CPMSM Exam Study Questions and Correct Solutions 2025

According to URAC who should oversee the clinical aspects of the credentialing program within the organization? - Answer -Senior Clinical Staff Person Name 3 sources of verification of education of a dentist according to NCQA - Answer -Dental school, specialty board, state licensing board NCQA requires MCO's to recredential practitioners at least every - Answer -3 years HFAP is commonly known as - Answer -AOA, an osteopathic organization T/F No accreditation body requires verification of malpractice insurance - Answer -True What six criteria are observed in an initial site visit by NCQA - Answer -1. Physical accessibility 2. Physical appearance 3. Adequacy of waiting and exam rooms 4. Appointment availability 5. Adequacy of treatment 6. Record keeping processes According to TJC which of the following should be used to verify current competence? 1. Board Certification 2. Malpractice Face Sheet 3. Hospital Verification 4. Patient complaint record - Answer - Hospital verification According to NCQA, who has ultimate authority in credentialing decision? - Answer -Credentials committee of medical director if it is a clean file What two entities does EMTALA not apply - Answer -Military and Shriners Name the six general competencies according to ACGME and ABMS - Answer -1. Patient Care 2. Medical/clinical knowledge 3. Practice based learning and improvement 4. Interpersonal and communication skills 5.Professionalism 6. System based practice The medical staff is actively involved in measuring, assessing and improving what? - Answer -Patient safety data If a hospital loses accreditation for providing falsified information to the joint commission, it m