CPCS EXAM Questions and Answers
Verified Solutions Latest Update
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:
According to URAC, within how many days must the practitioner be notified of
credentialing decisions?
Answer:
10 Days
Question:
How many days does a practitioner have to dispute an NPDB report accuracy?
Answer:
60 Days
Question:
Which accrediting body requires five year verification of malpractice history?
Answer:
NCQA
Verified Solutions Latest Update
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:
According to URAC, within how many days must the practitioner be notified of
credentialing decisions?
Answer:
10 Days
Question:
How many days does a practitioner have to dispute an NPDB report accuracy?
Answer:
60 Days
Question:
Which accrediting body requires five year verification of malpractice history?
Answer:
NCQA
