Medical Staff Committee Support and Management Flashcards
7 cards from real CPCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Medical Staff Committee Support and Management flashcards as text
A credentialing specialist notices that a physician's reappointment file lacks a required peer reference. What is the correct action?
Answer: Place the file on hold and obtain the missing reference before presenting to the committee
Incomplete files should not be presented to the committee; the specialist must obtain all required documentation before the file proceeds to review.
Which of the following best describes the role of the credentials committee versus the medical executive committee in the credentialing process?
Answer: The credentials committee makes recommendations; the MEC acts on those recommendations
The credentials committee evaluates applications and makes recommendations that are then reviewed and acted upon by the medical executive committee.
What is the significance of the '30-day rule' commonly referenced in medical staff committee proceedings?
Answer: Physicians have 30 days to respond to a notice of adverse action
Most medical staff bylaws and fair hearing policies give physicians 30 days to request a hearing after receiving notice of an adverse credentialing action.
What is the purpose of a 'proctoring' or 'supervision' requirement attached to newly granted clinical privileges?
Answer: To allow observed evaluation of competency before independent practice is confirmed
Proctoring provides direct observation of a physician's clinical performance to validate competency before granting unrestricted independent privileges.
Which accreditation standard requires hospitals to define the criteria used to evaluate clinical privilege requests?
Answer: The Joint Commission MS standard requiring criteria-based privileging
The Joint Commission MS standards require that hospitals establish and apply defined, criteria-based processes for evaluating privilege requests.
When a physician is granted 'telemedicine privileges,' what unique credentialing consideration typically applies?
Answer: Telemedicine practitioners must be licensed in the originating site's state
Telemedicine practitioners must hold licensure in the state where the patient is located (the originating site), adding a multi-state licensing dimension to credentialing.
A committee is reviewing a physician's application and discovers an undisclosed malpractice settlement. What is the most appropriate next step?
Answer: Request the physician provide a written explanation and review the circumstances before deciding
Due process requires that the physician be given the opportunity to explain an undisclosed item before the committee makes a final determination.