CPCS Exam Review Questions with Verified
Correct Answers
What two accreditors state: a hospital may not rely solely on board certification when
considering practitioner for medical staff membership?
HFAP, CMS
According to JC & HFAP name four approved sources PSV for Medical Education
Medical School, AMA, ECFMG, AOA
According to NCQA practitioners must be notified of credentialing decision within how
many days?
60 Days
The DHHS mails a copy of the NPDB report to the named provider. If the provider
wishes to dispute the reports accuracy, the provider has how many days to do so?
60 Days
According to URAQ, within how many days must the practitioner be notified of
credentialing decisions?
10 Days
How many days does a practitioner have to dispute an NPDB report accuracy
60 Days
Which accrediting body requires five year verification of malpractice history
NCQA
What is commonly used source for verifying malpractice history
,NPDB
According to the JC a fair hearing and appeals process as described in the medical staff
bylaws is available to whom?
Medical staff members and non-members holding clinical privileges
T/F Only the highest of training must be verified according to NCQA
True
According to the Joint Commission a peer recommendation should address what six
competencies?
Medical knowledge\nTechnical & clinical skill\nclinical judgment\ninterpersonal
skills\ncommunication skills\nprofessionalism
Telemedicine - according to JC what two options are available for credentialing a the
original site?
Full credentialing, use of the distant sites credentialing
According to JC what is included in the process of planning and implementing
privileges?
Develop & approve procedure list\nProcess the application\nEvaluate applicant specific
information\nSubmit recommendations to governing body for applicant specific delineated
privileges\nNotify the applicant, relevant personnel\nMonitor the use of privileges
Are payments made by a physician in a malpractice claim reportable to the NPDB?
No
Who requires Peer References
, JC, HFAP, AAAHC
Who reappoints
JC, HFAP, NCQA, URAC
Who requires an attestation?
NCQA, URAC, AAAHC
Who requires education verification?
JC, HFAP, URAC, AAAHC
Who requires statement regarding felony convictions?
HFAP, NCQA, AAAHC
Attestation must state that the information submitted is complete & correct
NCQA, AAAHC
Attestation must state that the information submitted is complete & accurate
URAC
Attestation must include inquiry regarding illegal drug use?
NCAQ
Attestation must include inquiry regarding inability to perform essential functions?
NCQA
Attestation must include inquiry regarding history or loss or limitations of licensure or
privileges or disciplinary actions?
NCQA
Correct Answers
What two accreditors state: a hospital may not rely solely on board certification when
considering practitioner for medical staff membership?
HFAP, CMS
According to JC & HFAP name four approved sources PSV for Medical Education
Medical School, AMA, ECFMG, AOA
According to NCQA practitioners must be notified of credentialing decision within how
many days?
60 Days
The DHHS mails a copy of the NPDB report to the named provider. If the provider
wishes to dispute the reports accuracy, the provider has how many days to do so?
60 Days
According to URAQ, within how many days must the practitioner be notified of
credentialing decisions?
10 Days
How many days does a practitioner have to dispute an NPDB report accuracy
60 Days
Which accrediting body requires five year verification of malpractice history
NCQA
What is commonly used source for verifying malpractice history
,NPDB
According to the JC a fair hearing and appeals process as described in the medical staff
bylaws is available to whom?
Medical staff members and non-members holding clinical privileges
T/F Only the highest of training must be verified according to NCQA
True
According to the Joint Commission a peer recommendation should address what six
competencies?
Medical knowledge\nTechnical & clinical skill\nclinical judgment\ninterpersonal
skills\ncommunication skills\nprofessionalism
Telemedicine - according to JC what two options are available for credentialing a the
original site?
Full credentialing, use of the distant sites credentialing
According to JC what is included in the process of planning and implementing
privileges?
Develop & approve procedure list\nProcess the application\nEvaluate applicant specific
information\nSubmit recommendations to governing body for applicant specific delineated
privileges\nNotify the applicant, relevant personnel\nMonitor the use of privileges
Are payments made by a physician in a malpractice claim reportable to the NPDB?
No
Who requires Peer References
, JC, HFAP, AAAHC
Who reappoints
JC, HFAP, NCQA, URAC
Who requires an attestation?
NCQA, URAC, AAAHC
Who requires education verification?
JC, HFAP, URAC, AAAHC
Who requires statement regarding felony convictions?
HFAP, NCQA, AAAHC
Attestation must state that the information submitted is complete & correct
NCQA, AAAHC
Attestation must state that the information submitted is complete & accurate
URAC
Attestation must include inquiry regarding illegal drug use?
NCAQ
Attestation must include inquiry regarding inability to perform essential functions?
NCQA
Attestation must include inquiry regarding history or loss or limitations of licensure or
privileges or disciplinary actions?
NCQA
