CPCS – CERTIFIED PROVIDER
CREDENTIALING SPECIALIST EXAM
(ACTUAL EXAM) WITH QUESTIONS WITH
VERY ELABORATED ANSWERS CORRECTRY
WELL ORGANIZED LATEST 2024 – 2025
ALREADY GRADED A+
NCQA requires MCO's to recredential practitioners at least every___________? -
ANSWERS-3 years
HFAP is commonly known as what? - ANSWERS-AOA, an osteopathic organization
No accreditation body requires verification of malpractice insurance. (T/F) -
ANSWERS-True
, According to TJC, which of the following should be used to verify current
competence? Board certification, malpractice face sheet, hospital verification or
patient complaint record. - ANSWERS-Hospital verification
NCQA requires the MCO to obtain a minimum of how may years of work history? -
ANSWERS-Five years
According to the NCQA what policy must an organization have in place to obtain
approval to enter into a delegated agreement? - ANSWERS-Credentialing policies
How often does the OIG report to the NPDB? - ANSWERS-Monthly
Are limitations of the clinical privileges of a psychiatrist for more than 30 days
reportable to the NPDB? - ANSWERS-Yes
According to TJC, who may amend the medical staff bylaws? - ANSWERS-
Governing body/board.
Failure to meet the established qualifications and criteria for appointment should
be reported to whom? - ANSWERS-The applicant
When must hospitals query the NPDB? - ANSWERS-Initial appointment, granting
of privileges, every two years.
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