CPCS Quiz I

40 Questions | Total Attempts: 1513

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CPCS Quiz I


Questions and Answers
  • 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