CPCS EXAM BUNDLE 2026 AND 2027 ELITE TEST
BANK REAL QUESTIONS WITH EXPERT
VERIFIED 100 % ACCURATE ANSWERS.
◎ Which of the following credentials must be tracked on an ongoing basis? ANSWER:-
a. Post graduate education completed
b. Closed medical malpractice claims
c. Licensure.
◎ According to NCQA standards, an organization that discovers sanction information,
complaints, or adverse events regarding a practitioner must take what action?
ANSWER:- a. Determine if there is evidence of poor quality that could affect the health
and safety of its members.
b. Immediately take action to remove the provider from its panel
c. Notify the practitioner that he/she is under investigation and initiate the hearing
process
◎ What is the name of the entity that was established through the Health Care Quality
Improvement Act of 1986 to restrict the ability of incompetent practitioners to move from
state to state without disclosure or discovery of previous medical malpractice payment
and adverse action history? ANSWER:- a. Emergency Medical Treatment and Active
Labor Act
b. The National Practitioner Data Bank.
c. The Patient Safety and Quality Improvement Act
◎ When developing clinical privileging criteria, which of the following is important to
evaluate? ANSWER:- a. How many providers are in that specialty
b. Established standards of practice, such as specialty board recommendations.
c. Whether or not the quality department can support the FPPE process
◎ What is the main reason for periodically assessing appropriateness of clinical
privileges of each specialty? ANSWER:- a. It is required by accreditation standards
b. It is required by the Medicare Conditions of Participation
c. To protect patient safety by ensuring current competency, relevance to the facility,
and accepted standards of care.
◎ Which of the following specialists is most likely to perform a PTCA? ANSWER:- a.
OB/GYN
b. Urologist
c. Interventional Cardiologist.
(PTCA = Percutaneous transluminal coronary angioplasty aka stent placement)
, ◎ The Joint Commission hospital standards require that clinical privileges are hospital
specific and... ANSWER:- a. Based on the individual's demonstrated current
competence and the procedures the hospital can support.
b. Based on board certification
c. Based on the privileges the individual is currently approved to perform at other
hospitals
◎ Which of the following would be routinely performed by a cardiologist? ANSWER:- a.
Hysterectomy
b. Transesophageal Echocardiography.
c. Urethral dilation
◎ Which NCQA-required committee makes recommendations regarding credentialing
decisions? ANSWER:- a. Medical Executive Committee
b. Quality Care Committee
c. Credentialing Committee.
◎ HFAP standards require which three medical staff committees to be delineated in the
medical staff structure? ANSWER:- a. Medical Executive Committee.
b. Utilization of Osteopathic Methods & Concepts Committee. (required for hospitals
with ten or more DOs who admit patients and provide direct patient care)
c. Utilization Review Committee.
d. Credentials Committee
e. Investigational Review Board
◎ How often does NCQA require that delegation reports be evaluated by the health
plan? ANSWER:- a. Monthly
b. Quarterly
c. Semi-Annually.
◎ Peer references should be obtained from: ANSWER:- a. Practitioners who have
referred patients to the provider
b. Former hospital administrators
c. Practitioners in the same professional discipline as the applicant.
◎ NCQA recognizes which of the following as the final approval of an applicant who
does not meet criteria for a clean file? ANSWER:- a. Medical Director
b. Credentialing Committee.
c. Board of Directors
◎ If a medical staff member has privileges and/or medical staff appointment revoked,
he/she must be: ANSWER:- a. Granted temporary privileges
b. Provided due process.
c. Reported immediately to the National Practitioner Data Bank
BANK REAL QUESTIONS WITH EXPERT
VERIFIED 100 % ACCURATE ANSWERS.
◎ Which of the following credentials must be tracked on an ongoing basis? ANSWER:-
a. Post graduate education completed
b. Closed medical malpractice claims
c. Licensure.
◎ According to NCQA standards, an organization that discovers sanction information,
complaints, or adverse events regarding a practitioner must take what action?
ANSWER:- a. Determine if there is evidence of poor quality that could affect the health
and safety of its members.
b. Immediately take action to remove the provider from its panel
c. Notify the practitioner that he/she is under investigation and initiate the hearing
process
◎ What is the name of the entity that was established through the Health Care Quality
Improvement Act of 1986 to restrict the ability of incompetent practitioners to move from
state to state without disclosure or discovery of previous medical malpractice payment
and adverse action history? ANSWER:- a. Emergency Medical Treatment and Active
Labor Act
b. The National Practitioner Data Bank.
c. The Patient Safety and Quality Improvement Act
◎ When developing clinical privileging criteria, which of the following is important to
evaluate? ANSWER:- a. How many providers are in that specialty
b. Established standards of practice, such as specialty board recommendations.
c. Whether or not the quality department can support the FPPE process
◎ What is the main reason for periodically assessing appropriateness of clinical
privileges of each specialty? ANSWER:- a. It is required by accreditation standards
b. It is required by the Medicare Conditions of Participation
c. To protect patient safety by ensuring current competency, relevance to the facility,
and accepted standards of care.
◎ Which of the following specialists is most likely to perform a PTCA? ANSWER:- a.
OB/GYN
b. Urologist
c. Interventional Cardiologist.
(PTCA = Percutaneous transluminal coronary angioplasty aka stent placement)
, ◎ The Joint Commission hospital standards require that clinical privileges are hospital
specific and... ANSWER:- a. Based on the individual's demonstrated current
competence and the procedures the hospital can support.
b. Based on board certification
c. Based on the privileges the individual is currently approved to perform at other
hospitals
◎ Which of the following would be routinely performed by a cardiologist? ANSWER:- a.
Hysterectomy
b. Transesophageal Echocardiography.
c. Urethral dilation
◎ Which NCQA-required committee makes recommendations regarding credentialing
decisions? ANSWER:- a. Medical Executive Committee
b. Quality Care Committee
c. Credentialing Committee.
◎ HFAP standards require which three medical staff committees to be delineated in the
medical staff structure? ANSWER:- a. Medical Executive Committee.
b. Utilization of Osteopathic Methods & Concepts Committee. (required for hospitals
with ten or more DOs who admit patients and provide direct patient care)
c. Utilization Review Committee.
d. Credentials Committee
e. Investigational Review Board
◎ How often does NCQA require that delegation reports be evaluated by the health
plan? ANSWER:- a. Monthly
b. Quarterly
c. Semi-Annually.
◎ Peer references should be obtained from: ANSWER:- a. Practitioners who have
referred patients to the provider
b. Former hospital administrators
c. Practitioners in the same professional discipline as the applicant.
◎ NCQA recognizes which of the following as the final approval of an applicant who
does not meet criteria for a clean file? ANSWER:- a. Medical Director
b. Credentialing Committee.
c. Board of Directors
◎ If a medical staff member has privileges and/or medical staff appointment revoked,
he/she must be: ANSWER:- a. Granted temporary privileges
b. Provided due process.
c. Reported immediately to the National Practitioner Data Bank
