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Quiz: Test Your Credentialing, Privileging & Enrollment Knowledge Blog Feature

By: Maureen Clarke on December 3rd, 2019

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Quiz: Test Your Credentialing, Privileging & Enrollment Knowledge

Payor Enrollment | Provider Credentialing | Provider Privileging | Provider Management | blockchain

Some may call you a medical staff services department whiz or maybe you’re new to the profession. You could even fit somewhere in between. Take our 10-question quiz to discover where you rank in terms of your knowledge of medical credentialing, clinical privileging, and payer enrollment!

(Answers and score key at bottom)

1. A credentials verification organization’s (CVO’s) primary function is to:
  1. monitor monthly sanction files for its clients
  2. primary source verification of licenses
  3. perform credentialing services outlined in the agreement
  4. review applications for completeness
2. A payer enrollment challenge many healthcare organizations face is:
  1. failure to use e-signature technology
  2. a lack of commercial payers
  3. collecting data
  4. varying payer requirements

3. A reason to consider integrating payer enrollment within the credentialing function is to:

  1. eliminate unnecessary resources
  2. reduce the volume of incomplete applications
  3. collect practitioner data only once
  4. support accreditation
4. Which verification source(s) is/are approved by The Joint Commission for medical education for initial appointment?
  1. Verification of board certification by applicable specialty board
  2. American Medical Association (AMA) Physician Masterfile or the American Osteopathic Association (AOA) Physician Database for all United States and Puerto Rico medical school education
  3. Educational Commission for Foreign Medical Graduates (ECFMG) for United States and Puerto Rico medical school education
  4. American Board of Medical Specialties (ABMS)

5. The Conditions of Participation were created and are maintained by what organization? 

  1. The Joint Commission (TJC)
  2. Det Norske Veritas (DNV GL)
  3. Centers for Medicare & Medicaid Services (CMS)
  4. National Committee for Quality Assurance (NCQA)

6. Which organizations require ongoing professional performance evaluation (OPPE) of privileged practitioners?

  1. TJC and DNV GL
  2. CMS and TJC
  3. DNV GL and CMS
  4. HFAP and TJC

7. Which organization does not have requirements for privileging practitioners?

  1. TJC
  2. NCQA
  3. DNV GL
  4. HFAP

8. Which of the following is not a common challenge associated with medical staff bylaws?

  1. Limited resource for addressing today’s challenges
  2. Source of conflicts
  3. Inflexible tool in the face of accelerating change
  4. Too many credentialed practitioners

9. Can employed practitioners serve in medical staff leadership positions?

  1. Yes
  2. No

10. Depending on the state, current licensure for physician assistants (PAs) allows for:

  1. practice only with a supervisory agreement
  2. practice with a supervisory or collaborative agreement
  3. practice through a supervisory, collaborative agreement and independent practice
  4. independent practice

 

SCORE KEY

0-3 CORRECT ANSWERS: Keep studying!

4-6 CORRECT ANSWERS: You’re on your way.

7-9 CORRECT ANSWERS: You’re well rounded in credentialing, privileging & PE.

10 CORRECT ANSWERS: You’re a pro. Ever consider being a mentor?

 

ANSWERS

1. A credentials verification organization’s (CVO’s) primary function is to:
     c. perform credentialing activities outlined in the agreement
2. A payer/provider enrollment challenge many healthcare organizations face is:
     d. varying payer requirements
3. A reason to consider integrating provider enrollment within the credentialing function is to:
     c. collect practitioner data only once
4. Which verification source(s) is/are approved by The Joint Commission for medical education for initial appointment?
     b. AMA Physician Masterfile or the AOA Physician Database for all United States and Puerto Rico medical school education
5. The Conditions of Participation were created and are maintained by what organization? 
     c. CMS
6. Which organizations require ongoing professional performance evaluation (OPPE) of privileged practitioners?
     d. HFAP and TJC
7. Which organization does not have requirements for privileging practitioners?
     b. NCQA
8. Which of the following is not a common challenge associated with medical staff bylaws?
     d. Too many credentialed practitioners
9. Can employed practitioners serve in medical staff leadership positions?
     a. Yes
10. Depending on the state, current licensure for physician assistants (PAs) allows for:
     b. practice with a supervisory or collaborative agreement

Thanks for taking the quiz! 

SOURCES

 

 

Credentialing CTA