CPCS Certified Provider Credentialing Specialist Questions
AND Correct Answers
10 days - ✔✔Organizations notified of a conditional
accreditation decision have how many business days to
request a re-examination of the survey findings?
15 days - ✔✔Adverse actions affecting clinical privileges
report should be submitted to the state and NPDB within how
many days of the action?
2 years - ✔✔NCQA grants a CVO certification for a period of
how long?
3 years, 1 year, denial - ✔✔What are the categories of
possible NCQA accreditation?
30 days - ✔✔Adverse actions affecting clinical privileges for a
period longer than how many days must be reported to the
NPDB?
30 days - ✔✔Within how many days of a licensure disciplinary
action, based on reasons related to professional conduct,
must the licensing board report to the NPDB?
, Approval of Provisional Credentialing - NCQA - ✔✔If the file
meets the organization's definition of a "clean file", the
Medical Director can approve.
Bell v Sharp Carbrillo Hospital, California 1989 - ✔✔Negligent
credentialing. Hospital liable for failure to request data from
another hospital regarding it's summary suspension of
practitioner.
Boyd v Albert Einstein Hospital, 1988 - ✔✔Doctrine of
ostensible agency. HMO found liable in patient's death. Chest
perforation during biopsy, chest pain/MI six weeks later.
CAHPS - ✔✔What does NCQA call a core survey administered
separately to commercially insurance Medicare and Medicaid
populations?
CMS - ✔✔Which agency requires a Medicare attestation?
Committee Chair - ✔✔When preparing for a committee
meeting, who would the MSP most likely meet with to
coordinate the agenda and meeting packet?
AND Correct Answers
10 days - ✔✔Organizations notified of a conditional
accreditation decision have how many business days to
request a re-examination of the survey findings?
15 days - ✔✔Adverse actions affecting clinical privileges
report should be submitted to the state and NPDB within how
many days of the action?
2 years - ✔✔NCQA grants a CVO certification for a period of
how long?
3 years, 1 year, denial - ✔✔What are the categories of
possible NCQA accreditation?
30 days - ✔✔Adverse actions affecting clinical privileges for a
period longer than how many days must be reported to the
NPDB?
30 days - ✔✔Within how many days of a licensure disciplinary
action, based on reasons related to professional conduct,
must the licensing board report to the NPDB?
, Approval of Provisional Credentialing - NCQA - ✔✔If the file
meets the organization's definition of a "clean file", the
Medical Director can approve.
Bell v Sharp Carbrillo Hospital, California 1989 - ✔✔Negligent
credentialing. Hospital liable for failure to request data from
another hospital regarding it's summary suspension of
practitioner.
Boyd v Albert Einstein Hospital, 1988 - ✔✔Doctrine of
ostensible agency. HMO found liable in patient's death. Chest
perforation during biopsy, chest pain/MI six weeks later.
CAHPS - ✔✔What does NCQA call a core survey administered
separately to commercially insurance Medicare and Medicaid
populations?
CMS - ✔✔Which agency requires a Medicare attestation?
Committee Chair - ✔✔When preparing for a committee
meeting, who would the MSP most likely meet with to
coordinate the agenda and meeting packet?
