CPCS Certified Provider Credentialing Specialist Exam Study Questions 2023 Correct Answers – Complete Solution

Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to The Joint Commission, who may amend medical staff bylaws? - Medical Staff Failure to meet the established qualifications and criteria for appointment should be reported to whom? - The applicant NCQA requires the MCO to obtain a minimum of ______ years of work history? - Five years According to NCQA what policy must an organization have in place to obtain approval to enter into a delegated agreement? - Credentialing policies How often does the OIG report to the NPDB? - Monthly Hospitals must query the NPDB when: - Initial appointment, granting of privileges, every two years. NCQA requires verifications be less than how many days old? - 180 What is the verification time limit on malpractice history according to the NCQA? - 180 days Time limited credential must be verified by the CVO within how many days prior to submission to the client? - 120 days According to AAAHC, for initial appointments, in addition to licensure and education, what verification is required? - Experience and hospital affiliation What accreditation body state "the NPDB is an acceptable source for sanctions or limitations on licensure, Medicaid/Medicare sanctions and malpractice history"? - NCQA