CPMSM Exam Study Guide Questions and Correct Solutions 2025

What are four models of HMOs? - Answer -Staff Model Group Model Network Model Independent Practice Association (IPA) What are the four types of committees? - Answer -Standing Ad hoc Task force Continuous quality improvement team How many medical staff members comprise a Bylaws Committee? - Answer -5 At least five active medical staff How many medical staff members comprise a Credentials Committee? - Answer -5 At least five active medical staff How many medical staff members must serve on an Infection Control Committee? - Answer -3 At least three active medical staff How many medical staff members must serve on a Medical Records Committee? - Answer -1 At least one active medical staff How often should the Medical Records committee meet? - Answer -At least quarterly How many medical staff members must serve on a Pharmacy & Therapeutics Committee? - Answer -5At least five active medical staff How often should the Pharmacy & Therapeutics committee meet? - Answer -At least quarterly How many medical staff members must serve on a Utilization Review Committee? - Answer -1 At least one active medical staff How often should the Utilization Review Committee meet? - Answer -Every other month What is the process of obtaining, verifying, and assessing the qualifications of a health care practitioner who seeks to provide patient care services in or for a hospital? - Answer -Credentialing What are the three reasons for credentialing? - Answer -Patient Safety Risk Management Required by agencies Which three accreditors have been granted "deemed status"? - Answer -TJC, HFAP, DNV Which two organizations offer accreditation for managed care organizations? - Answer -NCQA, URAC Who is the main accreditor for ambulatory care facilities? - Answer -AAAHC Physicians who are employees of a facility as hospitalists and who are not listed in the provider directory are not included in the scope of the credentialing standards with this accreditation? - Answer -URAC For which accreditation, do the following practitioners need *not* to be credentialed including: -exclusively in the inpatient setting caring for organization members only in the hospital setting