Telemedicine Credentialing and Privileging Standards 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 Telemedicine Credentialing and Privileging Standards flashcards as text
A critical access hospital (CAH) uses a telemedicine agreement with an urban hospital for emergency radiology coverage. Under CMS rules, who is responsible for granting privileges to the teleradiology provider?
Answer: The CAH must grant its own privileges based on the urban hospital's credentialing decisions
Even under proxy credentialing, the CAH retains responsibility for formally granting privileges to the telemedicine provider using the distant site's credentialing process.
What does NPDB stand for and what is its primary function in telemedicine credentialing?
Answer: National Practitioner Data Bank — reports and queries adverse actions and malpractice payments
The NPDB is a federal repository that collects and releases information about adverse actions, malpractice payments, and certain negative credentialing decisions affecting practitioners.
Which body of law primarily governs the standard of care applicable to telemedicine encounters in the United States?
Answer: State law in the jurisdiction where the patient is located
In telemedicine, the standard of care is generally governed by the laws of the state where the patient is physically located at the time of the encounter.
A hospital's medical staff bylaws require all practitioners to hold a valid DEA registration. A telemedicine provider delivers only behavioral health counseling services without prescribing. How should this be handled?
Answer: The medical staff can grant an exception if the provider's scope does not include prescribing controlled substances
Medical staffs may grant exceptions to DEA registration requirements for practitioners whose privileges do not include prescribing controlled substances.
In telemedicine credentialing, what is 'OPPE' designed to measure?
Answer: A practitioner's ongoing clinical competency and performance based on data over time
OPPE uses aggregate data on clinical performance, outcomes, and professional conduct to evaluate ongoing competency between formal reappointment cycles.
A telemedicine company contracts with 50 hospitals to provide hospitalist coverage. Which credentialing model would be MOST efficient for managing this arrangement?
Answer: The telemedicine company obtains URAC or NCQA accreditation as a CVO to streamline credentialing
An accredited CVO centrally manages primary source verification, allowing hospitals to rely on verified data rather than each conducting independent full verifications.
Which scenario represents a conflict of interest that should be disclosed during a telemedicine provider's credentialing process?
Answer: The provider has a financial investment in the telemedicine technology platform used by the hospital
A financial interest in the telemedicine platform creates a potential conflict of interest that must be disclosed to ensure objectivity in care delivery decisions.