CPCS Practice Exam Questions With
Correct Answers
Why |is |it |important |to |check |that |the |practitioner |is |not |currently |excluded, |suspended, |
debarred, |or |ineligible |to |participate |in |Federal |health |care |programs? |- |CORRECT |
ANSWER✔✔-a. |A |facility |could |lose |its |accreditation |if |it |does |not |do |so
b. |It |is |required |by |Medicare |Conditions |or |Participation
c. |The |facility |won't |get |paid |for |treating |patients |unless |service |is |provided |by |an |authorized |
provider.
Which |of |the |following |credentials |must |be |tracked |on |an |ongoing |basis? |- |CORRECT |
ANSWER✔✔-a. |Post |graduate |education |completed
b. |Closed |medical |malpractice |claims
c. |Licensure.
According |to |NCQA |standards, |an |organization |that |discovers |sanction |information, |complaints,
|or |adverse |events |regarding |a |practitioner |must |take |what |action? |- |CORRECT |ANSWER✔✔-a. |
Determine |if |there |is |evidence |of |poor |quality |that |could |affect |the |health |and |safety |of |its |
members. |
b. |Immediately |take |action |to |remove |the |provider |from |its |panel
c. |Notify |the |practitioner |that |he/she |is |under |investigation |and |initiate |the |hearing |process
What |is |the |name |of |the |entity |that |was |established |through |the |Health |Care |Quality |
Improvement |Act |of |1986 |to |restrict |the |ability |of |incompetent |practitioners |to |move |from |
state |to |state |without |disclosure |or |discovery |of |previous |medical |malpractice |payment |and |
adverse |action |history? |- |CORRECT |ANSWER✔✔-a. |Emergency |Medical |Treatment |and |Active |
Labor |Act
,b. |The |National |Practitioner |Data |Bank.
c. |The |Patient |Safety |and |Quality |Improvement |Act
When |developing |clinical |privileging |criteria, |which |of |the |following |is |important |to |evaluate? |-
|CORRECT |ANSWER✔✔-a. |How |many |providers |are |in |that |specialty
b. |Established |standards |of |practice, |such |as |specialty |board |recommendations. |
c. |Whether |or |not |the |quality |department |can |support |the |FPPE |process
What |is |the |main |reason |for |periodically |assessing |appropriateness |of |clinical |privileges |of |
each |specialty? |- |CORRECT |ANSWER✔✔-a. |It |is |required |by |accreditation |standards
b. |It |is |required |by |the |Medicare |Conditions |of |Participation
c. |To |protect |patient |safety |by |ensuring |current |competency, |relevance |to |the |facility, |and |
accepted |standards |of |care.
Which |of |the |following |specialists |is |most |likely |to |perform |a |PTCA? |- |CORRECT |ANSWER✔✔-a.
|OB/GYN
b. |Urologist
c. |Interventional |Cardiologist.
(PTCA |= |Percutaneous |transluminal |coronary |angioplasty |aka |stent |placement)
The |Joint |Commission |hospital |standards |require |that |clinical |privileges |are |hospital |specific |
and... |- |CORRECT |ANSWER✔✔-a. |Based |on |the |individual's |demonstrated |current |competence |
and |the |procedures |the |hospital |can |support. |
b. |Based |on |board |certification
c. |Based |on |the |privileges |the |individual |is |currently |approved |to |perform |at |other |hospitals
Which |of |the |following |would |be |routinely |performed |by |a |cardiologist? |- |CORRECT |
ANSWER✔✔-a. |Hysterectomy
, b. |Transesophageal |Echocardiography.
c. |Urethral |dilation
Which |NCQA-required |committee |makes |recommendations |regarding |credentialing |decisions?
|- |CORRECT |ANSWER✔✔-a. |Medical |Executive |Committee
b. |Quality |Care |Committee
c. |Credentialing |Committee.
HFAP |standards |require |which |three |medical |staff |committees |to |be |delineated |in |the |medical |
staff |structure? |- |CORRECT |ANSWER✔✔-a. |Medical |Executive |Committee.
b. |Utilization |of |Osteopathic |Methods |& |Concepts |Committee. |(required |for |hospitals |with |ten |
or |more |DOs |who |admit |patients |and |provide |direct |patient |care)
c. |Utilization |Review |Committee.
d. |Credentials |Committee
e. |Investigational |Review |Board
How |often |does |NCQA |require |that |delegation |reports |be |evaluated |by |the |health |plan? |- |
CORRECT |ANSWER✔✔-a. |Monthly
b. |Quarterly
c. |Semi-Annually.
Peer |references |should |be |obtained |from: |- |CORRECT |ANSWER✔✔-a. |Practitioners |who |have |
referred |patients |to |the |provider
b. |Former |hospital |administrators
c. |Practitioners |in |the |same |professional |discipline |as |the |applicant.
NCQA |recognizes |which |of |the |following |as |the |final |approval |of |an |applicant |who |does |not |
meet |criteria |for |a |clean |file? |- |CORRECT |ANSWER✔✔-a. |Medical |Director
Correct Answers
Why |is |it |important |to |check |that |the |practitioner |is |not |currently |excluded, |suspended, |
debarred, |or |ineligible |to |participate |in |Federal |health |care |programs? |- |CORRECT |
ANSWER✔✔-a. |A |facility |could |lose |its |accreditation |if |it |does |not |do |so
b. |It |is |required |by |Medicare |Conditions |or |Participation
c. |The |facility |won't |get |paid |for |treating |patients |unless |service |is |provided |by |an |authorized |
provider.
Which |of |the |following |credentials |must |be |tracked |on |an |ongoing |basis? |- |CORRECT |
ANSWER✔✔-a. |Post |graduate |education |completed
b. |Closed |medical |malpractice |claims
c. |Licensure.
According |to |NCQA |standards, |an |organization |that |discovers |sanction |information, |complaints,
|or |adverse |events |regarding |a |practitioner |must |take |what |action? |- |CORRECT |ANSWER✔✔-a. |
Determine |if |there |is |evidence |of |poor |quality |that |could |affect |the |health |and |safety |of |its |
members. |
b. |Immediately |take |action |to |remove |the |provider |from |its |panel
c. |Notify |the |practitioner |that |he/she |is |under |investigation |and |initiate |the |hearing |process
What |is |the |name |of |the |entity |that |was |established |through |the |Health |Care |Quality |
Improvement |Act |of |1986 |to |restrict |the |ability |of |incompetent |practitioners |to |move |from |
state |to |state |without |disclosure |or |discovery |of |previous |medical |malpractice |payment |and |
adverse |action |history? |- |CORRECT |ANSWER✔✔-a. |Emergency |Medical |Treatment |and |Active |
Labor |Act
,b. |The |National |Practitioner |Data |Bank.
c. |The |Patient |Safety |and |Quality |Improvement |Act
When |developing |clinical |privileging |criteria, |which |of |the |following |is |important |to |evaluate? |-
|CORRECT |ANSWER✔✔-a. |How |many |providers |are |in |that |specialty
b. |Established |standards |of |practice, |such |as |specialty |board |recommendations. |
c. |Whether |or |not |the |quality |department |can |support |the |FPPE |process
What |is |the |main |reason |for |periodically |assessing |appropriateness |of |clinical |privileges |of |
each |specialty? |- |CORRECT |ANSWER✔✔-a. |It |is |required |by |accreditation |standards
b. |It |is |required |by |the |Medicare |Conditions |of |Participation
c. |To |protect |patient |safety |by |ensuring |current |competency, |relevance |to |the |facility, |and |
accepted |standards |of |care.
Which |of |the |following |specialists |is |most |likely |to |perform |a |PTCA? |- |CORRECT |ANSWER✔✔-a.
|OB/GYN
b. |Urologist
c. |Interventional |Cardiologist.
(PTCA |= |Percutaneous |transluminal |coronary |angioplasty |aka |stent |placement)
The |Joint |Commission |hospital |standards |require |that |clinical |privileges |are |hospital |specific |
and... |- |CORRECT |ANSWER✔✔-a. |Based |on |the |individual's |demonstrated |current |competence |
and |the |procedures |the |hospital |can |support. |
b. |Based |on |board |certification
c. |Based |on |the |privileges |the |individual |is |currently |approved |to |perform |at |other |hospitals
Which |of |the |following |would |be |routinely |performed |by |a |cardiologist? |- |CORRECT |
ANSWER✔✔-a. |Hysterectomy
, b. |Transesophageal |Echocardiography.
c. |Urethral |dilation
Which |NCQA-required |committee |makes |recommendations |regarding |credentialing |decisions?
|- |CORRECT |ANSWER✔✔-a. |Medical |Executive |Committee
b. |Quality |Care |Committee
c. |Credentialing |Committee.
HFAP |standards |require |which |three |medical |staff |committees |to |be |delineated |in |the |medical |
staff |structure? |- |CORRECT |ANSWER✔✔-a. |Medical |Executive |Committee.
b. |Utilization |of |Osteopathic |Methods |& |Concepts |Committee. |(required |for |hospitals |with |ten |
or |more |DOs |who |admit |patients |and |provide |direct |patient |care)
c. |Utilization |Review |Committee.
d. |Credentials |Committee
e. |Investigational |Review |Board
How |often |does |NCQA |require |that |delegation |reports |be |evaluated |by |the |health |plan? |- |
CORRECT |ANSWER✔✔-a. |Monthly
b. |Quarterly
c. |Semi-Annually.
Peer |references |should |be |obtained |from: |- |CORRECT |ANSWER✔✔-a. |Practitioners |who |have |
referred |patients |to |the |provider
b. |Former |hospital |administrators
c. |Practitioners |in |the |same |professional |discipline |as |the |applicant.
NCQA |recognizes |which |of |the |following |as |the |final |approval |of |an |applicant |who |does |not |
meet |criteria |for |a |clean |file? |- |CORRECT |ANSWER✔✔-a. |Medical |Director
