CPCS QUESTIONS & ANSWERS
What does the acronym TJC stand for? - Answers - The Joint Commission
TJC Board Certification standard - Answers - Not specifically required but if the
organization requires certification or recertification, verification should be performed.
NCQA Board Certification standard - Answers - If a practitioner claims to be board
certified, the organization must verify it. Verification of board certification meets the
requirement for verification of education and residency training. Verification of board
certification is not applicable to nurse practitioners or other health care professionals
unless the organization communicates board certification to members.
ACHC Board Certification standard - Answers - The medical staff may not make its
recommendation solely based on the presence or absence of board certification, but
must also consider the request for clinical privileges, current licensure, training and
professional Education, experience, and supporting references of competence. Board
certification must be reviewed for each applicant/reapplicant during the review and
approval process.
DNV Board Certification standard - Answers - A medical staff may not rely solely on
board certification when making a decision on privileges. All credentials are examined.
MS.6 SR.4a & 5a Any organization required certifications must be primary source
verified initially and at reappointment.
URAC Board Certification standard - Answers - This is required for initial credentialing
only, unless the board certification no record of the verification in the practitioner's
record. If a physician has multiple board certifications, then at a minimum, verify for the
specialty under which the practitioner will be listed in the directory.
AAAHC Board Certification standard - Answers - Verify from primary or secondary
source.
Medicare CoPs Board Certification standard - Answers - The governing body must
ensure that under no circumstances is the accordance of staff membership or
professional privileges in the hospital dependent solely upon certification, fellowship or
membership in a specialty body or society.
TJC states Board Certifications can be verified at which primary verification sites? -
Answers - ABMS (and its certified agents are considered primary sources) and AOA
NCQA states Board Certifications can be verified at which primary verification sites? -
Answers - ABMS, AOA Official Osteopathic Physician Profile Report, AMA / AOA
Physician Masterfile, Confirmation from the specialty board, Confirmation from the state
licensing agency if there is confirmation that the agency conducts primary verification of
board status. Must verify at recredentialing
,ACHC states Board Certifications can be verified at which primary verification sites? -
Answers - ABMS or AOA
DNV states Board Certifications can be verified at which primary verification sites? -
Answers - Any organization required certifications must be primary source verified
initially and at reappointment
URAC states Board Certifications can be verified at which primary verification sites? -
Answers - Sources can include the AMA master file, AOA master file, or Special Board
of Registry.
URAC recognizes those sources that the ABMS has designated as primary equivalents
as ones that are primary as well.
An organization can rely on the verification activities of state licensing boards. If this is
done, it should be noted in the credentials file. Confirm that the state board does verify a
credential before relying on the board
AAAHC states Board Certifications can be verified at which primary verification sites? -
Answers - Verify from primary or secondary source
Medicare CoPs states Board Certifications can be verified at which primary verification
sites? - Answers - Does not list primary sources
What is and 'Arthroscopy' and who would perform this? - Answers - "arthro" - joint
"skopein" - to look
"to look within the joint"
orthopedic surgeons
"-pathy" - Answers - refers to disease
ex) Arthropathy = disease of a joint
What is an Endarterectomy and who would perform this? - Answers - "end" - inner or
internal
"arter" - artery
"ectomy" - removal or excision
"to remove atheromatous plaque that is causing arterial stenosis"
Neurosurgeon or Vascular Surgeon
"Chondromalacia" is what? - Answers - "chondro" - cartilage
"-malacia" - soft, softening
the abnormal softening or degermation of cartilage, especially of the knee joint. Occurs
often in avid runners
, "-plasty" - Answers - Surgical repair
"ureter/o-" - Answers - pertaining to the ureter
"Thrombus" - Answers - Blood clot
"-lysis" - Answers - breakdown
"Embolism" - Answers - 'Blockage' of a vessel by a clot or foreign material brought to
the site by the blood current.
"pulmonary" - Answers - lungs
"-lithos-" - Answers - stone
Who is an example of a dependent AHP? - Answers - Dental assistant, private nurse,
social worker, or private scrub tech
Who defines how to credential AHPs? - Answers - Medical Staff or Human Resources
A ________ is typically licensed by the state and is able to provide patient care,
treatment, or services without supervision - Answers - independent non-physician
practitioner or APP
Which accreditations do not use the term allied health practitioners, rather they use the
term "non-physician practitioners"? - Answers - ACHC, Medicare, DNV, NCQA
Which accreditation uses the term "licensed independent practitioners"? - Answers -
TJC
Which accreditations uses the term "allied health practitioners"? - Answers - URAC
and AAAHC
What is an independent non-physician practitioner? - Answers - An independent non-
physician practitioner is typically licensed by the state and can provide patient care,
treatment, or services without supervision.
This organization verifies the qualifications of all allied health professionals(AHPs) that
may provide clinical services to consumers through a written agreement with the
organization. - Answers - URAC
Which accrediting body requires an initial appointment profile to provide a clear report of
the review of all submitted information? - Answers - ACHC - they're the only accreditor
with this standard
What does the acronym TJC stand for? - Answers - The Joint Commission
TJC Board Certification standard - Answers - Not specifically required but if the
organization requires certification or recertification, verification should be performed.
NCQA Board Certification standard - Answers - If a practitioner claims to be board
certified, the organization must verify it. Verification of board certification meets the
requirement for verification of education and residency training. Verification of board
certification is not applicable to nurse practitioners or other health care professionals
unless the organization communicates board certification to members.
ACHC Board Certification standard - Answers - The medical staff may not make its
recommendation solely based on the presence or absence of board certification, but
must also consider the request for clinical privileges, current licensure, training and
professional Education, experience, and supporting references of competence. Board
certification must be reviewed for each applicant/reapplicant during the review and
approval process.
DNV Board Certification standard - Answers - A medical staff may not rely solely on
board certification when making a decision on privileges. All credentials are examined.
MS.6 SR.4a & 5a Any organization required certifications must be primary source
verified initially and at reappointment.
URAC Board Certification standard - Answers - This is required for initial credentialing
only, unless the board certification no record of the verification in the practitioner's
record. If a physician has multiple board certifications, then at a minimum, verify for the
specialty under which the practitioner will be listed in the directory.
AAAHC Board Certification standard - Answers - Verify from primary or secondary
source.
Medicare CoPs Board Certification standard - Answers - The governing body must
ensure that under no circumstances is the accordance of staff membership or
professional privileges in the hospital dependent solely upon certification, fellowship or
membership in a specialty body or society.
TJC states Board Certifications can be verified at which primary verification sites? -
Answers - ABMS (and its certified agents are considered primary sources) and AOA
NCQA states Board Certifications can be verified at which primary verification sites? -
Answers - ABMS, AOA Official Osteopathic Physician Profile Report, AMA / AOA
Physician Masterfile, Confirmation from the specialty board, Confirmation from the state
licensing agency if there is confirmation that the agency conducts primary verification of
board status. Must verify at recredentialing
,ACHC states Board Certifications can be verified at which primary verification sites? -
Answers - ABMS or AOA
DNV states Board Certifications can be verified at which primary verification sites? -
Answers - Any organization required certifications must be primary source verified
initially and at reappointment
URAC states Board Certifications can be verified at which primary verification sites? -
Answers - Sources can include the AMA master file, AOA master file, or Special Board
of Registry.
URAC recognizes those sources that the ABMS has designated as primary equivalents
as ones that are primary as well.
An organization can rely on the verification activities of state licensing boards. If this is
done, it should be noted in the credentials file. Confirm that the state board does verify a
credential before relying on the board
AAAHC states Board Certifications can be verified at which primary verification sites? -
Answers - Verify from primary or secondary source
Medicare CoPs states Board Certifications can be verified at which primary verification
sites? - Answers - Does not list primary sources
What is and 'Arthroscopy' and who would perform this? - Answers - "arthro" - joint
"skopein" - to look
"to look within the joint"
orthopedic surgeons
"-pathy" - Answers - refers to disease
ex) Arthropathy = disease of a joint
What is an Endarterectomy and who would perform this? - Answers - "end" - inner or
internal
"arter" - artery
"ectomy" - removal or excision
"to remove atheromatous plaque that is causing arterial stenosis"
Neurosurgeon or Vascular Surgeon
"Chondromalacia" is what? - Answers - "chondro" - cartilage
"-malacia" - soft, softening
the abnormal softening or degermation of cartilage, especially of the knee joint. Occurs
often in avid runners
, "-plasty" - Answers - Surgical repair
"ureter/o-" - Answers - pertaining to the ureter
"Thrombus" - Answers - Blood clot
"-lysis" - Answers - breakdown
"Embolism" - Answers - 'Blockage' of a vessel by a clot or foreign material brought to
the site by the blood current.
"pulmonary" - Answers - lungs
"-lithos-" - Answers - stone
Who is an example of a dependent AHP? - Answers - Dental assistant, private nurse,
social worker, or private scrub tech
Who defines how to credential AHPs? - Answers - Medical Staff or Human Resources
A ________ is typically licensed by the state and is able to provide patient care,
treatment, or services without supervision - Answers - independent non-physician
practitioner or APP
Which accreditations do not use the term allied health practitioners, rather they use the
term "non-physician practitioners"? - Answers - ACHC, Medicare, DNV, NCQA
Which accreditation uses the term "licensed independent practitioners"? - Answers -
TJC
Which accreditations uses the term "allied health practitioners"? - Answers - URAC
and AAAHC
What is an independent non-physician practitioner? - Answers - An independent non-
physician practitioner is typically licensed by the state and can provide patient care,
treatment, or services without supervision.
This organization verifies the qualifications of all allied health professionals(AHPs) that
may provide clinical services to consumers through a written agreement with the
organization. - Answers - URAC
Which accrediting body requires an initial appointment profile to provide a clear report of
the review of all submitted information? - Answers - ACHC - they're the only accreditor
with this standard
