Study 03/18/2025 Flashcards
According to this standard, applicants must provide clinical activity documentation and competency to be used in consideration of privileges requested.
a. URAC
b. ACHC
c. TJC
ACHC
Verification of board certification is not applicable to nurse practitioners or other health care professionals unless the organization communicates board certification status to its members, such as in a directory.
a. NCQA
b. URAC
c. AAAHC
NCQA
The credentialing application must include information on the practitioner’s hospital affiliations or privileges, if applicable. Verification is not required.
a. NCQA
b. AAAHC
c. URAC
URAC
In addition to contacting the primary source (the training program), the organization allows use of the following: AMA, AOA for postdoctoral education approved by the AOA Council on Postdoctoral Training.
a. ACHC
b. NCQA
c. TJC
TJC
License sanctions must be verified and documented on initial appointment and continually monitored thereafter at a minimum at expiration, initial appointment and reappointment.
a. NCQA
b. URAC
c. AAAHC
AAAHC
What organization states relevant training is verity with primary or secondary source on initial appointment.
a. AAAHC
b. DNV
c. TJC
AAAHC
This standard requires, at the time of appointment to membership and initial granting of privileges, verification of relevant training or experience be obtained from the primary source(s), whenever feasible.
a. DNV
b. ACHC
c. TJC
TJC
The __________ query can serve for verification for actions against a physician’s medical license.
a. NPDB
b. FSMB
c. FACIS
FSMB
License Sanctions are not specifically addressed under __________.
a. TJC
b. DNV
c. AAAHC
DNV
All patients must be under the care of a member of the medical staff or under the care of a practitioner who is directly under the supervision of a member of the medical staff under ____________.
a. URAC
b. TJC
c. DNV
DNV
For these two accreditation bodies, _____ and _____ no specific sources for verification of Board Certification are specifically stated.
a. DNV and AAAHC
b. TJC and DNV
c. ACHC and AAAHC
DNV and AAAHC
If recognized by the organization, this accreditation body allows board certification to be PSV with non-ABMS / AOA boards in the United States.
a. DNV
b. TJC
c. NCQA
NCQA
________ and ______ mention reviewing a five-year licensure history.
a. ACHC and NCQA
b. URAC and DNV
c. NCQA and URAC
NCQA and URAC
Key Word: Comparative
a. URAC
b. AAAHC
c. DNV
DNV
Key Word: Waived
a. ACHC
b. NCQA
c. DNV
NCQA
Key Word: Consumers
a. URAC
b. DNV
c. Medicare
URAC
Key Word: Illegal Drug Use
a. TJC
b. ACHC
c. NCQA
NCQA
Key Word: Feasible
a. TJC
b. ACHC
c. Medicare
TJC
Board Certification: Verify from Primary or Secondary Source
AAAHC
Board Certification: A medical staff can not rely solely on board cert when making a decision on privileges. All credentials are examined. Any organization required certification must be primary source verified initially and at reappointment
DNV
Board Certification: Verify Board Cert if applicable required on initial credentialing only. If physician has multiple board certifications you must verify for the specialty under which the practitioner will be listed in the directory
URAC
Board Certification: If a provider claims to be board certified, the organization must verify it. Verification of board certification meets the requirements of education and residency training. Must document the expiration date of the board cert. If it’s a “lifetime” certification verify that it is current and document verification date
NCQA
Board Certification: Not specifically required but if the organization requires certification or recertification, verification should be performed. Verification may be obtained directly from the specialty board. ABMS and its certified display agents are considered an equivalent (primary) source
TJC
Board Certification: The governing body must ensure that under no circumstances is the accordance of staff membership or professional privileges in the hospital dependently solely on certification, fellowship or membership in a specialty body or society
Medicare
