CPCS - CERTIFIED PROVIDER
CREDENTIALING SPECIALIST EXAM
UPDATED QUESTIONS AND CORRECT
ANSWERS.
Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the
NPDB? - ANS Yes
According to TJC, who may amend the medical staff bylaws? - ANS Governing body/board.
Failure to meet the established qualifications and criteria for appointment should be reported
to whom? - ANS The applicant
NCQA requires the MCO to obtain a minimum of how may years of work history? - ANS Five
years
According to the NCQA what policy must an organization have in place to obtain approval to
enter into a delegated agreement? - ANS Credentialing policies
How often does the OIG report to the NPDB? - ANS Monthly
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, When must hospitals query the NPDB? - ANS Initial appointment, granting of privileges,
every two years.
NCQA requires verifications must be less than how many days old? - ANS 180 days
What is the verification time limit on malpractice history according to the NCQA? - ANS 180
days
Time limited credential must be verified by the CVO with how may days prior to submission to
the client? - ANS 120 days
According the AAAHC, for initial appointments, in addition to licensure and education, what
verification is required? - ANS Experience and hospital affiliations.
What accreditation body states "The NPDB is an acceptable source for sanctions or limitations
on licensure, Medicaid/ Medicare sanctions and malpractice history? - ANS NCQA
Who is required to query the NPDB? - ANS Hospitals
Is disciplinary action taken against the license of a dentist reportable to the NPDB? - ANS Yes
Under HCQIA a hospital failure to report an adverse privilege action lasting longer than 30 days
may cause the organization to lose HCQIA immunity for how many years? - ANS 3 years
According to NCQA, verification of Medicare/Medicaid sanctions can be queried by any of what
sources? - ANS AMA, FSMB, HIPDB, OIG Sanctions Report, NPDB, State Agency
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
CREDENTIALING SPECIALIST EXAM
UPDATED QUESTIONS AND CORRECT
ANSWERS.
Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the
NPDB? - ANS Yes
According to TJC, who may amend the medical staff bylaws? - ANS Governing body/board.
Failure to meet the established qualifications and criteria for appointment should be reported
to whom? - ANS The applicant
NCQA requires the MCO to obtain a minimum of how may years of work history? - ANS Five
years
According to the NCQA what policy must an organization have in place to obtain approval to
enter into a delegated agreement? - ANS Credentialing policies
How often does the OIG report to the NPDB? - ANS Monthly
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, When must hospitals query the NPDB? - ANS Initial appointment, granting of privileges,
every two years.
NCQA requires verifications must be less than how many days old? - ANS 180 days
What is the verification time limit on malpractice history according to the NCQA? - ANS 180
days
Time limited credential must be verified by the CVO with how may days prior to submission to
the client? - ANS 120 days
According the AAAHC, for initial appointments, in addition to licensure and education, what
verification is required? - ANS Experience and hospital affiliations.
What accreditation body states "The NPDB is an acceptable source for sanctions or limitations
on licensure, Medicaid/ Medicare sanctions and malpractice history? - ANS NCQA
Who is required to query the NPDB? - ANS Hospitals
Is disciplinary action taken against the license of a dentist reportable to the NPDB? - ANS Yes
Under HCQIA a hospital failure to report an adverse privilege action lasting longer than 30 days
may cause the organization to lose HCQIA immunity for how many years? - ANS 3 years
According to NCQA, verification of Medicare/Medicaid sanctions can be queried by any of what
sources? - ANS AMA, FSMB, HIPDB, OIG Sanctions Report, NPDB, State Agency
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
