1|Page
CPCS EXAM NEWEST 2025 ACTUAL EXAM TEST
BANK| CERTIFIED PROVIDER CREDENTIALING
SPECIALIST FINAL EXAM REVIEW WITH 450 REAL
EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
What accrediting body states that surgical privileges shall correspond
with the established competencies of each practitioner?
a. URAC
b. TJC
c. DNV – Correct Answer - DNV
This accrediting body uses the language “substance abuse” in their
standard regarding ability to perform
a. NCQA
b. AAAHC
c. URAC – Correct Answer - URAC
This accrediting body uses the language “chemical dependency” in their
standard regarding ability to perform
a. AAAHC
b. URAC
c. NCQA – Correct Answer - AAAHC
pg. 1
,2|Page
At what time(s) does AAAHC consider ability to perform?
a. Initial and Reappointment
b. Reappointment
c. Initial Appointment – Correct Answer - Initial and Reappointment
What accrediting body requires qualifications and competence of non
physician’s to be assessed prior to providing care?
a. HFAP
b. The Joint Commission
c. URAC – Correct Answer - The Joint Commission
According to the Joint Commission, the equivalent medical staff process
for non-physicians must be approved by
a. Credentials Committee
b. Medical Executive Committee
c. Governing Board – Correct Answer - Governing Board
HFAP standards regarding Allied Health/Non Physicians are a direct
quote from what regulatory agency?
a. The Joint Commission
b. CMS Managed Care Manual
c. CMS COPs – Correct Answer - CMS COPs
pg. 2
,3|Page
CMS COPs state that medical staff categories eligible for appointment
are determined by
a. Credentials Committee
b. Governing Board
c. Standing Committee – Correct Answer - Governing Board
According to CMS COP's who has the authority, in accordance with
state law, to grant medical staff privileges and membership to non-
physician practitioners?
a. Director of Medical Staff
b. Chief of Medical Staff
c. Governing Board – Correct Answer - Governing Board
Which accrediting body states there must be a mechanism to determine
the applicant is the individual identified in the credentialing documents
by viewing a hospital ID or driver's license?
a. DNV
b. HFAP
c. TJC – Correct Answer - TJC
What two capabilities must be present to remotely verify a provider's
identity according to Joint Commission Standards?
a. Notary and certified mail
b. Audio and video
pg. 3
, 4|Page
c. Visual and hearing impairment services – Correct Answer - Audio and
Video
Which accrediting body states that appointments are not to exceed two
years and are measured by the day?
a. HFAP
b. TJC
c. URAC – Correct Answer - TJC
Which accrediting bodies state providers must be recredentialed at least
every 3 years and is measured by the month
a. DNV & NCQA
b. CMS Managed Care & NCQA
c. NCQA & URAC – Correct Answer - NCQA & URAC
This accrediting body quotes CMS COPs stating that reappraisals must
be conducted at least every 24 months for each practitioner
a. HFAP
b. DNV
c. TJC – Correct Answer - HFAP
According to HFAP – information regarding ability to perform is
requested for each
pg. 4
CPCS EXAM NEWEST 2025 ACTUAL EXAM TEST
BANK| CERTIFIED PROVIDER CREDENTIALING
SPECIALIST FINAL EXAM REVIEW WITH 450 REAL
EXAM QUESTIONS AND CORRECT VERIFIED
ANSWERS/ ALREADY GRADED A+ (MOST RECENT!!)
What accrediting body states that surgical privileges shall correspond
with the established competencies of each practitioner?
a. URAC
b. TJC
c. DNV – Correct Answer - DNV
This accrediting body uses the language “substance abuse” in their
standard regarding ability to perform
a. NCQA
b. AAAHC
c. URAC – Correct Answer - URAC
This accrediting body uses the language “chemical dependency” in their
standard regarding ability to perform
a. AAAHC
b. URAC
c. NCQA – Correct Answer - AAAHC
pg. 1
,2|Page
At what time(s) does AAAHC consider ability to perform?
a. Initial and Reappointment
b. Reappointment
c. Initial Appointment – Correct Answer - Initial and Reappointment
What accrediting body requires qualifications and competence of non
physician’s to be assessed prior to providing care?
a. HFAP
b. The Joint Commission
c. URAC – Correct Answer - The Joint Commission
According to the Joint Commission, the equivalent medical staff process
for non-physicians must be approved by
a. Credentials Committee
b. Medical Executive Committee
c. Governing Board – Correct Answer - Governing Board
HFAP standards regarding Allied Health/Non Physicians are a direct
quote from what regulatory agency?
a. The Joint Commission
b. CMS Managed Care Manual
c. CMS COPs – Correct Answer - CMS COPs
pg. 2
,3|Page
CMS COPs state that medical staff categories eligible for appointment
are determined by
a. Credentials Committee
b. Governing Board
c. Standing Committee – Correct Answer - Governing Board
According to CMS COP's who has the authority, in accordance with
state law, to grant medical staff privileges and membership to non-
physician practitioners?
a. Director of Medical Staff
b. Chief of Medical Staff
c. Governing Board – Correct Answer - Governing Board
Which accrediting body states there must be a mechanism to determine
the applicant is the individual identified in the credentialing documents
by viewing a hospital ID or driver's license?
a. DNV
b. HFAP
c. TJC – Correct Answer - TJC
What two capabilities must be present to remotely verify a provider's
identity according to Joint Commission Standards?
a. Notary and certified mail
b. Audio and video
pg. 3
, 4|Page
c. Visual and hearing impairment services – Correct Answer - Audio and
Video
Which accrediting body states that appointments are not to exceed two
years and are measured by the day?
a. HFAP
b. TJC
c. URAC – Correct Answer - TJC
Which accrediting bodies state providers must be recredentialed at least
every 3 years and is measured by the month
a. DNV & NCQA
b. CMS Managed Care & NCQA
c. NCQA & URAC – Correct Answer - NCQA & URAC
This accrediting body quotes CMS COPs stating that reappraisals must
be conducted at least every 24 months for each practitioner
a. HFAP
b. DNV
c. TJC – Correct Answer - HFAP
According to HFAP – information regarding ability to perform is
requested for each
pg. 4
