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CERTIFIED PROVIDER CREDENTIALING SPECIALIST STUDY GUIDE 2026 VERIFIED QUESTION SET AND SOLUTIONS

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CERTIFIED PROVIDER CREDENTIALING SPECIALIST STUDY GUIDE 2026 VERIFIED QUESTION SET AND SOLUTIONS

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CERTIFIED PROVIDER CREDENTIALING
SPECIALIST STUDY GUIDE 2026 VERIFIED
QUESTION SET AND SOLUTIONS

◉ 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


◉ According to TJC, which of the following should be used to verify
current competence? Board certification, malpractice face sheet,
hospital verification or patient complaint record.
Answer: Hospital verification


◉ According to NCQA, who has ultimate authority in credentialing
decisions?
Answer: Credentials committee and medical director if it is a clean
file


◉ What two entities does EMTALA not apply?
Answer: Military and Shriners


◉ Do TJC or NCQA require date stamping?
Answer: No


◉ What does NCQA require in place of date stamping?

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