CPCS - Certified Provider Credentialing Specialist Exam
Questions AND Correct Answers
A hospital that does not query the databank as required by
HCQIA is what? - ✔✔Legally liable for knowledge of any
information reported.
According the AAAHC, for initial appointments, in addition to
licensure and education, what verification is required? -
✔✔Experience and hospital affiliations.
According to CMS, who in the organization may make
decisions regarding approval of credentialing applications? -
✔✔Governing body/board.
According to NCQA application PSV must be dated within how
many days of the credentialing decision? - ✔✔180 days
According to NCQA how long is a verification of work history
valid? - ✔✔One year
According to NCQA standards, if deficiencies are noted during
a site visit an action plan must be developed. The office site
,must implement the plan within how many months of the
initial visit? - ✔✔Six months
According to NCQA what credential must be verified at the
time or recredentialing? - ✔✔Current malpractice, state
license
According to NCQA, a provisional period is granted for no
longer than how many days? - ✔✔60 days
According to NCQA, how long is the signature on the
attestation good for CVO's? - ✔✔305 days
According to NCQA, how long is the signature on the
attestation good for? - ✔✔365 days
According to NCQA, how often must an organization conduct
an audit of the credentialing process delegated to another
organization? - ✔✔Annually
According to NCQA, practitioners must be notified of
credentialing decisions within how many days? - ✔✔60 days
, According to NCQA, verification of Medicare/Medicaid
sanctions can be queried by any of what sources? - ✔✔AMA,
FSMB, HIPDB, OIG Sanctions Report, NPDB, State Agency
According to NCQA, what requires ongoing monitoring
between credentialing cycles? - ✔✔License sanctions
According to NCQA, what verification is required before
provisional credentialing is permitted? - ✔✔Current license,
five-year malpractice history
According to NCQA, who has ultimate authority in
credentialing decisions? - ✔✔Credentials committee and
medical director if it is a clean file
According to the Joint Commission, a fair hearing and appeals
process as described in the medical staff bylaws is available to
whom? - ✔✔Medical staff members, non-members holding
clinical privileges
Questions AND Correct Answers
A hospital that does not query the databank as required by
HCQIA is what? - ✔✔Legally liable for knowledge of any
information reported.
According the AAAHC, for initial appointments, in addition to
licensure and education, what verification is required? -
✔✔Experience and hospital affiliations.
According to CMS, who in the organization may make
decisions regarding approval of credentialing applications? -
✔✔Governing body/board.
According to NCQA application PSV must be dated within how
many days of the credentialing decision? - ✔✔180 days
According to NCQA how long is a verification of work history
valid? - ✔✔One year
According to NCQA standards, if deficiencies are noted during
a site visit an action plan must be developed. The office site
,must implement the plan within how many months of the
initial visit? - ✔✔Six months
According to NCQA what credential must be verified at the
time or recredentialing? - ✔✔Current malpractice, state
license
According to NCQA, a provisional period is granted for no
longer than how many days? - ✔✔60 days
According to NCQA, how long is the signature on the
attestation good for CVO's? - ✔✔305 days
According to NCQA, how long is the signature on the
attestation good for? - ✔✔365 days
According to NCQA, how often must an organization conduct
an audit of the credentialing process delegated to another
organization? - ✔✔Annually
According to NCQA, practitioners must be notified of
credentialing decisions within how many days? - ✔✔60 days
, According to NCQA, verification of Medicare/Medicaid
sanctions can be queried by any of what sources? - ✔✔AMA,
FSMB, HIPDB, OIG Sanctions Report, NPDB, State Agency
According to NCQA, what requires ongoing monitoring
between credentialing cycles? - ✔✔License sanctions
According to NCQA, what verification is required before
provisional credentialing is permitted? - ✔✔Current license,
five-year malpractice history
According to NCQA, who has ultimate authority in
credentialing decisions? - ✔✔Credentials committee and
medical director if it is a clean file
According to the Joint Commission, a fair hearing and appeals
process as described in the medical staff bylaws is available to
whom? - ✔✔Medical staff members, non-members holding
clinical privileges
