Certified Provider Credentialing Specialist
(CPCS) study guide
NCQA time limits on professional liability /malpractice for HP/MBHO -
Correct Answer ✔ ✔ The credentials information must be valid,
current, and no more than 365 calendar days old at the time of the
credentialing
NCQA time limits on professional liability /malpractice for CVO -
Correct Answer ✔ ✔ The credentials information must be valid,
current, and verified within 305 calendar days prior to submission to
each client.
Verification of professional liability/ malpractice coverage according
to CMS - Correct Answer ✔ ✔ PSV is not required, the
requirement for professional liability coverage is common in
healthcare , thus verification of coverage is appropriate.
, Verification of malpractice history according to TJC. - Correct Answer
✔ ✔ The standards are silent regarding the specific method to
accomplish this requirement , but it is suggested that the organized
medical staff evaluate any evidence of unusual pattern or excessive
numbers of professional liability actions resulting in a final judgment.
Verification of malpractice history according to NCQA - Correct
Answer ✔ ✔ The applicant must provide at least a five-year
history of malpractice settlements or judgments. This information is
to be verified either through written comfirmation from the
Malpractice carrier or through the NPDB.
NCQA malpractice verification time limits for HP/ MBHO - Correct
Answer ✔ ✔ 180 days
NCQA malpractice verification time limits for CVO - Correct Answer
✔ ✔ 120 days
(CPCS) study guide
NCQA time limits on professional liability /malpractice for HP/MBHO -
Correct Answer ✔ ✔ The credentials information must be valid,
current, and no more than 365 calendar days old at the time of the
credentialing
NCQA time limits on professional liability /malpractice for CVO -
Correct Answer ✔ ✔ The credentials information must be valid,
current, and verified within 305 calendar days prior to submission to
each client.
Verification of professional liability/ malpractice coverage according
to CMS - Correct Answer ✔ ✔ PSV is not required, the
requirement for professional liability coverage is common in
healthcare , thus verification of coverage is appropriate.
, Verification of malpractice history according to TJC. - Correct Answer
✔ ✔ The standards are silent regarding the specific method to
accomplish this requirement , but it is suggested that the organized
medical staff evaluate any evidence of unusual pattern or excessive
numbers of professional liability actions resulting in a final judgment.
Verification of malpractice history according to NCQA - Correct
Answer ✔ ✔ The applicant must provide at least a five-year
history of malpractice settlements or judgments. This information is
to be verified either through written comfirmation from the
Malpractice carrier or through the NPDB.
NCQA malpractice verification time limits for HP/ MBHO - Correct
Answer ✔ ✔ 180 days
NCQA malpractice verification time limits for CVO - Correct Answer
✔ ✔ 120 days
