CPCS Quiz I
- 1.How many peer references does HFAP require at initial appointmen?
- A.
One
- B.
Two
- 2.According to URAC, who should oversee the clinical aspects of the credentialing program within the organization?
- A.
Department chair
- B.
Chief executive officer
- C.
Senior clinical staff person
- 3.Which of the following best determines which procedures should be performed by which specialty?
- A.
ACGME
- B.
Medical school
- C.
Specialty board
- 4.According to NCQA, which of the following credentials must be verified at the time of recredentialing?
- A.
Lifetime board certification
- B.
Hospital privileges
- C.
Current DEA
- 5.Each hospital must request information from the NPDB when a physician applies for which of the following?
- A.
Residency
- B.
Status change
- C.
Clinical privileges
- 6.According to The Joint Commission, ongoing professional practice evaluation (OPPE) should be conducted for which of the following individuals?
- A.
Physician only
- B.
All privileges practitioners
- C.
All allied health practitioners
- 7.According to NCQA, which of the following sources may be used to verify ongoing monitoring of licenses sanctions?
- A.
AMA
- B.
EPLS
- C.
NPDB
- 8.According to NCQA, how often must an organization conduct an audit of the credentialing process delegated to another organization?
- A.
Annually
- B.
Every 2 years
- C.
Every 3 years
- 9.According to AAAHC primary or acceptable secondary source verification is required for which of the following?
- A.
Education and training
- B.
Board certification and license
- C.
Hospital affiliations and work experience
- 10.What type of release should the medical services professional obtain for the release of negative information to another facility?
- A.
Standard release for the organization
- B.
Special release developed by the legal department
- C.
Special release developed by the medical executive committee
- 11.According to NCQA, which of the following sources can be used for verification of state licensure?
- A.
AMA
- B.
FSMB
- C.
State licensing board
- 12.According to URAC, the credentialing application must include which of the following?
- A.
Date of birth
- B.
Social Security number
- C.
Release of information
- 13.According to The Joint Commission, which of the following documents is required to be verified at the time of expiration?
- A.
DEA
- B.
License
- C.
Professional liability insurance
- 14.Which of the following is an essential source when developing a policy regarding the functions of a peer review committee?
- A.
CMS
- B.
HCQIA
- C.
HEDIS
- 15.According to The Joint Commission, which of the following must be evaluated when determining a practitioner's current competence?
- A.
Medicare/Medicaid sanctions
- B.
Evidence of physical ability to perform the requested privilege
- C.
Evidence of compliance with the facility's bylaws, rules, and regulations
- 16.According to NCQA, which of the following verifications must be documented for credentialing?
- A.
Board certification for all levels of training
- B.
DEA license for all states where care is provided
- C.
Hospital privileges with admitting status
- 17.According to NCQA, in which situation should a practitioner be notified about a discrepancy and be required to submit additional information?
- A.
Actions on a license
- B.
Missing peer reference
- C.
Six-year-old malpractice claim
- 18.According to The Joint Commission, which of the following entities may amend the medical staff bylaws?
- A.
Governing body
- B.
Medical Staff
- C.
Medical executive committee
- 19.According to The Joint Commission, a fair hearing and appeals process as described in the medical staff bylaws is available to which of the following?
- A.
Active medical staff members
- B.
All medical staff members
- C.
Medical staff members and non-members holding clinical privileges
- 20.According to NCQA, which of the following providers must be credentialed when working in an independent relationship setting?
- A.
Radiologists
- B.
Chiropractors
- C.
Anesthesiologist
- 21.According to NCQA, which primary source must be utilized to verify licensure?
- A.
State licensing agency
- B.
AMA
- C.
FSMB
- 22.When preparing for a committee meeting, the medical services professional MOST likely would meet with whom to coordinate the agenda and meeting packet?
- A.
Medical director
- B.
Committee chairperson
- C.
Vice president of medical affairs
- 23.Which of the following organizations could a credentialing professional query to obtain a current copy of a practitioner's DEA?
- A.
NTIS
- B.
NPDB
- C.
FSMB
- 24.According to The Joint Commission, which of the following dictates the qualifications and criteria for appointment to the medical staff?
- A.
Credentialing policies and procedures
- B.
Medical executive committee
- C.
Medical staff bylaws
- 25.According to The Joint Commission, which of the following is an approved source for verification of a medical degree from a United States educational Institution?
- A.
ACGME
- B.
ECFMG
- C.
AMA Physician Masterfile
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