CPCS Exam as of June 2026
Study online at https://quizlet.com/_faxvjd
1. The main ones are NCQA and URAC: Health Plan/Managed Care Organization
(MCO)
2. For HFAP and TJC, Nurse Practitioners and Physician Assistants are re-
quired to have either a or agreement, per State
regulations, with a physician who holds the same privileges.: Collaborative or
Supervisory
3. Details what med staff appointees can/cannot do, specific for clinical
processes, includes rules for each department, requirements for ER coverage
for unassigned patients, guidelines for obtaining consultation, provisions for
LOA, med records completion, call coverage, meeting attendance, etc: Rules
and Regulations
4. Require that bylaws must describe the qualifications required of a candidate
in order for the medical staff to recommend appointment to the governing
body.: Medicare CoPs
5. AAAHC is the accrediting body for what type of facility?: ambulatory care
6. Who determines whether to grant, deny, continue, revise, discontinue, limit,
or revoke, specified privileges, including medical staff membership, for a
specific practitioner after considering the recommendation of the medical
staff?: The governing body
7. Membership requirements set by forces outside the organization are called
what? This includes accrediting and certifying bodies, such as TJC, HFAP,
DNV, AAAHC, NCQA, URAC: External criteria
8. Factors defined by the hospitals, medical staff, and Governing board or the
MCO board and credentialing committee: Internal criteria
9. The amount of days that NCQA requires that notification to practitioners of
credentialing and recredentialing decisions.: 60 days
10. Per CoPs, the governing body must include in the bylaws criteria for
determining the privileges that may be granted to individual practitioners
based on their: (hint: C, C T, E, J): Character, competence, training, experience,
and judgment.
11. Applicant must submit a statement that no health problems exist; on initial
appt., this statement should be confirmed by a director of training program,
chief of services, or chief of staff at another hospital where the applicant holds
privileges, or an MD/DO approved by medical staff. Medical staff can require
evaluation by external/internal source.: TJC standard for Ability to Perform Clini-
cal Privileges Requested (Health Status)
12. There is a current signed attestation from the application regarding rea-
sons for any inability to perform the essential functions of the position, with
, CPCS Exam as of June 2024
Study online at https://quizlet.com/_faxvjd
or without accommodation, and the lack of present illegal drug use.: NCQA
standard for Ability to Perform Clinical Privileges Requested (Health Status)
13. Health status is considered for each (re)applicant during review & approval
process. Info can come from peers who are familiar with the reapplicants prac-
tice; peer review activities or reviews by the credentials committee, depart-
ment chair, or MEC.: HFAP (Acute Care Hospital) standard for Ability to Perform
Clinical Privileges Requested (Health Status)
14. Surveyors will validate the hospital's method for reviewing practitioner's
surgical privileges to determine if the process includes required verification of
practitioner's training, experience, health status, and performance. Surveyor
must confirm that organization provides a roster of each practitioner's surgi-
cal privileges that is available in the surgery suite and scheduling, including
a list of surgeons suspended from performing surgery/have restricted privi-
leges.: DNV standard for Ability to Perform Clinical Privileges Requested (Health
Status)
15. App includes disclosure of any physical, mental, substance abuse prob-
lems that could, without reasonable accommodation, impede practitioner's
ability to provide care, or pose a threat to the health and safety of patients.: -
URAC standard for Ability to Perform Clinical Privileges Requested (Health Status)
16. The application includes information concerning the applicant's current
physical, mental health, or chemical dependency problems that would in-
terfere with the ability to provide high-quality patient care or services. The
organization reviews at initial and reappointment and privileging.: AAAHC
standard for Ability to Perform Clinical Privileges Requested (Health Status)
17. Regarding Surgical Services, instruct surveyors as follows: "Review the
hospital's method for reviewing the surgical privileges of practitioners. This
method should require a written assessment of the practitioner's training,
experience, health status, and performance.: Medicare CoPs standard for Ability
to Perform Clinical Privileges Requested (Health Status)
18. Do not use the term AHP, rather "licensed practitioners".: TJC on creden-
tialing Allied Health Professionals (AHPs)/ Non-Physician Practitioners
19. For staff other than PAs and APRNs: HR standards require that, before
providing care, treatment or services, the qualifications and competence of a
non-employee individual, brought into the hospital by a licensed practitioner
are assessed by the hospital and are determined to commensurate with
the qualifications and competence required if the individual were to be em-
ployed.: TJC on credentialing Allied Health Professionals (AHPs)/ Non-Physician
Practitioners
Study online at https://quizlet.com/_faxvjd
1. The main ones are NCQA and URAC: Health Plan/Managed Care Organization
(MCO)
2. For HFAP and TJC, Nurse Practitioners and Physician Assistants are re-
quired to have either a or agreement, per State
regulations, with a physician who holds the same privileges.: Collaborative or
Supervisory
3. Details what med staff appointees can/cannot do, specific for clinical
processes, includes rules for each department, requirements for ER coverage
for unassigned patients, guidelines for obtaining consultation, provisions for
LOA, med records completion, call coverage, meeting attendance, etc: Rules
and Regulations
4. Require that bylaws must describe the qualifications required of a candidate
in order for the medical staff to recommend appointment to the governing
body.: Medicare CoPs
5. AAAHC is the accrediting body for what type of facility?: ambulatory care
6. Who determines whether to grant, deny, continue, revise, discontinue, limit,
or revoke, specified privileges, including medical staff membership, for a
specific practitioner after considering the recommendation of the medical
staff?: The governing body
7. Membership requirements set by forces outside the organization are called
what? This includes accrediting and certifying bodies, such as TJC, HFAP,
DNV, AAAHC, NCQA, URAC: External criteria
8. Factors defined by the hospitals, medical staff, and Governing board or the
MCO board and credentialing committee: Internal criteria
9. The amount of days that NCQA requires that notification to practitioners of
credentialing and recredentialing decisions.: 60 days
10. Per CoPs, the governing body must include in the bylaws criteria for
determining the privileges that may be granted to individual practitioners
based on their: (hint: C, C T, E, J): Character, competence, training, experience,
and judgment.
11. Applicant must submit a statement that no health problems exist; on initial
appt., this statement should be confirmed by a director of training program,
chief of services, or chief of staff at another hospital where the applicant holds
privileges, or an MD/DO approved by medical staff. Medical staff can require
evaluation by external/internal source.: TJC standard for Ability to Perform Clini-
cal Privileges Requested (Health Status)
12. There is a current signed attestation from the application regarding rea-
sons for any inability to perform the essential functions of the position, with
, CPCS Exam as of June 2024
Study online at https://quizlet.com/_faxvjd
or without accommodation, and the lack of present illegal drug use.: NCQA
standard for Ability to Perform Clinical Privileges Requested (Health Status)
13. Health status is considered for each (re)applicant during review & approval
process. Info can come from peers who are familiar with the reapplicants prac-
tice; peer review activities or reviews by the credentials committee, depart-
ment chair, or MEC.: HFAP (Acute Care Hospital) standard for Ability to Perform
Clinical Privileges Requested (Health Status)
14. Surveyors will validate the hospital's method for reviewing practitioner's
surgical privileges to determine if the process includes required verification of
practitioner's training, experience, health status, and performance. Surveyor
must confirm that organization provides a roster of each practitioner's surgi-
cal privileges that is available in the surgery suite and scheduling, including
a list of surgeons suspended from performing surgery/have restricted privi-
leges.: DNV standard for Ability to Perform Clinical Privileges Requested (Health
Status)
15. App includes disclosure of any physical, mental, substance abuse prob-
lems that could, without reasonable accommodation, impede practitioner's
ability to provide care, or pose a threat to the health and safety of patients.: -
URAC standard for Ability to Perform Clinical Privileges Requested (Health Status)
16. The application includes information concerning the applicant's current
physical, mental health, or chemical dependency problems that would in-
terfere with the ability to provide high-quality patient care or services. The
organization reviews at initial and reappointment and privileging.: AAAHC
standard for Ability to Perform Clinical Privileges Requested (Health Status)
17. Regarding Surgical Services, instruct surveyors as follows: "Review the
hospital's method for reviewing the surgical privileges of practitioners. This
method should require a written assessment of the practitioner's training,
experience, health status, and performance.: Medicare CoPs standard for Ability
to Perform Clinical Privileges Requested (Health Status)
18. Do not use the term AHP, rather "licensed practitioners".: TJC on creden-
tialing Allied Health Professionals (AHPs)/ Non-Physician Practitioners
19. For staff other than PAs and APRNs: HR standards require that, before
providing care, treatment or services, the qualifications and competence of a
non-employee individual, brought into the hospital by a licensed practitioner
are assessed by the hospital and are determined to commensurate with
the qualifications and competence required if the individual were to be em-
ployed.: TJC on credentialing Allied Health Professionals (AHPs)/ Non-Physician
Practitioners
