CPCS CERTIFIED PROVIDER
CREDENTIALING SPECIALIST PRACTICE
SET 2026 CORE TOPICS QUESTIONS
ANSWERS HIGH YIELD A+
◉ When an applicant for membership or privileges with a clean
application is awaiting approval of MEC and the governing body,
temporary privileges may be granted for a limited time not to exceed
how many days?
Answer: 120 days
◉ Medical malpractice payers may query the NPDB. (T/F)
Answer: False
◉ Name two sources of verification of education of a chiropractor
according to NCQA.
Answer: Chiropractic college, state licensing agency
◉ TJC requires PSV of board certification. (T/F)
Answer: False
◉ According to URAC, what must be verified using primary source?
,Answer: State licensure, highest level of education
◉ According to TJC, who has the ultimate authority in credentialing
decisions?
Answer: Governing body/board.
◉ According to NCQA, a provisional period is granted for no longer
than how many days?
Answer: 60 days
◉ According to NCQA, what verification is required before
provisional credentialing is permitted?
Answer: Current license, five-year malpractice history
◉ NCQA requires an attestation of good health and competence to
perform essential functions. How is this achieved?
Answer: Signed attestation
◉ Within how many days must a medical malpractice payer report
payment resulting from written claim or judgment to the NPDB &
state licensing board?
Answer: 30 days
,◉ According to TJC, appointment or reappointment to the medical
staff and granting, renewal or revision of clinical privileges are made
for a period of how long?
Answer: No more than two years
◉ According to NCQA how long is a verification of work history
valid?
Answer: One year
◉ What came first HIPDB or NPDB?
Answer: HIPDB
◉ According to NCQA, how long is the signature on the attestation
good for?
Answer: 365 days
◉ According to NCQA, how long is the signature on the attestation
good for CVO's?
Answer: 305 days
◉ What is the verification time limit for verification of
Medicare/Medicaid sanctions according to NCQA?
Answer: 180 days
, ◉ How often does AAAHC require recredentialing?
Answer: At least every three years
◉ According to URAC, who should oversee the clinical aspects of the
credentialing program within the organization?
Answer: Senior clinical staff person
◉ Name three sources of verification of education of a dentist
according to NCQA.
Answer: Dental school, specialty board, state licensing board
◉ NCQA requires MCO's to recredential practitioners at least
every___________?
Answer: 3 years
◉ HFAP is commonly known as what?
Answer: AOA, an osteopathic organization
◉ No accreditation body requires verification of malpractice
insurance. (T/F)
Answer: True
CREDENTIALING SPECIALIST PRACTICE
SET 2026 CORE TOPICS QUESTIONS
ANSWERS HIGH YIELD A+
◉ When an applicant for membership or privileges with a clean
application is awaiting approval of MEC and the governing body,
temporary privileges may be granted for a limited time not to exceed
how many days?
Answer: 120 days
◉ Medical malpractice payers may query the NPDB. (T/F)
Answer: False
◉ Name two sources of verification of education of a chiropractor
according to NCQA.
Answer: Chiropractic college, state licensing agency
◉ TJC requires PSV of board certification. (T/F)
Answer: False
◉ According to URAC, what must be verified using primary source?
,Answer: State licensure, highest level of education
◉ According to TJC, who has the ultimate authority in credentialing
decisions?
Answer: Governing body/board.
◉ According to NCQA, a provisional period is granted for no longer
than how many days?
Answer: 60 days
◉ According to NCQA, what verification is required before
provisional credentialing is permitted?
Answer: Current license, five-year malpractice history
◉ NCQA requires an attestation of good health and competence to
perform essential functions. How is this achieved?
Answer: Signed attestation
◉ Within how many days must a medical malpractice payer report
payment resulting from written claim or judgment to the NPDB &
state licensing board?
Answer: 30 days
,◉ According to TJC, appointment or reappointment to the medical
staff and granting, renewal or revision of clinical privileges are made
for a period of how long?
Answer: No more than two years
◉ According to NCQA how long is a verification of work history
valid?
Answer: One year
◉ What came first HIPDB or NPDB?
Answer: HIPDB
◉ According to NCQA, how long is the signature on the attestation
good for?
Answer: 365 days
◉ According to NCQA, how long is the signature on the attestation
good for CVO's?
Answer: 305 days
◉ What is the verification time limit for verification of
Medicare/Medicaid sanctions according to NCQA?
Answer: 180 days
, ◉ How often does AAAHC require recredentialing?
Answer: At least every three years
◉ According to URAC, who should oversee the clinical aspects of the
credentialing program within the organization?
Answer: Senior clinical staff person
◉ Name three sources of verification of education of a dentist
according to NCQA.
Answer: Dental school, specialty board, state licensing board
◉ NCQA requires MCO's to recredential practitioners at least
every___________?
Answer: 3 years
◉ HFAP is commonly known as what?
Answer: AOA, an osteopathic organization
◉ No accreditation body requires verification of malpractice
insurance. (T/F)
Answer: True
