CERTIFIED PROVIDER CREDENTIALING
SPECIALIST EXAMINATION SCRIPT 2026
COMPLETE QUESTIONS WITH ACCURATE
ANSWERS
◉ Initial Appointment / Clinical privileges/ practioners covered
according to the NCQA
Answer: HP's and MBHO's must have documented Credentialing
policies and procedures that apply to all practitioners who provide
care to the organizations members
◉ Initial Appointment / Clinical privileges/ practioners covered
according to CMS
Answer: The Governing body determines, in accordance with Staye
Law, which categories of practitioners are eligible for appointment
to the medical staff. At a minimum the medical staff must be
composed of MD 's and DO's.
◉ Verification of Medical education according to the TJC
Answer: Requires verification from the medical school or accepted
PSV
◉ TJC Accepted PSV for medical education
,Answer: The AMA, the AOA, and the ECFMG
◉ Verification of Medical education according to the NCQA
Answer: Requires HP/CVO the highest of three levels of education
and training.
◉ The three levels of education and training as defined by NCQA
Answer: Graduation from medical or professional school, residency,
board certification.
◉ Verification of Medical education according to CMS
Answer: The medical staff must have a mechanism to examine
evidence of professional education
◉ Verification of postgraduate training according to TJC
Answer: Requires verification from the primary source or
designated equivalent sources.
◉ TJC accepted PSV for postgraduate training
Answer: AMA and AOA
◉ Verification of postgraduate training according to NCQA
, Answer: The highest of the three levels of education and training
attained. If board certified, than board certification suffices.
◉ Verification of postgraduate training according to CMS
Answer: The medical staff must have a mechanism to examine
evidence of training and documented experiences.
◉ Verification of board certification according to TJC
Answer: The TJC standards do not specifically require verification of
board certification, if the medical staff bylaws, policies, or rules and
regulations require certification. However, it is an expectation that
board certification be verified in some manner.
◉ Verification of board certification according to NCQA
Answer: NCQA does not require board certification. If the individual
is board certified verification may be obtained directly form the
specialty board, AMA, or AOA.
◉ ABMS certified Doctor Verification
Answer: Not recognized by the NCQA as a source for verification of
board certification. The site is a consumer reference only
◉ Verification of board certification according to CMS
SPECIALIST EXAMINATION SCRIPT 2026
COMPLETE QUESTIONS WITH ACCURATE
ANSWERS
◉ Initial Appointment / Clinical privileges/ practioners covered
according to the NCQA
Answer: HP's and MBHO's must have documented Credentialing
policies and procedures that apply to all practitioners who provide
care to the organizations members
◉ Initial Appointment / Clinical privileges/ practioners covered
according to CMS
Answer: The Governing body determines, in accordance with Staye
Law, which categories of practitioners are eligible for appointment
to the medical staff. At a minimum the medical staff must be
composed of MD 's and DO's.
◉ Verification of Medical education according to the TJC
Answer: Requires verification from the medical school or accepted
PSV
◉ TJC Accepted PSV for medical education
,Answer: The AMA, the AOA, and the ECFMG
◉ Verification of Medical education according to the NCQA
Answer: Requires HP/CVO the highest of three levels of education
and training.
◉ The three levels of education and training as defined by NCQA
Answer: Graduation from medical or professional school, residency,
board certification.
◉ Verification of Medical education according to CMS
Answer: The medical staff must have a mechanism to examine
evidence of professional education
◉ Verification of postgraduate training according to TJC
Answer: Requires verification from the primary source or
designated equivalent sources.
◉ TJC accepted PSV for postgraduate training
Answer: AMA and AOA
◉ Verification of postgraduate training according to NCQA
, Answer: The highest of the three levels of education and training
attained. If board certified, than board certification suffices.
◉ Verification of postgraduate training according to CMS
Answer: The medical staff must have a mechanism to examine
evidence of training and documented experiences.
◉ Verification of board certification according to TJC
Answer: The TJC standards do not specifically require verification of
board certification, if the medical staff bylaws, policies, or rules and
regulations require certification. However, it is an expectation that
board certification be verified in some manner.
◉ Verification of board certification according to NCQA
Answer: NCQA does not require board certification. If the individual
is board certified verification may be obtained directly form the
specialty board, AMA, or AOA.
◉ ABMS certified Doctor Verification
Answer: Not recognized by the NCQA as a source for verification of
board certification. The site is a consumer reference only
◉ Verification of board certification according to CMS
