CPCS - Certified Provider Credentialing Specialist Medical Staff Governance Questions and Answers Flashcards
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Read the first 6 CPCS - Certified Provider Credentialing Specialist Medical Staff Governance Questions and Answers flashcards as text
What is the purpose of the 'credentialing committee' within the medical staff governance structure?
Answer: To review completed credentialing files and make recommendations to the MEC regarding appointments and privileges
The credentials committee reviews completed credentialing files prepared by the medical staff office and makes recommendations regarding appointments, reappointments, and privileges to the Medical Executive Committee.
Which of the following best describes 'summary suspension' in the context of medical staff governance?
Answer: Immediate suspension of privileges without a prior hearing when patient safety requires immediate action
Summary suspension is the immediate suspension of a practitioner's clinical privileges without prior notice or hearing when there is an imminent threat to patient safety. A fair hearing must follow promptly.
A hospital's medical staff bylaws establish a 'Department of Medicine' with a designated 'Department Chief.' Which of the following is typically a responsibility of the Department Chief?
Answer: Reviewing and approving credentialing applications for practitioners seeking privileges in the department
Department chiefs typically review and recommend on credentialing applications from practitioners seeking privileges in their department, serving as the clinical expert in the medical staff governance process.
Under HCQIA, which of the following actions does NOT require reporting to the National Practitioner Data Bank?
Answer: Temporary suspension of privileges for failure to complete medical records
Temporary suspensions for administrative reasons (such as incomplete medical records) rather than for clinical competence or conduct reasons are generally not reportable to the NPDB under HCQIA.
The organized medical staff at a hospital is proposing to amend its bylaws to eliminate the fair hearing rights for employed physicians. The hospital's legal counsel advises against this change. What is the most likely basis for this advice?
Answer: TJC standards and most state laws require hospitals to provide fair hearing procedures for adverse credentialing actions
TJC standards (MS.06.01.09) and most state laws require hospitals to provide fair hearing and appeal procedures for practitioners facing adverse credentialing actions, making it difficult or impossible to eliminate these rights in bylaws.
Which of the following best describes the role of the hospital's Governing Board in the credentialing process?
Answer: The governing board approves or denies appointments based on MEC recommendations and retains ultimate accountability for credentialing decisions
The governing board has ultimate fiduciary accountability for the quality of care at the institution, which includes approving medical staff appointments and privileges based on recommendations from the MEC.