CPCS CURRENT EXAM QUESTIONS AND
VERIFIED ANSWERS
What is the NCQA timeframe for appointment?
LE 60 days
According to TJC who may amend the Medical Staff Bylaws?
Medical Staff
Failure to meet the established qualifications and Criteria for appointment
should be reported to whom?
The applicant
Are limitations of the clinical privileges of a psychiatrist for more than 30 days
reportable to the NPDB?
YES
NCQA requires the MCO to obtain a minimum of ___ years of work history?
5 years
According NCQA what policy must an organization in place to obtain approval
to enter into a delegated agreement?
Credentialing Policies
,How often does the OIG report to the NPDB
Monthly
According to AAAHC, for initial appointments, in addition to licensure and
education, what verification is required ?
Experience and hospital affiliation
Time limited credential must be verified by the CVO within how many 120
daysdays prior to submission to the client?
120 days
For what must hospitals query the NPDB?
Initial appt, granting of privileges, every two years
How many days old can verifications be to meet NCQA requirements?
180
What is the NCQA verification time limit regarding malpractice history?
180 days
, The time limited credential must be verified by the CVO how many days prior
to submission to the client?
120 days
What credentialing organization states "the NPDB is an acceptable source for
sanctions or limitations on licensure, Medicaid/Medicare sanctions and
malpractice history"?
NCQA
Who must query the NPDB?
Hospitals
Is a disciplinary action taken against the license of a dentist reportable to the
NPDB?
Yes
Under HCQIA, a hospital failure to report an adverse privilege action lasting
longer than 30 days may cause the organization to lose HCQIA immunity for
how many years?
3 years
According to NCQA verification of Medicare/Medicaid sanctions can be
queried by any of what sources?
AMA, FSMB, HIPDB, OIG, Sanctions Report, NPDB, State Agency
VERIFIED ANSWERS
What is the NCQA timeframe for appointment?
LE 60 days
According to TJC who may amend the Medical Staff Bylaws?
Medical Staff
Failure to meet the established qualifications and Criteria for appointment
should be reported to whom?
The applicant
Are limitations of the clinical privileges of a psychiatrist for more than 30 days
reportable to the NPDB?
YES
NCQA requires the MCO to obtain a minimum of ___ years of work history?
5 years
According NCQA what policy must an organization in place to obtain approval
to enter into a delegated agreement?
Credentialing Policies
,How often does the OIG report to the NPDB
Monthly
According to AAAHC, for initial appointments, in addition to licensure and
education, what verification is required ?
Experience and hospital affiliation
Time limited credential must be verified by the CVO within how many 120
daysdays prior to submission to the client?
120 days
For what must hospitals query the NPDB?
Initial appt, granting of privileges, every two years
How many days old can verifications be to meet NCQA requirements?
180
What is the NCQA verification time limit regarding malpractice history?
180 days
, The time limited credential must be verified by the CVO how many days prior
to submission to the client?
120 days
What credentialing organization states "the NPDB is an acceptable source for
sanctions or limitations on licensure, Medicaid/Medicare sanctions and
malpractice history"?
NCQA
Who must query the NPDB?
Hospitals
Is a disciplinary action taken against the license of a dentist reportable to the
NPDB?
Yes
Under HCQIA, a hospital failure to report an adverse privilege action lasting
longer than 30 days may cause the organization to lose HCQIA immunity for
how many years?
3 years
According to NCQA verification of Medicare/Medicaid sanctions can be
queried by any of what sources?
AMA, FSMB, HIPDB, OIG, Sanctions Report, NPDB, State Agency
