terminated from the organization, an enrollment form will first need to be submitted to Medicare with the necessary details. Once a Medicare approval letter regarding the change is received, organizations will need to send practitioner and location additions, changes, and terminations to each contracted commercial payer. - ✔✔️T️rue 31 [Date]  How often are Medicare revalidations usually required for practitioners and providers?  2 years  3 years  5 years  10 years - ✔✔️C️. Medicare revalidation is required every five years but may vary based on type of provider. Finally, most state Medicaid programs require location revalidation. The frequency of revalidation is often every five years. 32 [Date]  How often does CAQH require practitioner data to be updated and attested to?  Every 90 days  Every 120 days  Every 180 days  Every year - ✔✔️B️  What are the functions of the medical staff?  Provide patient care  Evaluate the quality of patient care 35 [Date]  Bylaws  Performance improvement - ✔✔️B️. Health care Quality Improvement Act requires hearing rights be provided in the case of a professional review action against a physician or dentist. State laws also have provisions for hearing rights.  T/F Rules and regulations describe the course of conduct or action pursued or the management of a matter in certain circumstances. - ✔✔️F️alse. Rules and regulations 36 [Date] detail what medical staff appointees may or may not do. Policies and procedures describe the course of conduct or action pursued or the management of a matter in certain circumstances.  What is the corporate negligence doctrine?  Hospitals are not held liable to adverse outcomes due to charitable immunity.  Hospitals only need to follow bylaws, not state laws. 37 [Date]  If a patient suffers an adverse outcome at the hospital, the hospital can be held liable.  Hospitals can defend poor administrative practices by asserting that other hospitals operate similarly. - ✔✔️C️.  T/F It is important to reinforce the need for consistently and constancy in following the bylaws for the protection of the individual and the organization in the event of legal action. - ✔✔️T️rue 40 [Date] medical staff bylaws or rules and regulations.  Which accrediting/regulatory bodies do not specifically address bylaws?  NCQA, URAC  CMS  AAAHC, DNV  NCQA, URAC, AAAHC - ✔✔️D️.  Which accrediting/regulatory bodies require a medical executive committee?  TJC, HFAP, DNV 41 [Date]  CMS, DNV, HFAP  TJC, HFAP, AAAHC  DNV, AAAHC - ✔✔️A️.  TJC - MEC  NCQA - not addressed  HFAP - MEC and URC  DNV - MEC  URAC - not addressed  AAAHC - not addressed  CMS - not addressed  What are the two types of due process?  Appeal and hearing 42 [Date]  Substantive and procedural  Polies and procedures  Liability and immunity  Bonus points: What do the 2 types of due process require? - ✔✔️B️. Substantive due process requires proof  that an adverse recommendation concerning a medical staff appointee be reasonable and not arbitrary, capricious or  discriminatory. Procedural due process requires adherence to 45 [Date] clinical privileges - ✔✔️D️. Hearings are typically provided when a recommendation is made that "adversely affects" a physician's clinical privileges or medical staff appointment or when an application for initial appointment or reappointment to the medical staff is denied. The HCQIA defines "adversely affecting" as "reducing restricting, suspending, revoking, denying or failing to renew clinical privileges or membership in a health care entity." 46 [Date]  Which accrediting body does not address due process?  NCQA  URAC  DNV  AAAHC - ✔✔️B️.  What is the definition of quality improvement?  The use of a deliberate and defined process, which is focused on activities that are responsive to 47 [Date] community needs and improving population health.  Positive changes in capacity, process and outcomes of public health.  The practice of actively using performance data to improve the public's health.  The evaluation or review of the performance of colleagues by professionals with similar types and degrees of clinical expertise. - ✔✔️A️. Quality improvement in public health is the use of a deliberate and defined 50 [Date] performance data to improve the public's health. This involves the strategic use of performance standards, measures, progress reports, and ongoing quality improvement efforts to ensure an agency achieves desired results. Ideally, these practices should be integrated into core operations, and  can occur at multiple levels, including the program, organization or system level.  Peer review is defined as the evaluation or review of the 51 [Date] performance of colleagues by professionals with similar types and degrees of clinical expertise.  T/F Results of peer review should be included in the information reviewed at reappointment. - ✔✔️T️rue.  T/F Peer review began with the implementation of HCQIA. - ✔✔️F️alse. Peer review began with the American College of Surgeons Minimum Standard in 1919 which required that "the staff review and 52 [Date] analyze at regular intervals their clinical experience in the various departments of the hospital...the clinical records of patients, free and pay, to be the basis of such review and analysis."  T/F Peer review files are typically kept separate from the practitioner's credentials file. - ✔✔️T️rue  What must be in place in order to determine whether peer review is necessary?