Organizations

Question 1

What does ABMS stand for?

Answer 1

American Board of Medical Specialties

The ABMS oversees the certification of physician specialists in the United States.

Question 2

What does ACHC stand for?

Answer 2

Accreditation Commission for Health Care

ACHC provides accreditation services for various healthcare organizations.

Question 3

What does AHPs stand for?

Answer 3

Allied Health Professionals

AHPs include a diverse group of healthcare workers who provide a range of diagnostic, technical, therapeutic, and support services.

Question 4

What does AMA stand for?

Answer 4

American Medical Association

The AMA is a professional association that advocates for physicians and patients in the United States.

Question 5

What does AOA stand for?

Answer 5

American Osteopathic Association

The AOA represents osteopathic physicians and promotes public health.

Question 6

What does APRN stand for?

Answer 6

Advanced Practice Registered Nurse

APRNs include nurse practitioners, clinical nurse specialists, nurse anesthetists, and nurse midwives.

Question 7

What does ASC stand for?

Answer 7

Ambulatory Surgical Center

ASCs provide same-day surgical care, including diagnostic and preventive procedures.

Question 8

What does CAMH stand for?

Answer 8

Comprehensive Accreditation Manual for Hospitals

CAMH provides standards and guidelines for hospital accreditation.

Question 9

What does CDS stand for?

Answer 9

Controlled Dangerous Substances

CDS refers to drugs that are regulated under the Controlled Substances Act.

Question 10

What does CEO stand for?

Answer 10

Chief Executive Officer

Question 11

What does CIHQ stand for?

Answer 11

Center for Improvement in Healthcare Quality

CIHQ focuses on improving healthcare quality and patient safety.

Question 12

What does CMS stand for?

Answer 12

Centers for Medicare & Medicaid Services

Question 13

What does CPCS stand for?

Answer 13

Certified Provider Credentialing Specialist

CPCS professionals manage the credentialing process for healthcare providers.

Question 14

What does CPES stand for?

Answer 14

Certified Provider Enrollment Specialist

CPES professionals assist with enrolling healthcare providers in various programs.

Question 15

What does CPMSM stand for?

Answer 15

Certified Professional in Medical Services Management

CPMSM certification recognizes expertise in medical services management.

Question 16

What does CRNA stand for?

Answer 16

Certified Registered Nurse Anesthetist

CRNAs are advanced practice nurses who provide anesthesia care.

Question 17

What does CVO stand for?

Answer 17

Credentials Verification Organization

CVOs verify the credentials of healthcare providers.

Question 18

What does DEA stand for?

Answer 18

Drug Enforcement Agency

The DEA enforces the controlled substances laws and regulations.

Question 19

What does DNV stand for?

Answer 19

Det Norske Veritas

DNV provides risk management and quality assurance services.

Question 20

What does ECFMG stand for?

Answer 20

Education Commission for Foreign Medical Graduates

ECFMG certifies international medical graduates for entry into U.S. residency programs.

Question 21

What does FCVS stand for?

Answer 21

Federation Credentials Verification Service

FCVS provides a centralized service for verifying the credentials of healthcare professionals.

Question 22

What does FEHB stand for?

Answer 22

Federal Employees Health Benefits

FEHB provides health insurance for federal employees and their families.

Question 23

What does FSMB stand for?

Answer 23

Federation of State Medical Boards
FSMB represents the state medical boards in the United States.

Question 24

What does FTCA stand for?

Answer 24

Federal Tort Claims Act

FTCA allows for lawsuits against the United States for certain torts.

Question 25

What does **HRSA** stand for?

Answer 25

Health Resources and Services Administration HRSA provides access to essential health services for uninsured and underserved populations.

Question 26

What does **TJC** stand for?

Answer 26

The Joint Commission The Joint Commission accredits and certifies healthcare organizations.

Question 27

What does **LEIE** stand for?

Answer 27

List of Excluded Individuals and Entities LEIE identifies individuals and entities excluded from participation in federal healthcare programs.

Question 28

What does **LIP** stand for?

Answer 28

Licensed Independent Practitioner LIPs are healthcare providers who are licensed to practice independently.

Question 29

What does **MCO** stand for?

Answer 29

Managed Care Organization MCOs provide healthcare services through a network of providers.

Question 30

What does **MEC** stand for?

Answer 30

Medical Executive Committee MEC is responsible for the oversight of medical staff activities.

Question 31

What does **NPDB** stand for?

Answer 31

National Practitioner Data Bank NPDB collects and releases information on healthcare practitioners.

Question 32

What does **OIG** stand for?

Answer 32

Office of Inspector General OIG conducts audits and investigations to promote efficiency and prevent fraud.

Question 33

What does **OLCP** stand for?

Answer 33

Other Licensed or Certified Practitioner OLCP refers to healthcare providers who are licensed or certified in their respective fields.

Question 34

What does **OPPE** stand for?

Answer 34

Ongoing Professional Practice Evaluation OPPE is a process to evaluate the performance of healthcare providers.

Question 35

What does **PA** stand for?

Answer 35

Physician Assistant PAs are healthcare professionals who practice medicine under the supervision of a physician.

Question 36

What does **PI** stand for?

Answer 36

Performance Improvement PI refers to systematic efforts to improve healthcare services.

Question 37

What does **PSV** stand for?

Answer 37

Primary Source Verification PSV is the process of verifying a healthcare provider's credentials directly from the source.

Question 38

What does **QUAD A** stand for?

Answer 38

American Association for Accreditation of Ambulatory Surgery Facilities QUAD A provides accreditation for ambulatory surgery facilities.

Question 39

What does **URAC** stand for?

Answer 39

Utilization Review Accreditation Commission URAC promotes healthcare quality through accreditation and education.

Question 40

What are the factors that influence hospital credentialing?

Answer 40

*Federal/state laws and regulations *Accreditation standards * ISO 9001 Quality Management System(QMS)bylaws/rules/ regulations/policies *Standard of care (legal aspect)

Question 41

What are the federal/state laws & regulations that influence hospital credentialing?

Answer 41

*Health Care Quality Improvement Act (HCQIA) *Medicare Hospital Conditions of Participation (CoPs) *State licensing regulation

Question 42

What are the accreditation standards that influence hospital credentialing?

Answer 42

The Joint Commission (TJC) Accreditation Commission for Health Care (ACHC) Center for Improvement in Healthcare Quality (CIHQ) Det Norske Veritas (DNV)

Question 43

What are the factors that influence health plans/provider organizations' credentialing?

Answer 43

*Accreditation standards *Federal/state laws and regulations *Healthcare Effectiveness Data and Information Set (HEDIS) *Consumer Assessment of Healthcare Providers and Systems (CAHPS) *Policies and procedures * *Standard of care (legal aspect)

Question 44

What are the accrediting standards that influence health plans/provider organizations' credentialing?

Answer 44

*National Committee for Quality Assurance (NCQA) *Utilization Review Accreditation Commission (URAC)

Question 45

What are the factors that influence credentialing in a CVO?

Answer 45

Contracts Accreditation standards CMS regulations Policies and procedures Federal/State laws & regulations