CPCS EXAM BUNDLE 2026 AND 2027 ULTIMATE
SUCCESS PACK COMPLETE QUESTIONS AND
ANSWERS 100% ACCURATE.
◎ According to JC & HFAP name four approved sources PSV for Medical Education
ANSWER:- Medical School, AMA, ECFMG, AOA
◎ According to NCQA practitioners must be notified of credentialing decision within
how many days? ANSWER:- 60 Days
◎ The DHHS mails a copy of the NPDB report to the named provider. If the provider
wishes to dispute the reports accuracy, the provider has how many days to do so?
ANSWER:- 60 Days
◎ According to URAQ, within how many days must the practitioner be notified of
credentialing decisions? ANSWER:- 10 Days
◎ How many days does a practitioner have to dispute an NPDB report accuracy
ANSWER:- 60 Days
◎ Which accrediting body requires five year verification of malpractice history
ANSWER:- NCQA
◎ What is commonly used source for verifying malpractice history ANSWER:- NPDB
◎ According to the JC a fair hearing and appeals process as described in the medical
staff bylaws is available to whom? ANSWER:- Medical staff members and non-
members holding clinical privileges
◎ T/F Only the highest of training must be verified according to NCQA ANSWER:- True
◎ According to the Joint Commission a peer recommendation should address what six
competencies? ANSWER:- Medical knowledge\nTechnical & clinical skill\nclinical
judgment\ninterpersonal skills\ncommunication skills\nprofessionalism
◎ Telemedicine - according to JC what two options are available for credentialing a the
original site? ANSWER:- Full credentialing, use of the distant sites credentialing
◎ According to JC what is included in the process of planning and implementing
privileges? ANSWER:- Develop & approve procedure list\nProcess the
application\nEvaluate applicant specific information\nSubmit recommendations to
,governing body for applicant specific delineated privileges\nNotify the applicant,
relevant personnel\nMonitor the use of privileges
◎ Are payments made by a physician in a malpractice claim reportable to the NPDB?
ANSWER:- No
◎ Who requires Peer References ANSWER:- JC, HFAP, AAAHC
◎ Who reappoints ANSWER:- JC, HFAP, NCQA, URAC
◎ Who requires an attestation? ANSWER:- NCQA, URAC, AAAHC
◎ Who requires education verification? ANSWER:- JC, HFAP, URAC, AAAHC
◎ Who requires statement regarding felony convictions? ANSWER:- HFAP, NCQA,
AAAHC
◎ Attestation must state that the information submitted is complete & correct
ANSWER:- NCQA, AAAHC
◎ Attestation must state that the information submitted is complete & accurate
ANSWER:- URAC
◎ Attestation must include inquiry regarding illegal drug use? ANSWER:- NCAQ
◎ Attestation must include inquiry regarding inability to perform essential functions?
ANSWER:- NCQA
◎ Attestation must include inquiry regarding history or loss or limitations of licensure or
privileges or disciplinary actions? ANSWER:- NCQA
◎ Attestation must include inquiry regarding current malpractice coverage? ANSWER:-
NCQA
◎ Attestation must include inquiry regarding felony convictions? ANSWER:- NCQA
◎ Applicant must attest to limitations on ability to perform functions of the position with
or without accomodation, if any ANSWER:- NCQA
◎ Applicant must attest to lack of present illegal drug use ANSWER:- AAAHC
◎ Applicant must attest to history or loss of license and felony convictions, if any
ANSWER:- AAAHC
, ◎ Applicant must attest to history of loss or limitations of privileges or disciplinary
actions, if any ANSWER:- AAAHC
◎ Applicant must attest to current malpractice insurance coverage? ANSWER:-
AAAHC
◎ Who requires a malpractice history for applicants? ANSWER:- JC, HFAP, NCQA,
URAC, AAAHC
◎ Who must have a process in place to address complaints? ANSWER:- JC, HFAP,
NCQA, URAC
◎ Who requires Board Certification? ANSWER:- None
◎ Who requires criminal background checks? ANSWER:- HFAP
◎ Who requires applicant ID ANSWER:- JC
◎ Who requires an NPDB ANSWER:- JC, HFAP, NCQA, AAAHC
◎ Who requires current competence? ANSWER:- JC, HFAP, CMS
◎ How often does the OIG report to the NPDB? ANSWER:- Monthly
◎ Are limitations of the clinical privileges of a psychiatrist for more than 30 days
reportable to the NPDB? ANSWER:- Yes
◎ According to the JC, who may amend the medical staff bylaws? ANSWER:-
Governing Body
◎ Failure to meet the established qualifications and criteria for appointment should be
reported to whom? ANSWER:- The applicant
◎ NCQA requires the MCO to obtain a minimum of ???? years of work history?
ANSWER:- Five Years
◎ According to NCQA what policy must an organization have in place to obtain
approval to enter into a delegated agreement? ANSWER:- Credentialing policies
◎ Hospitals must query the NPDB when: ANSWER:- Initial appointment\ngranting of
priveleges\nevery two years
◎ NCQA requires verifications must be less than how many days old? ANSWER:- 180
SUCCESS PACK COMPLETE QUESTIONS AND
ANSWERS 100% ACCURATE.
◎ According to JC & HFAP name four approved sources PSV for Medical Education
ANSWER:- Medical School, AMA, ECFMG, AOA
◎ According to NCQA practitioners must be notified of credentialing decision within
how many days? ANSWER:- 60 Days
◎ The DHHS mails a copy of the NPDB report to the named provider. If the provider
wishes to dispute the reports accuracy, the provider has how many days to do so?
ANSWER:- 60 Days
◎ According to URAQ, within how many days must the practitioner be notified of
credentialing decisions? ANSWER:- 10 Days
◎ How many days does a practitioner have to dispute an NPDB report accuracy
ANSWER:- 60 Days
◎ Which accrediting body requires five year verification of malpractice history
ANSWER:- NCQA
◎ What is commonly used source for verifying malpractice history ANSWER:- NPDB
◎ According to the JC a fair hearing and appeals process as described in the medical
staff bylaws is available to whom? ANSWER:- Medical staff members and non-
members holding clinical privileges
◎ T/F Only the highest of training must be verified according to NCQA ANSWER:- True
◎ According to the Joint Commission a peer recommendation should address what six
competencies? ANSWER:- Medical knowledge\nTechnical & clinical skill\nclinical
judgment\ninterpersonal skills\ncommunication skills\nprofessionalism
◎ Telemedicine - according to JC what two options are available for credentialing a the
original site? ANSWER:- Full credentialing, use of the distant sites credentialing
◎ According to JC what is included in the process of planning and implementing
privileges? ANSWER:- Develop & approve procedure list\nProcess the
application\nEvaluate applicant specific information\nSubmit recommendations to
,governing body for applicant specific delineated privileges\nNotify the applicant,
relevant personnel\nMonitor the use of privileges
◎ Are payments made by a physician in a malpractice claim reportable to the NPDB?
ANSWER:- No
◎ Who requires Peer References ANSWER:- JC, HFAP, AAAHC
◎ Who reappoints ANSWER:- JC, HFAP, NCQA, URAC
◎ Who requires an attestation? ANSWER:- NCQA, URAC, AAAHC
◎ Who requires education verification? ANSWER:- JC, HFAP, URAC, AAAHC
◎ Who requires statement regarding felony convictions? ANSWER:- HFAP, NCQA,
AAAHC
◎ Attestation must state that the information submitted is complete & correct
ANSWER:- NCQA, AAAHC
◎ Attestation must state that the information submitted is complete & accurate
ANSWER:- URAC
◎ Attestation must include inquiry regarding illegal drug use? ANSWER:- NCAQ
◎ Attestation must include inquiry regarding inability to perform essential functions?
ANSWER:- NCQA
◎ Attestation must include inquiry regarding history or loss or limitations of licensure or
privileges or disciplinary actions? ANSWER:- NCQA
◎ Attestation must include inquiry regarding current malpractice coverage? ANSWER:-
NCQA
◎ Attestation must include inquiry regarding felony convictions? ANSWER:- NCQA
◎ Applicant must attest to limitations on ability to perform functions of the position with
or without accomodation, if any ANSWER:- NCQA
◎ Applicant must attest to lack of present illegal drug use ANSWER:- AAAHC
◎ Applicant must attest to history or loss of license and felony convictions, if any
ANSWER:- AAAHC
, ◎ Applicant must attest to history of loss or limitations of privileges or disciplinary
actions, if any ANSWER:- AAAHC
◎ Applicant must attest to current malpractice insurance coverage? ANSWER:-
AAAHC
◎ Who requires a malpractice history for applicants? ANSWER:- JC, HFAP, NCQA,
URAC, AAAHC
◎ Who must have a process in place to address complaints? ANSWER:- JC, HFAP,
NCQA, URAC
◎ Who requires Board Certification? ANSWER:- None
◎ Who requires criminal background checks? ANSWER:- HFAP
◎ Who requires applicant ID ANSWER:- JC
◎ Who requires an NPDB ANSWER:- JC, HFAP, NCQA, AAAHC
◎ Who requires current competence? ANSWER:- JC, HFAP, CMS
◎ How often does the OIG report to the NPDB? ANSWER:- Monthly
◎ Are limitations of the clinical privileges of a psychiatrist for more than 30 days
reportable to the NPDB? ANSWER:- Yes
◎ According to the JC, who may amend the medical staff bylaws? ANSWER:-
Governing Body
◎ Failure to meet the established qualifications and criteria for appointment should be
reported to whom? ANSWER:- The applicant
◎ NCQA requires the MCO to obtain a minimum of ???? years of work history?
ANSWER:- Five Years
◎ According to NCQA what policy must an organization have in place to obtain
approval to enter into a delegated agreement? ANSWER:- Credentialing policies
◎ Hospitals must query the NPDB when: ANSWER:- Initial appointment\ngranting of
priveleges\nevery two years
◎ NCQA requires verifications must be less than how many days old? ANSWER:- 180
