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Regulatory Compliance & Accreditation Flashcards

7 cards from real CHCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Regulatory Compliance & Accreditation flashcards as text

  1. Which source is acceptable for primary source verification of graduation from a foreign medical school?

    Answer: ECFMG certification

    ECFMG certification is an accepted primary source for verifying foreign medical education.

  2. How often must practitioners re-attest to their CAQH ProView profile to keep it active for health plans?

    Answer: Every 120 days

    CAQH ProView requires re-attestation every 120 days.

  3. Under NCQA standards, how many years of malpractice claims history must be verified at initial credentialing?

    Answer: 5 years

    NCQA requires verification of the most recent five years of malpractice settlements or judgments.

  4. Under the ACA, which Medicaid provider risk category requires fingerprint-based criminal background checks?

    Answer: High risk

    Fingerprint-based background checks are required for providers in the high-risk screening category.

  5. A hospital receives a TJC accreditation decision and wants to know how often it will be resurveyed. What is the standard hospital survey cycle?

    Answer: Up to every 36 months, unannounced

    TJC conducts unannounced full hospital surveys at least every 36 months.

  6. Which of the following is NOT one of the four HCQIA standards a professional review action must meet for immunity?

    Answer: Approval by the state licensing board before action

    HCQIA immunity does not require prior licensing board approval; it requires quality purpose, fact-finding, due process, and a warranted belief.

  7. Which organization accredits ambulatory health care settings such as surgery centers and medical groups?

    Answer: AAAHC

    AAAHC is a CMS-approved accreditor focused on ambulatory health care organizations.

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