CPCS EXAM 318 REVIEW SHEET COMPLETE QUESTIONS ANSWERS GRADED A PLUS
Question:
What accreditation body states "the NPDB is an acceptable source for sanctions or limitations on
licensure, Medicaid/Medicare sanctions and malpractice history?
Answer:
NCQA
Question:
Who is required to query the NPDB
Answer:
Hospitals
Question:
Is disciplinary action taken against the license of a dentist reportable to the NPDB?
Answer:
Yes
Question:
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?
Answer:
3 years
,Question:
According to NCQA verification of Medicare/Medicaid sanctions can be queried by any of what
sources?
Answer:
AMA, FSMB, HIPDB, OIG, Sanctions Report, NPDB, State Agency
Question:
According to NCQA, how often must an organization conduct an audit of the credentialing process
delegated to another organization?
Answer:
Annually
Question:
How far back does the Joint Commission require evaluation of malpractice history?
Answer:
Back to Medical School
Question:
According to JC, what source may be used to verify malpractice history?
Answer:
NPDB
Question:
Is an internet verification from a website not contracted by the primary source that attest to the
accuracy and timeliness of the information considered a complete verification by NCQA?
Answer:
No
,Question:
What accreditation bodies require privileges to be distributed to essential department personnnel?
Answer:
Joint Commission - CMS
Question:
Who requires background checks?
Answer:
HFAP (the only organization that requires)
Question:
Is a payment made by an insurance company reportable to the NPDB?
Answer:
Yes
Question:
According to NCQA what providers are NOT required to be credentialed when working in an
independent relationship?
Answer:
Locum Tenens\nHospital based practitioners (i.e., anesthesia, pathology, radiology, etc.)
Question:
Is denial of a medical license application by a state medical board reportable to the NPDB
Answer:
Yes
, Question:
Telemedicine - according to JC what two options are available for credentialing at the originating
site?
Answer:
Full credentialing\nUse of the distant sites credentialing
Question:
What two accreditors state: a hospital may not rely solely on board certification when considering
practitioner for medical staff membership
Answer:
HFAP, CMS
Question:
According to who? Medical School, AMA, ECFMG, AOA are approves sources of medical
education?
Answer:
JC, HFAP
Question:
According to NCQA practitioners must be notified of credentialing decision within how many days?
Answer:
60 Days
Question:
How long does a named provider have to dispute the accuracy of an NPDB report?
Answer:
60 Days
Question:
What accreditation body states "the NPDB is an acceptable source for sanctions or limitations on
licensure, Medicaid/Medicare sanctions and malpractice history?
Answer:
NCQA
Question:
Who is required to query the NPDB
Answer:
Hospitals
Question:
Is disciplinary action taken against the license of a dentist reportable to the NPDB?
Answer:
Yes
Question:
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?
Answer:
3 years
,Question:
According to NCQA verification of Medicare/Medicaid sanctions can be queried by any of what
sources?
Answer:
AMA, FSMB, HIPDB, OIG, Sanctions Report, NPDB, State Agency
Question:
According to NCQA, how often must an organization conduct an audit of the credentialing process
delegated to another organization?
Answer:
Annually
Question:
How far back does the Joint Commission require evaluation of malpractice history?
Answer:
Back to Medical School
Question:
According to JC, what source may be used to verify malpractice history?
Answer:
NPDB
Question:
Is an internet verification from a website not contracted by the primary source that attest to the
accuracy and timeliness of the information considered a complete verification by NCQA?
Answer:
No
,Question:
What accreditation bodies require privileges to be distributed to essential department personnnel?
Answer:
Joint Commission - CMS
Question:
Who requires background checks?
Answer:
HFAP (the only organization that requires)
Question:
Is a payment made by an insurance company reportable to the NPDB?
Answer:
Yes
Question:
According to NCQA what providers are NOT required to be credentialed when working in an
independent relationship?
Answer:
Locum Tenens\nHospital based practitioners (i.e., anesthesia, pathology, radiology, etc.)
Question:
Is denial of a medical license application by a state medical board reportable to the NPDB
Answer:
Yes
, Question:
Telemedicine - according to JC what two options are available for credentialing at the originating
site?
Answer:
Full credentialing\nUse of the distant sites credentialing
Question:
What two accreditors state: a hospital may not rely solely on board certification when considering
practitioner for medical staff membership
Answer:
HFAP, CMS
Question:
According to who? Medical School, AMA, ECFMG, AOA are approves sources of medical
education?
Answer:
JC, HFAP
Question:
According to NCQA practitioners must be notified of credentialing decision within how many days?
Answer:
60 Days
Question:
How long does a named provider have to dispute the accuracy of an NPDB report?
Answer:
60 Days
