CPCS Exam UPDATED Actual Exam
Questions and CORRECT Answers
What two accreditors state: a hospital may not rely solely on board certification when
considering practitioner for medical staff membership? - CORRECT ANSWER✔✔ - HFAP,
CMS
According to JC & HFAP name four approved sources PSV for Medical Education -
CORRECT ANSWER✔✔ - Medical School, AMA, ECFMG, AOA
According to NCQA practitioners must be notified of credentialing decision within how
many days? - CORRECT 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? - CORRECT
ANSWER✔✔ - 60 Days
According to URAQ, within how many days must the practitioner be notified of credentialing
decisions? - CORRECT ANSWER✔✔ - 10 Days
How many days does a practitioner have to dispute an NPDB report accuracy - CORRECT
ANSWER✔✔ - 60 Days
Which accrediting body requires five year verification of malpractice history - CORRECT
ANSWER✔✔ - NCQA
What is commonly used source for verifying malpractice history - CORRECT ANSWER✔✔
- NPDB
According to the JC a fair hearing and appeals process as described in the medical staff
bylaws is available to whom? - CORRECT ANSWER✔✔ - Medical staff members and non-
members holding clinical privileges
,T/F Only the highest of training must be verified according to NCQA - CORRECT
ANSWER✔✔ - True
According to the Joint Commission a peer recommendation should address what six
competencies? - CORRECT 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? - CORRECT ANSWER✔✔ - Full credentialing, use of the distant sites credentialing
According to JC what is included in the process of planning and implementing privileges? -
CORRECT 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? -
CORRECT ANSWER✔✔ - No
Who requires Peer References - CORRECT ANSWER✔✔ - JC, HFAP, AAAHC
Who reappoints - CORRECT ANSWER✔✔ - JC, HFAP, NCQA, URAC
Who requires an attestation? - CORRECT ANSWER✔✔ - NCQA, URAC, AAAHC
Who requires education verification? - CORRECT ANSWER✔✔ - JC, HFAP, URAC,
AAAHC
Who requires statement regarding felony convictions? - CORRECT ANSWER✔✔ - HFAP,
NCQA, AAAHC
Attestation must state that the information submitted is complete & correct - CORRECT
ANSWER✔✔ - NCQA, AAAHC
,Attestation must state that the information submitted is complete & accurate - CORRECT
ANSWER✔✔ - URAC
Attestation must include inquiry regarding illegal drug use? - CORRECT ANSWER✔✔ -
NCAQ
Attestation must include inquiry regarding inability to perform essential functions? -
CORRECT ANSWER✔✔ - NCQA
Attestation must include inquiry regarding history or loss or limitations of licensure or
privileges or disciplinary actions? - CORRECT ANSWER✔✔ - NCQA
Attestation must include inquiry regarding current malpractice coverage? - CORRECT
ANSWER✔✔ - NCQA
Attestation must include inquiry regarding felony convictions? - CORRECT ANSWER✔✔ -
NCQA
Applicant must attest to limitations on ability to perform functions of the position with or
without accomodation, if any - CORRECT ANSWER✔✔ - NCQA
Applicant must attest to lack of present illegal drug use - CORRECT ANSWER✔✔ -
AAAHC
Applicant must attest to history or loss of license and felony convictions, if any - CORRECT
ANSWER✔✔ - AAAHC
Applicant must attest to history of loss or limitations of privileges or disciplinary actions, if
any - CORRECT ANSWER✔✔ - AAAHC
Applicant must attest to current malpractice insurance coverage? - CORRECT ANSWER✔✔
- AAAHC
, Who requires a malpractice history for applicants? - CORRECT ANSWER✔✔ - JC, HFAP,
NCQA, URAC, AAAHC
Who must have a process in place to address complaints? - CORRECT ANSWER✔✔ - JC,
HFAP, NCQA, URAC
Who requires Board Certification? - CORRECT ANSWER✔✔ - None
Who requires criminal background checks? - CORRECT ANSWER✔✔ - HFAP
Who requires applicant ID - CORRECT ANSWER✔✔ - JC
Who requires an NPDB - CORRECT ANSWER✔✔ - JC, HFAP, NCQA, AAAHC
Who requires current competence? - CORRECT ANSWER✔✔ - JC, HFAP, CMS
How often does the OIG report to the NPDB? - CORRECT ANSWER✔✔ - Monthly
Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to
the NPDB? - CORRECT ANSWER✔✔ - Yes
According to the JC, who may amend the medical staff bylaws? - CORRECT ANSWER✔✔ -
Governing Body
Failure to meet the established qualifications and criteria for appointment should be reported
to whom? - CORRECT ANSWER✔✔ - The applicant
NCQA requires the MCO to obtain a minimum of ???? years of work history? - CORRECT
ANSWER✔✔ - Five Years
Questions and CORRECT Answers
What two accreditors state: a hospital may not rely solely on board certification when
considering practitioner for medical staff membership? - CORRECT ANSWER✔✔ - HFAP,
CMS
According to JC & HFAP name four approved sources PSV for Medical Education -
CORRECT ANSWER✔✔ - Medical School, AMA, ECFMG, AOA
According to NCQA practitioners must be notified of credentialing decision within how
many days? - CORRECT 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? - CORRECT
ANSWER✔✔ - 60 Days
According to URAQ, within how many days must the practitioner be notified of credentialing
decisions? - CORRECT ANSWER✔✔ - 10 Days
How many days does a practitioner have to dispute an NPDB report accuracy - CORRECT
ANSWER✔✔ - 60 Days
Which accrediting body requires five year verification of malpractice history - CORRECT
ANSWER✔✔ - NCQA
What is commonly used source for verifying malpractice history - CORRECT ANSWER✔✔
- NPDB
According to the JC a fair hearing and appeals process as described in the medical staff
bylaws is available to whom? - CORRECT ANSWER✔✔ - Medical staff members and non-
members holding clinical privileges
,T/F Only the highest of training must be verified according to NCQA - CORRECT
ANSWER✔✔ - True
According to the Joint Commission a peer recommendation should address what six
competencies? - CORRECT 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? - CORRECT ANSWER✔✔ - Full credentialing, use of the distant sites credentialing
According to JC what is included in the process of planning and implementing privileges? -
CORRECT 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? -
CORRECT ANSWER✔✔ - No
Who requires Peer References - CORRECT ANSWER✔✔ - JC, HFAP, AAAHC
Who reappoints - CORRECT ANSWER✔✔ - JC, HFAP, NCQA, URAC
Who requires an attestation? - CORRECT ANSWER✔✔ - NCQA, URAC, AAAHC
Who requires education verification? - CORRECT ANSWER✔✔ - JC, HFAP, URAC,
AAAHC
Who requires statement regarding felony convictions? - CORRECT ANSWER✔✔ - HFAP,
NCQA, AAAHC
Attestation must state that the information submitted is complete & correct - CORRECT
ANSWER✔✔ - NCQA, AAAHC
,Attestation must state that the information submitted is complete & accurate - CORRECT
ANSWER✔✔ - URAC
Attestation must include inquiry regarding illegal drug use? - CORRECT ANSWER✔✔ -
NCAQ
Attestation must include inquiry regarding inability to perform essential functions? -
CORRECT ANSWER✔✔ - NCQA
Attestation must include inquiry regarding history or loss or limitations of licensure or
privileges or disciplinary actions? - CORRECT ANSWER✔✔ - NCQA
Attestation must include inquiry regarding current malpractice coverage? - CORRECT
ANSWER✔✔ - NCQA
Attestation must include inquiry regarding felony convictions? - CORRECT ANSWER✔✔ -
NCQA
Applicant must attest to limitations on ability to perform functions of the position with or
without accomodation, if any - CORRECT ANSWER✔✔ - NCQA
Applicant must attest to lack of present illegal drug use - CORRECT ANSWER✔✔ -
AAAHC
Applicant must attest to history or loss of license and felony convictions, if any - CORRECT
ANSWER✔✔ - AAAHC
Applicant must attest to history of loss or limitations of privileges or disciplinary actions, if
any - CORRECT ANSWER✔✔ - AAAHC
Applicant must attest to current malpractice insurance coverage? - CORRECT ANSWER✔✔
- AAAHC
, Who requires a malpractice history for applicants? - CORRECT ANSWER✔✔ - JC, HFAP,
NCQA, URAC, AAAHC
Who must have a process in place to address complaints? - CORRECT ANSWER✔✔ - JC,
HFAP, NCQA, URAC
Who requires Board Certification? - CORRECT ANSWER✔✔ - None
Who requires criminal background checks? - CORRECT ANSWER✔✔ - HFAP
Who requires applicant ID - CORRECT ANSWER✔✔ - JC
Who requires an NPDB - CORRECT ANSWER✔✔ - JC, HFAP, NCQA, AAAHC
Who requires current competence? - CORRECT ANSWER✔✔ - JC, HFAP, CMS
How often does the OIG report to the NPDB? - CORRECT ANSWER✔✔ - Monthly
Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to
the NPDB? - CORRECT ANSWER✔✔ - Yes
According to the JC, who may amend the medical staff bylaws? - CORRECT ANSWER✔✔ -
Governing Body
Failure to meet the established qualifications and criteria for appointment should be reported
to whom? - CORRECT ANSWER✔✔ - The applicant
NCQA requires the MCO to obtain a minimum of ???? years of work history? - CORRECT
ANSWER✔✔ - Five Years
