CPCS - Credentialing and Privileging
Exam 2026 Questions and Answers
TJC Phone PSV - Correct Answer-What accreditation can use phone for PSV for
all information including: licensure, education, training, experience, competence,
and peer references
LIP - Correct Answer-any individual permitted by law and by the hospital to
provide patient care services w/o direction or supervision,
LIP - Correct Answer-any individual permitted by law and by the hospital to
provide patient care services w/o direction or supervision,
TJC - DNV - HFAP - Correct Answer-Accreditation bodies for hospitals
TJC - DNV - HFAP - Correct Answer-Accreditation bodies for hospitals
NCQA - URAC - Correct Answer-Accreditation bodies for Managed Care
Organizations (MCO)
NCQA who to credential - Correct Answer-credentialing is required for all licensed
practitioners (physicians and non physicians)
©COPYRIGHT2025, ALL RIGHTS RESERVED 1
,NCQA - URAC - Correct Answer-Accreditation bodies for Managed Care
Organizations (MCO)
NCQA not credentialed - Correct Answer-inpatient setting for organizational
member only - pharmacy benefits management - locum tenens unless over 90 days
-
NCQA - Correct Answer-What accreditation requires credentialing for all licensed
practitioners (physicians and non physicians)
URAC who to credential - Correct Answer-All participating providers as well as
facilities that provide covered health care services to consumers. All practitioners
listed in the directory must be credentialed
NCQA - Correct Answer-What accreditation does not require credentialing in these
settings? Inpatient setting for organizational member only - pharmacy benefits
management - locum tenens unless over 90 days -
URAC Directory Criteria - Correct Answer-Quality of Care, Service, and business
need of organization
URAC - Correct Answer-What accreditation requires all participating providers as
well as facilities that provide covered health care services to consumers. All
practitioners listed in the directory must be credentialed
©COPYRIGHT2025, ALL RIGHTS RESERVED 2
, URAC Directory Criteria - Correct Answer-What accreditation required the
following criteria? Quality of Care, Service, and business need of organization
URAC - not credentialed - Correct Answer-Physicians who are employees of a
facility as hospitalists and who are not listed in the directory.
URAC - Correct Answer-What accreditation does not require you to credential:
Physicians who are employees of a facility as hospitalists and who are not listed in
the directory.
Ambulatory Care Facility (AAAHC) - Correct Answer-the governing body defines
criteria for initial and reappointment of physicians and dentist. They do not specify
which providers need to be credentialed.
Definition of Criteria - Correct Answer-requirements for appointment to the
medical staff or provider panel
Ambulatory Care Facility (AAAHC) - Correct Answer-What accreditation requires
the governing body to define criteria for initial and reappointment of physicians
and dentist. They do not specify which providers need to be credentialed.
core criteria - Correct Answer-education, training, current competence, health
status, and licensure
©COPYRIGHT2025, ALL RIGHTS RESERVED 3
Exam 2026 Questions and Answers
TJC Phone PSV - Correct Answer-What accreditation can use phone for PSV for
all information including: licensure, education, training, experience, competence,
and peer references
LIP - Correct Answer-any individual permitted by law and by the hospital to
provide patient care services w/o direction or supervision,
LIP - Correct Answer-any individual permitted by law and by the hospital to
provide patient care services w/o direction or supervision,
TJC - DNV - HFAP - Correct Answer-Accreditation bodies for hospitals
TJC - DNV - HFAP - Correct Answer-Accreditation bodies for hospitals
NCQA - URAC - Correct Answer-Accreditation bodies for Managed Care
Organizations (MCO)
NCQA who to credential - Correct Answer-credentialing is required for all licensed
practitioners (physicians and non physicians)
©COPYRIGHT2025, ALL RIGHTS RESERVED 1
,NCQA - URAC - Correct Answer-Accreditation bodies for Managed Care
Organizations (MCO)
NCQA not credentialed - Correct Answer-inpatient setting for organizational
member only - pharmacy benefits management - locum tenens unless over 90 days
-
NCQA - Correct Answer-What accreditation requires credentialing for all licensed
practitioners (physicians and non physicians)
URAC who to credential - Correct Answer-All participating providers as well as
facilities that provide covered health care services to consumers. All practitioners
listed in the directory must be credentialed
NCQA - Correct Answer-What accreditation does not require credentialing in these
settings? Inpatient setting for organizational member only - pharmacy benefits
management - locum tenens unless over 90 days -
URAC Directory Criteria - Correct Answer-Quality of Care, Service, and business
need of organization
URAC - Correct Answer-What accreditation requires all participating providers as
well as facilities that provide covered health care services to consumers. All
practitioners listed in the directory must be credentialed
©COPYRIGHT2025, ALL RIGHTS RESERVED 2
, URAC Directory Criteria - Correct Answer-What accreditation required the
following criteria? Quality of Care, Service, and business need of organization
URAC - not credentialed - Correct Answer-Physicians who are employees of a
facility as hospitalists and who are not listed in the directory.
URAC - Correct Answer-What accreditation does not require you to credential:
Physicians who are employees of a facility as hospitalists and who are not listed in
the directory.
Ambulatory Care Facility (AAAHC) - Correct Answer-the governing body defines
criteria for initial and reappointment of physicians and dentist. They do not specify
which providers need to be credentialed.
Definition of Criteria - Correct Answer-requirements for appointment to the
medical staff or provider panel
Ambulatory Care Facility (AAAHC) - Correct Answer-What accreditation requires
the governing body to define criteria for initial and reappointment of physicians
and dentist. They do not specify which providers need to be credentialed.
core criteria - Correct Answer-education, training, current competence, health
status, and licensure
©COPYRIGHT2025, ALL RIGHTS RESERVED 3
