CPMSM

Question 1

The medical staff is actively involved in measuring, assessing, and improving what?

Answer 1

Patient safety data

Question 2

An independent review committee consisting of physicians external to NCQA is called what?

Answer 2

ROC

Question 3

If a hospital loses accreditation for providing falsified information to TJC, it may not participate in the accreditation process again for a period of how long?

Answer 3

1 year

Question 4

What does the NCQA use for public reporting of survey results?

Answer 4

Health Plan Report Card

Question 5

Areas of an organization’s system, structure and process that are most relevant to the organization’s patient safety & quality of care, AND most at risk for negative outcomes are referred to as what according to the Joint Commission?

Answer 5

Critical focus areas

Question 6

According to NCQA what must be included in the organizations rights to appeal policies?

Answer 6

Written notification of the action including the reasons for the action

Question 7

If a CVO wishes to request reconsideration of denial is certification it must do so within how many days?

Answer 7

30 days

Question 8

An MCO may appeal the accreditation decision by NCQA within how many days?

Answer 8

30 days

Question 9

T/F

Negligence is considered a standard of care violation

Answer 9

True

Question 10

According to TJC what is the number or quantifiable measure usually related to an audit that determines if an action was effective and sustained?

Answer 10

MOS

Question 11

If a hospital changes ownership/control/change in capacity, it must notify TJC in writing not less than how many days after the change?

Answer 11

30 days

Question 12

According to TJC what report details the actions an organization took to bring itself into compliance with a standard or that clarifies why an organization believes it was in compliance with the standard for which it received a recommendation?

Answer 12

ESC

Question 13

Cancer Registry programs may be accredited for up to ____ Years?

Answer 13

3 years

Question 14

TJC - A mid-cycle self assessment against applicable standards is

Answer 14

PPR/FSA

Question 15

In order for an organization to apply for NCQA survey, they must have been in operation for how long?

Answer 15

18 months

Question 16

In order to apply for NCQA certification the CVO must have been under contract to provide verification services for at least____

Answer 16

Six months

Question 17

What does NCQA call a core survey administered separately to commercially insured Medicare and Medicaid populations?

Answer 17

CAHPS

Question 18

NCQA
A set of standardized measures used to compare health plans
is ?

Answer 18

HEDIS

Question 19

NCQA grants a CVO certification for a period of______?

Answer 19

2 years

Question 20

What are the categories of possible NCQA accreditation?

Answer 20

3 years, 1 year, denial

Question 21

TJC
Organizations notified of a conditional accreditation decision have how many
business days to request re-examination of the survey findings?

Answer 21

10 days