Questions I've Missed - Alicia Flashcards
What 2 accreditations do not address requirements regarding governing body authority?
a. URAC, NCQA
b. TJC, DNV
c. AAAHC, URAC
URAC, NCQA
Which accreditor considers the date of the Credentialing Committee as the final decision date?
a. TJC
b. NCQA
c. ACHC
NCQA
What standard says that the committee must meet at least quarterly and as often as necessary to carry out its responsibilities.
a. NCQA
b. DNV
c. URAC
URAC
What accrediting body requires the organization to conduct ongoing monitoring that includes the collection and review of complaints?
a. TJC
b. Medicare CoP (CMS)
c. NCQA
NCQA
Which accreditation has a formal written grievance procedure?
a. URAC
b. ACHC
c. DNV
DNV
This standard at a minimum must review and send information to the distant-site’s telemedicine entity on all adverse events that result from a physician or practitioner’s provisions of telemedicine services, and on all complaints it has received.
a. TJC
b. Medicare CoP
c. ACHC
ACHC
This accreditation allows complaints to be part of the recredentialing process through data collected regarding the provider’s performance within the organization?
a. AAAHC
b. NCQA
c. URAC
URAC
Which accreditation does not require verification of education/training if board certification is verified?
a. TJC
b. NCQA
c. URAC
URAC
What accrediting body states the organization must only verify the highest level of credentials attained?
a. NCQA
b. URAC
c. Medicare CoP
NCQA
Regarding telemedicine, what accrediting body standards are a direct quotation of the CMS regulations?
a. DNV
b. ACHC
c. AAAHC
ACHC
Which standard states “criteria for determining the privileges to be granted to individual practitioners and a procedure for applying the criteria to individuals requesting privileges”, must be included in the bylaws?
a. TJC
b. DNV
c. Medicare CoP
Medicare CoP
With the exception of _____, the standards for the remaining accrediting bodies under “Compliance with Law” state there should be “compliance with all applicable federal, state and local laws.”
a. DNV
b. NCQA
c. ACHC
ACHC
Which 2 accreditations allow you to only verify the highest level of credentials attained when reviewing Residency and Fellowship?
a. TJC and Medicare CoP
b. NCQA and URAC
c. ACHC and AAAHC
NCQA and URAC
There are three accrediting bodies that address Telemedicine, one of the three specifically states the licensed practitioners providing patient care via telemedicine are subject to the credentialing and privileging processes of the originating site. Which one is that?
a. TJC
b. ACHC
c. DNV
TJC
Fast-track credentialing can be used for applications that pose no problems, including new graduates or physicians fully credentialed at a sister hospital with ______?
a. DNV
b. ACHC
c. AAAHC
ACHC
What accrediting agency states organizations must ensure that provisional credentialing does not extend for more than 60 calendar days?
a. TJC
b. URAC
c. NCQA
NCQA
To meet NCQA standards, provisional credentialing files must contain what information within the specified time frames?
a. Complete application with all required attachments; no unexplained gaps; all primary source verifications received; no discrepancies identified; and documentation of current competency and ability to perform privileges.
b. PSV of current, valid license to practice; PSV of five years of malpractice history; Complete application and signed attestation.
c. Current or previously successful challenge to licensure or registration; Involuntary termination of medical staff membership; Involuntary limitation, reduction, denial, or loss of clinical privileges; Unusual pattern of, or an excessive number of, professional liability actions resulting in a final judgment.
PSV of current, valid license to practice; PSV of five years of malpractice history; Complete application and signed attestation.
_________ conduct a one time provisional credentialing.
a. ACHC
b. NCQA
c. AAAHC
NCQA
________ is a time-limited period during which the organization evaluates and determines the practitioner’s professional performance?
a. Probation
b. OPPE
c. FPPE
FPPE
Documentation of attendance can be done by obtaining copies of program certificates.
a. ACHC
b. TJC
c. NCQA
TJC
___________ states that evidence of continuing educational activities every two years may be requested?
a. TJC
b. ACHC
c. DNV
ACHC
What accrediting body does not address CMEs for medical staff members?
a. AAAHC
b. DNV
c. ACHC
AAAHC
Which accreditation takes action until CME information is available and verified?
a. TJC
b. ACHC
c. DNV
DNV
_________ defines privileging as the process whereby the specific scope and content of patient care services (that is, clinical privileges) are authorized for a healthcare practitioner by a healthcare organization, based on evaluation of the individual’s credentials and performance.
a. TJC
b. ACHC
c. URAC
TJC
The organization’s credentialing process describes the building security that adequately limits physical access to credentials information.
a. NCQA
b. URAC
c. ACHC
NCQA
Temporary privileges cannot exceed _____ days.
a. 60
b. 90
c. 120
120
What is the only accrediting organization that has standards regarding Credentialing System Controls?
a. TJC
b. AAAHC
c. NCQA
NCQA
Maintenance of continuing education every 2 years may be requested.
a. TJC
b. NCQA
c. ACHC
ACHC
Which accreditation obtains a criminal background check to hospital employees?
a. TJC
b. ACHC
c. Medicare CoP
TJC
Name 3 organizations that do not specifically address criminal background checks.
a. Medicare CoP, DNV, NCQA
b. URAC, Medicare CoP, TJC
c. NCQA, URAC, AAAHC
NCQA, URAC, AAAHC
What type of vote is needed to Close a Debate?
a. 2/3
b. Majority
c. NA, the Chair determines when to close a debate
2/3
The temporary privilege process may include a provision for a designee to act in __________ the CEO or medical staff president when necessary.
a. the absence of
b. collaboration with
the absence of
______________ states medical staff bylaws must identify the individual(s) responsible for granting disaster privileges.
a. NCQA
b. TJC
c. URAC
TJC
__________ states that primary source verification of license must begin as soon as the immediate situation is under control or within 72 hours from the time the volunteer physician and/or other licensed practitioner begins working at the hospital, whichever occurs first.
a. TJC
b. ACHC
c. DNV
TJC
Which accreditation states that if temporary privileges are granted, any limits to the number of specific patients who may be cared for must be identified?
a. DNV
b. ACHC
c. AAAHC
ACHC
_____ accrediting body states bylaws must include a process for approving practitioners for care of patients in the event of an emergency or disaster.
a. DNV (NIAHO)
b. ACHC (HFAP)
c. TJC (CAMH)
ACHC (HFAP)
Which 2 recognize FSMB as a designated equivalent source?
a. DNV and AAAHC
b. NCQA and ACHC
c. TJC and ACHC
TJC and ACHC
____ the Bylaws must include a process for approving practitioners for care of patients in the event of an emergency or disaster.
a. TJC
b. DNV
c. ACHC
DNV
ACHC says the ________________ provide for the granting of temporary privileges.
a. CoP
b. Bylaws
c. Policies and procedures
Bylaws
For ______, documentation of current competence is obtained from Peers.
a. ACHC
b. AAAHC
c. TJC
AAAHC
Which accreditation collects ongoing professional practice evaluation data on an ongoing basis and summarized at least three (3) times during each three-year appointment cycle?
a. TJC (CAMH)
b. ACHC (HFAP)
c. DNV (NIAHO)
ACHC (HFAP)
_____ states that an organization can rely on the verification activities of state licensing boards and if this is done, it should be noted in the Credentials file.
a. NCQA
b. AAAHC
c. URAC
URAC
This accrediting body requires the medical staff to have a documented mechanism for oversight of the professional performance of volunteer physicians and other licensed practitioners who receive disaster privileges.
a. DNV
b. TJC
c. ACHC
TJC
Name the three accreditors that do not use the language “designated equivalent sources.”
a. TJC, NCQA, ACHC
b. DNV, URAC, AAAHC
c. NCQA, DNV, URAC
NCQA, DNV, URAC
Which accrediting body standard allows the CEO or his/her authorized designee to grant temporary privileges based on the recommendation of the president of the medical staff or authorized designee?
a. TJC
b. ACHC
c. DNV
TJC
Temporary privileges can be used in time of emergency and/or disaster under which accreditation?
a. TJC (CAMH)
b. ACHC (HFAP)
c. Medicare CoP
ACHC (HFAP)
__________ requires that the medical staff review and analyze all relevant information regarding current licensure, training, experience, current competence, and ability to perform the privileges requested.
a. DNV
b. TJC
c. AAAHC
TJC
All physicians or licensed practitioners providing patient care services via telemedicine are subject to the credentialing and privileging process of the ________ ____________.
a. Distant Site
b. Originating Site
c. Both a & b
Originating Site
Some accreditors have standards specific to the review of information received in the credentialing and privileging process. Who does not?
a. Medicare, AAAHC, DNV
b. AAAHC, ACHC, TJC, DNV
c. All have standards or requirements for review of information
Medicare, AAAHC, DNV
Which accreditation does not specifically address Telemedicine, BUT states if provided by contract, the governing body maintains responsibility?
a. URAC
b. AAAHC
c. DNV
AAAHC
If a practitioner does not prescribe medications requiring a DEA or CDS certificate, _______ requires a documented process to require an explanation as to why the practitioner does not prescribe medications?
a. DNV
b. AAAHC
c. NCQA
NCQA
Sealed transcripts may be accepted if the organization shows evidence that it inspected the contents of the envelope and confirmed that practitioner completed the appropriate training program with what accreditation?
a. TJC
b. URAC
c. NCQA
NCQA
The Credentialing Committee must, at a minimum, review the credentials for practitioners who do not meet established thresholds, consider the credentialing information and document its credentialing discussions in the meeting minutes. Files meeting established criteria may be reviewed and approved by the Credentialing Committee or by a medical director or designated physician.
a. URAC
b. ACHC
c. NCQA
NCQA
Initial appointment to the medical staff and granting of initial clinical privileges shall include Primary source verification of current Federal Narcotics Registration Certificate (DEA) number (if required).
a. AAAHC
b. ACHC
c. DNV
DNV
History of education and professional training must be included on the credentialing application.
a. URAC
b. NCQA
c. TJC
URAC
Regarding the analysis and use of information received, some _____________ have standards specific to the review of the information received in the credentialing and recredentialing processes.
a. Regulations
b. MS Bylaws
c. Accreditors
Accreditors
Parliamentary law protects the rights of the _________ while assuring the will of the ________.
a. Majority, Minority
b. Minority, Majority
c. Patients, Doctors
Minority, Majority
What accrediting body requires the highest level of education or training to be verified?
a. URAC
b. DNV
c. NCQA
URAC
These organizations DO address analysis and use of information received in the credentialing & privileging process.
a. Medicare, DNV, URAC & AAAHC
b. TJC, ACHC, NCQA, & URAC
c. ACHC, AAAHC, URAC & TJC
TJC, ACHC, NCQA, & URAC
The following are the typical elements included in credentialing and privileging databases:
a. Demographic, Addresses, Appointment, License, Certification, Medical Education/Training, CME, and Committees
b. Staff Membership, Malpractice Insurance, Appointment, Licenses, Peer Reviews, & Certifications
c. Demographic, Addresses, Committees, Malpractice Insurance, Privileges, FPPE & OPPE
Demographic, Addresses, Appointment, License, Certification, Medical Education/Training, CME, and Committees
This organization states that the practitioner application requests information regarding actions against DEA certificate or state CDS certificate.
a. DNV
b. ACHC
c. TJC
ACHC
When referencing telemedicine, who retains the responsibility for overseeing the safety and quality of services offered to its patients?
a. Distant site
b. Originating site
c. Healthcare facility
Originating site
Which standard does not require verification of DEA certificate or state controlled dangerous substance certificate?
a. NCQA
b. DNV
c. URAC
URAC
Education verification not required if the practitioner is board certified, under what standard?
a. ACHC (HFAP)
b. DNV
c. URAC
URAC
Which entity states that information received must be consistently applied for each requesting practitioner?
a. NCQA
b. TJC
c. AAAHC
TJC
Most groups formally adopt written rules of parliamentary procedure. How is this accomplished for the medical staff?
a. Adopting a bylaws provision specified manual of parliamentary law and edition be the authority
b. Once quorum is established, take a majority vote
c. Medical Executive Committee in conjunction with medical director decides
Adopting a bylaws provision specified manual of parliamentary law and edition be the authority
Which entity’s standard does not specifically address DEA?
a. NCQA
b. Medicare
c. ACHC
Medicare
Which accreditation states the application must include a statement regarding felony convictions.
a. TJC
b. NCQA
c. ACHC
NCQA
Primary source verification is required and includes: AMA, AOA, and ECFMG. Documentation regarding training and education must be sufficient to support requested privileges.
a. TJC
b. ACHC
c. NCQA
ACHC
The application requests information regarding any criminal history and a criminal background investigation is conducted based on information provided in the application or as required by Federal and State regulations.
a. DNV
b. ACHC
c. AAAHC
ACHC
Name the 3 accrediting bodies that do not specifically address analysis and use of information received.
a. Medicare, DNV, AAAHC
b. URAC, NCQA, Medicare
c. TJC, Medicare, DNV
Medicare, DNV, AAAHC
The ______ & ______ are recognized as ABMS display agents?
a. AOA & CIN-BAD
b. FSMB & AMA
c. OIG & ECFMG
FSMB & AMA
________ states that the organization can verify
Medicare/Medicaid sanctions with the issuing
organization or the NPDB?
a. URAC
b. NCQA
c. DNV
URAC
________ states that organizations are responsible for the ongoing monitoring of Medicare/Medicaid sanctions between recredentialing cycles and that information must be reviewed within 30 days of release by the reporting entity?
a. URAC
b. NCQA
c. DNV
NCQA
In certain cases, ___________ allows the use of other reliable secondary sources, such as another hospital that has documented PSV of the applicant’s credentials. Prior to using such sources, an attempt must be made to contact the primary source. This attempt should be documented by keeping the returned letters or by documenting the letters that were sent with no response.
a. AAAHC
b. NCQA
c. TJC
TJC
Organizations must have processes in place to ensure that credentials file are accessed only by authorized staff. Requirements for storage, maintenance and disposal of credentialing documents must also be defined.
a. NCQA
b. Medicare
c. URAC
URAC
The organization must verify the most recent 5- year period available for sanctions or limitations on any state licensure held (past and present).
a. NCQA
b. URAC
c. ACHC
NCQA
Must have evidence of professional liability insurance including current certificates showing amount insurance; malpractice litigation history from insurance carrier.
a. TJC
b. DNV
c. ACHC
ACHC
Query of the NPDB is required by these 3 accreditations on initial and reappointment:
a. DNV, ACHC, URAC
b. NCQA, URAC, TJC
c. ACHC, DNV, AAAHC
ACHC, DNV, AAAHC
The ___________ is NCQA certified as a CVO and also meets TJC and URAC standards. It is also recognized as an ABMS display agent.
a. AMA
b. PDC
c. DEA
PDC
Access to this information is available online through the ___________. Data that was formerly maintained in the Excluded Parties List System (EPLS) was integrated into SAM in 2012.
a. OIG
b. GSA
c. SAM
SAM
According to NCQA, if a practitioner is board certified, verification of ______ or _____ board certification meets this element because specialty boards verify education and training.
a. AMA and ECFMG
b. ABMS and AOA
c. AMA and AOA
ABMS and AOA
When you want to close a debate, what do you say?
a. I move to close debate
b. I move to adjourn
c. I move the previous question
I move the previous question
Which two standards do not specifically address Medicare/Medicaid Sanctions?
a. URAC and NCQA
b. AAAHC and Medicare
c. TJC and Medicare
TJC and Medicare
What four standards require query of NPDB?
a. TJC, NCQA, AAAHC, Medicare
b. NCQA, ACHC, URAC, AAAHC
c. TJC, ACHC, DNV, AAAHC
TJC, ACHC, DNV, AAAHC
The __________ is a national non-profit organization representing the 70 medical and osteopathic boards of the United States and its territories. This organization offers PDC reports which provide licensure history, biographical information, education and training, and national identification numbers (when available).
a. AMA
b. FSMB
c. ECFMG
FSMB
What accrediting body requires the practitioner’s history of education and professional training must be included on the application. PSV can be performed with the primary source (medical / professional school) or the state licensing
board. Verification of education is not required if the practitioner is board certified.
*Verification time limit: Six months
a. URAC
b. NCQA
c. Medicare
URAC
When you move to amend a motion, do you need a majority vote?
Yes
Who states that the application requests information regarding disciplinary actions taken or investigations pending by Medicare/Medicaid?
a. DNV
b. AAAHC
c. ACHC
ACHC
Who states that query of NPDB is required when clinical privileges are initially granted, on renewal of privileges, and when new privileges are requested (including temporary privileges)?
a. DNV
b. TJC
c. ACHC
TJC
The FSMB PDC is NCQA-certified as a CVO and also meets what other standards:
a. TJC & URAC
b. URAC & DNV
c. TJC & DNV
TJC & URAC
Education and Training verification for ___ has a limit of six months.
a. DNV
b. NCQA
c. URAC
URAC
There are two accrediting bodies that state NPDB should be queried on Initial Appointment and Reappointment, but only one of these two states that Continuous Query is acceptable.
a. DNV
b. ACHC
c. AAAHC
AAAHC
There are two accrediting bodies whose standards state that sanctions are reviewed and do not specifically state sanctions must be verified.
a. URAC and AAAHC
b. ACHC and TJC
c. AAAHC and ACHC
AAAHC and ACHC
The organization must verify the most recent 5- year period available for sanctions or limitations on any state licensure held (past and present).
a. NCQA
b. URAC
c. ACHC
NCQA
If there is no provision regarding a quorum in the bylaws, what provides that a majority of members constitutes a quorum?
a. Common law
b. Robert’s Rule of Order
c. applicable Federal, State, or Local law
Common law
__________ states that at least the past five-year history of professional liability actions resulting in final settlements or judgments must be evaluated.
Malpractice litigation history (final judgments and settlements) is received from insurance carrier or NPDB.
a. TJC
b. ACHC (HFAP)
c. DNV
ACHC (HFAP)
Which standard states the medical staff bylaws or credentials manual must indicate the requirements for the hospital to verify the licensure, certifications, education and training, post graduate experiences, and other references from primary sources whenever possible.
a. NCQA
b. ACHC
c. AAAHC
ACHC
AMA Physician Masterfile data meets select credentialing requirements for all standards except for one.
a. TJC
b. Medicare
c. NCQA
NCQA
When it is not possible to obtain the information from a primary source, like when a hospital is closed. When applicant records have been lost or destroyed. When applicant received education in a foreign country and verification information is not accessible, are examples of ____________ _____________
a. Primary Source
b. Designated Equivalent Source
c. Secondary Source
Secondary Source
This standard states that organizations are responsible for the ongoing monitoring of sanctions or limitations on licensure between recredentialing cycles.
a. TJC
b. NCQA
c. URAC
NCQA
Who states that a cover sheet or attestation from the insurance company is sufficient to prove attainment of liability coverage?
a. URAC
b. NCQA
c. AAAHC
URAC
___________________is the original issuing entity of a specific credential that can verify the accuracy of the credential reported by an individual health care practitioner. Primary source verification (PSV) is received directly from the issuing source. For example, if information on medical school graduation is verified directly with the medical school, this is considered PSV. A copy of the medical school diploma is not considered PSV.
a. Primary Source
b. Secondary Source
c. Designated Equivalent Source
Primary Source
In certain cases, ________ allows the use of other reliable secondary sources, such as another hospital that has documented PSV of the applicant’s credentials. Prior to using such sources, an attempt must be made to contact the primary source. This attempt should be documented by keeping the returned letters or by documenting the letters that were sent with no response.
a. AAAHC
b. NCQA
c. TJC
TJC
Who states that changes made to credentialing information must be tracked and the organization must document when and how the data was changed, who made the change and why the change was made?
a. TJC
b. URAC
c. NCQA
NCQA
Who allows the use of the Fraud and Abuse Control Information Systems (FACIS) for licensure/licensure sanctions verifications?
a. ACHC
b. NCQA
c. URAC
ACHC
Which accreditation states that practitioners with federal tort coverage, the practitioner file can include a copy of the federal tort letter or an attestation from the practitioner of federal tort coverage?
a. NCQA
b. DNV
c. TJC
NCQA
Which accrediting body can use the results from a search of the FSMB Disciplinary Action Databank or FACIS?
a. TJC
b. DNV
c. ACHC
ACHC
Not addressed, however, if the medical staff bylaws, rules and regulations require malpractice coverage, it is expected that the accrediting body have a method to verify such coverage.
a. Medicare
b. TJC
c. DNV
TJC
The application includes information regarding professional liability claims history and is reviewed at initial and reappointment.
a. DNV
b. URAC
c. AAAHC
AAAHC
Which accreditation standards have requirements regarding data base controls?
a. ACHC and TJC
b. NCQA and URAC
c. Medicare, DNV, and AAAHC
NCQA and URAC
Various types of entities are required to report adverse actions to the NPDB. Which one of the organizations listed below is NOT an example of a required reporting entity?
a. State Medicaid Fraud Control Units
b. HHS OIG
c. State Licensing and Certification Boards
State Medicaid Fraud Control Units
What motions can be amended?
a. Postpone to a certain time (I move to postpone motion to …)
b. Lay aside temporarily (I move to lay the question on the table)
c. Submit matter to assembly (I appeal from the decision of the chair)
Postpone to a certain time (I move to postpone motion to …)
There are 3 major approaches to verification. What are they?
a. Internal, External / Delegation, Centralized
b. Centralized, Database, Outside Company / External
c. Primary, Secondary, Designated Equivalent Source
Internal, External / Delegation, Centralized
What refers to maintaining and assuring the accuracy and consistency of data over it’s life cycle to make sure that data will always be correct, consistent, and accessible
a. Database Audits
b. Data Integrity
c. Data Preservation
Data Integrity
When you want to limit or extend a debate you say…
a. Let’s take this offline
b. I move the debate to be limited or extended
c. I move to refer the motion
I move the debate to be limited or extended
What is the timeframe of verification for NCQA and malpractice history?
a. 7-10 years
b. 36 months
c. 5 years
5 years
__________ requires specific credentials to be verified within six months of the decision as outlined in the section Primary Source Verification of Credentials.
a. TJC
b. AAAHC
c. URAC
URAC
NPDB querying entities include:
a. Hospitals and Healthcare Entities
b. Professional Societies with formal peer review
c. All of the above
All of the above
Must confirm that the practitioner holds a valid, current license, in effect at the time of the Credentialing Committee’s decision. Only required to verify license(s) in the state(s) where the practitioner provides care for organization members. Verification must be obtained directly from the state licensing agency or its website.
a. DNV
b. Medicare
c. NCQA
NCQA
Professional liability coverage not addressed. However, if the medical staff bylaws/ rules/ regulations require malpractice coverage, it is expected that the organization have a method to verify such coverage.
a. AAAHC
b. TJC
c. DNV
TJC
Which accreditation requires specific credentials to be verified within six months of the decision as outlined in the section primary source verification of credentials?
a. ACHC
b. DNV
c. URAC
URAC
Many organizations undertake credentials verification internally where the organization’s staff verifies all information from the primary and/or approved sources. – This is referencing what type of verification?
a. External
b. Internal
c. Centralized
Internal
These two organizations do NOT specifically address malpractice insurance or professional liability coverage.
a. AAAHC, URAC
b. ACHC, DNV
c. TJC, Medicare
TJC, Medicare
Email notifications are received within _________ of a reporting being received by NPDB on a practitioner.
a. 48 hrs
b. 180 days
c. 24 hrs
24 hrs
All actions in a meeting are initiated by _____________.
a. The Committee Chair
b. Motions
c. CEO or CMO
Motions
What accreditation standard states that you are only required to verify a license/s in the state/s where the practitioner provides care for the organization members?
a. URAC
b. Medicare
c. NCQA
NCQA
What accreditation standard states that before recommending privileges, the medical staff must evaluate any evidence of an unusual pattern/s resulting in a final judgement against the applicant?
a. TJC
b. DNV
c. ACHC
TJC
There is no specific requirement for verification of work history. The standards require, at the time of appointment to membership and initial granting of privileges verification of relevant training or experience be obtained from the PSV whenever feasible
a. URAC
b. TJC
c. DNV
TJC
Qualifications shall include primary source verification of experience
a. DNV
b. NCQA
c. URAC
DNV
Not specifically addressed, but application must include hospital affiliations and privileges.
a. ACHC
b. URAC
c. TJC
URAC
Sample application for Privileges requests explanation for a break in the continuity of medical education internship, residency, hospital affiliations medical practice etc.
a. URAC
b. AAAHC
c. NCQA
AAAHC
Which accreditations indicate that the NPDB’s continuous query is acceptable for ongoing monitoring?
a. TJC, NCQA, ACHC, DNV, URAC, AAAHC
b. TJC, ACHC, DNV, AAAHC
c. TJC, NCQA, URAC and AAAHC
TJC, NCQA, URAC and AAAHC
Which data bank maintains a database containing primary source information from the American
Academy of Physician Assistants (AAPA) and provides profiles for credentialing verification?
a. FSMB
b. AOA
c. AMA
AMA
Who only requires to have the applicant document work history, but does not necessarily verify the work history?
a. DNV and NCQA
b. Managed Care Plans
c. DNV
Managed Care Plans
What standard states that an NPDB query is required at initial, and reappointment and the use of Continuous Query is acceptable?
a. TJC
b. ACHC
c. AAAHC
AAAHC
____ is the only accrediting body that states verification of healthcare employment and work history is required.
a. DNV
b. NCQA
c. ACHC
ACHC
Per NCQA, how soon must information from the NPDB be reviewed once it is released by the reporting entity?
a. Within 30 days
b. Within six months
c. No specific timeframe is required
Within 30 days
TJC states that temporary privileges cannot exceed _____ days.
a. 180 days
b. 60 days
c. 120 days
120 days
Which two accreditations do not reference temporary privileges, but do have a process for provisional credentialing?
a. NCQA, ACHC
b. NCQA, URAC
c. DNV, URAC
NCQA, URAC
Per NCQA, if sanction reports are not published, the organization must query the source within how many months from the last credentialing cycle?
a. 9-12 months
b. 12-18 months
c. 12-24 months
12-18 months
Per __________, bylaws provide for the granting of temporary privileges:
* For care of specific patients
* Locum tenens
* Emergency or Disaster
* Prudent
a. DNV
b. ACHC
c. URAC
ACHC
Although work history is not specifically addressed for _____, they do state there must be primary source verification of experience.
a. ACHC
b. DNV
c. AAAHC
DNV
URAC standards state provisional participation can only be for _______
a. 60 days
b. 120 days
c. A limited time
A limited time
Work history not specifically addressed, but application must include hospital affiliations and privileges.
a. ACHC
b. URAC
c. Medicare
URAC
Per NCQA, what is the time limit for verification of work history?
a. 180 / 120 days
b. Prior to credentialing decision date
c. 365 / 305 days
365 / 305 days
At an ACHC accredited organization what should be obtained and verified for work history?
a. A minimum of five years of relevant work history
b. PSV of experience
c. History of medical staff appointments and affiliations where privileges have been granted
History of medical staff appointments and affiliations where privileges have been granted
URAC does not specifically address work history but what must be included on the application?
a. Minimum of 5-7 years of work history
b. Any disciplinary actions at other hospitals
c. Hospital affiliations and Privileges
Hospital affiliations and Privileges
Who can grant temporary privileges according to The Joint Commission?
a. The Chair of the credentialing committee
b. The CEO or designee, upon recommendation of the medical staff president
c. The governing board directly
The CEO or designee, upon recommendation of the medical staff president
Under NCQA, how long can a practitioner remain in provisional credentialing status?
a. 30 days
b. 90 days
c. 60 days
60 days
At an ACHC accredited hospital, which type of privileges can be granted during an emergency or disaster?
a. Full staff privileges
b. Temporary privileges
c. Provisional clinical privileges without verification
Temporary privileges
Per ACHC, how many references are required to grant temporary privileges?
a. One recent reference from a previous facility or department chair
b. Three references, including peer reviews
c. No references are required if NPDB is clear
One recent reference from a previous facility or department chair
