Cpmsm practice test Study guides, Class notes & Summaries

What does HEDIS stand for? - Healthcare Effectiveness Data and Information Set What is HEDIS? - is a widely used set of performance measures in the managed care industry. HEDIS is a multipurpose tool originally designed to address private employers' needs and has been adopted by public purchasers, regulators and consumers. HEDIS is an element of NCQA accreditation and the basis of consumer report cards for managed care. HEDIS data is collected through a combination of surveys, provider med...

CPMSM Practice Test Questions and Answers

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What does HEDIS stand for? - Healthcare Effectiveness Data and Information Set What is HEDIS? - is a widely used set of performance measures in the managed care industry. HEDIS is a multipurpose tool originally designed to address private employers' needs and has been adopted by public purchasers, regulators and consumers. HEDIS is an element of NCQA accreditation and the basis of consumer report cards for managed care. HEDIS data is collected through a combination of surveys, provider med...

CPMSM Practice Test/51 Questions and Answers

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CPMSM Practice TestWhy is it important to check that the practitioner is not currently excluded, suspended, debarred, or ineligible to participate in Federal health care programs? - correct answer The facility won't get paid for treating patients unless service is provided by authorized provider Which credentials must be tracked on an ongoing basis? - correct answer Licensure According to NCQA standards, an organization that discovers sanction info, complaints, or adverse events regarding...

Medical Staff - Correct Answer-according to the Joint Commission who is responsible for developing criteria for FPPE when issues affecting the provision of safety patient care are identified. 5 years - Correct Answer-NCQA requires an organization to obtain a claims history for a minimum of how many years every 6 Months - Correct Answer-According to NCQA how frequently must a delegate submit a report to the organization For health plans 180 days, for CVO 120 days - Correct Answer-verificat...

What does HEDIS stand for? - Correct Answer-Healthcare Effectiveness Data and Information Set What is HEDIS? - Correct Answer-is a widely used set of performance measures in the managed care industry. HEDIS is a multipurpose tool originally designed to address private employers' needs and has been adopted by public purchasers, regulators and consumers. HEDIS is an element of NCQA accreditation and the basis of consumer report cards for managed care. HEDIS data is collected through a combi...

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