Study 2/18/2025 Flashcards
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
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
Which 2 have requirements for Database Controls?
a. URAC and NCQA
b. DNV and TJC
c. AAAHC and ACHC
URAC and NCQA
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
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
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
Which accreditation states that before recommending privileges, the medical staff evaluates any evidence of an unusual pattern or an excessive number of professional liability actions resulting in a final judgment against the applicant?
a. TJC
b. AAAHC
c. DNV
TJC
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
Attestation of malpractice coverage by the practitioner is not acceptable by this accreditor?
a. URAC
b. TJC
c. NCQA
URAC
What is the time frame of verification for NCQA and the malpractice history?
a. 7-10 years
b. 36 months
c. 5 years
5 years
Name one organization that has requirements regarding database controls.
a. NCQA
b. Medicare
c. TJC
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 standards do not have any requirements regarding date base controls?
a. TJC, DNV, NCQA
b. TJC, DNV, URAC
c. TJC, DNV, ACHC, AAAHC, Medicare
TJC, DNV, ACHC, AAAHC, Medicare
These two organizations require the application contain information pertaining to malpractice / professional liability history.
a. AAAHC, URAC
b. ACHC, DNV
c. TJC, CMS
AAAHC, URAC
________ states before recommending privileges, the medical staff evaluates any evidence of an unusual pattern or an excessive number of professional liability actions resulting in a final judgment against the applicant.
a. DNV
b. NCQA
c. TJC
TJC
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
Endometriosis
Gynecologist
Primary Care Provider
Fluoroscopy
Radiologist
Cardiologists (for cardiac catheterization)
Gastroenterologists (for upper GI studies)
Orthopedic Surgeons (for guided orthopedic procedures)
Physician Assistants (with appropriate training and supervision)
Kyphoscoliosis
Orthopedic Surgeon
Physical Medicine and Rehabilitation
Neurosurgeon
Radiologist
