CPCS Exam Study Guide Exam Latest
2026/2027 Updated Verified Questions and
Solutions A+ Pass Guaranteed
1. What two accreditors state: a hospital may not rely solely on board
certification when considering practitioner for medical staff membership -
ANSWER ✔ HFAP, CMS
2. According to who? Medical School, AMA, ECFMG, AOA are approves sources of
medical education? - ANSWER ✔ JC, HFAP
3. Nondiscrimination according to AAAHC - ANSWER ✔ Not addressed
4. Medicare/Medicaid Sanctions/Exclusions:\n Requirement by JC - ANSWER ✔
Not addressed
5. Medicare/Medicaid Sanctions/Exclusions:\n Requirement by HFAP - ANSWER
✔ Sanctions or disciplinary actions must be reviewed at initial &
reappointment.\nThe application requests information regarding disciplinary
actions taken or investigations pending by Medicare/Medicaid.
6. Medicare/Medicaid Sanctions/Exclusions:\n Requirement by NCQA - ANSWER
✔ Organizations are responsible for ongoing monitoring of Medicare/Medicaid
sanctions between recredentialing cycles.
,7. NCQA requires a query of Medicare/Medicaid Sanctions by a query from: -
ANSWER ✔ Federal Employees Health Benefits
Plan\nFSMB\nNPDB/HIPDB\nList of Excluded individuals and entities
(maintained by OIG)\nMedicare and Medicaid Sanctions and Reinstatement
Report\nState Medicaid agency or Medicare Intermediary
8. Medicare/Medicaid Sanctions Exclusions:\n Requirement by URAC - ANSWER
✔ Required to be reported on application
9. Medicare/Medicaid Sanctions Exclusions:\n Requirement by AAAHC - ANSWER
✔ Disclosed and evaluated on initial and reapplication
10.What is Current Competence? - ANSWER ✔ A determination of an individual's
capability to perform up to defined expectations
11.Current competence is determined by the JC how? - ANSWER ✔ Through peer
references\nIt is recommended but not required that hospitals base
evaluations on the six areas of General Competencies adopted by ACGME and
ABMS
12.Current competence is determined by HFAP how? - ANSWER ✔ Information
obtained from residency or facilities where the applicant has been
practicing\nLow volume may require review of procedure logs and competency
from other facilities
,13.Current competence is determined by NCQA how? - ANSWER ✔ Not addressed
14.Current competence is determined by URAC how? - ANSWER ✔ Not addressed
15.Current competence is determined by AAAHC how? - ANSWER ✔ On initial
application. Obtained from peers
16.Attestation time limit for NCQA: - ANSWER ✔ 365\n305 For CVO
17.Attestation time limit for NCQA Medicare Advantage Deeming Surveys: -
ANSWER ✔ 180\n120 for CVO
18.Which accreditation standards address consent and release for credentialing? -
ANSWER ✔ None
19.The release form should permit release of: - ANSWER ✔ 1. Professional
evaluations \n2. Information from Insurance Carriers\n3. Information from
hospitals licensure boards, certification boards, insurance plans, etc.
20.According to NCQA practitioners must be notified of credentialing decision
within how many days? - ANSWER ✔ 60 Days
21.How long does a named provider have to dispute the accuracy of an NPDB
report? - ANSWER ✔ 60 Days
, 22.According to URAC, within how many days must the practitioner be notified of
credentialing decisions? - ANSWER ✔ 10 Days
23.How many days does a practitioner have to dispute an NPDB report accuracy? -
ANSWER ✔ 60 Days
24.Which accrediting body requires five year verification of malpractice history? -
ANSWER ✔ NCQA
25.What is the commonly used source for verifying malpractice history? -
ANSWER ✔ NPDB
26.According to the JC, a fair hearing and appeals process as described in the
medical staff bylaws is available to whom? - ANSWER ✔ Medical staff members
and non-members holding clinical privileges
27.Who requires only the highest level of training be verified? - ANSWER ✔ NCQA
28.According to the Joint Commission a peer recommendation should address
what 6 competencies? - ANSWER ✔ Medical knowledge\nTechnical
skills\nClinical judgment\ninterpersonal skills\ncommunication
skills\nprofessionalism
29.A hospital that does not query the databank as required by HCQIA is - ANSWER
✔ Legally liable for knowledge of any information reported
2026/2027 Updated Verified Questions and
Solutions A+ Pass Guaranteed
1. What two accreditors state: a hospital may not rely solely on board
certification when considering practitioner for medical staff membership -
ANSWER ✔ HFAP, CMS
2. According to who? Medical School, AMA, ECFMG, AOA are approves sources of
medical education? - ANSWER ✔ JC, HFAP
3. Nondiscrimination according to AAAHC - ANSWER ✔ Not addressed
4. Medicare/Medicaid Sanctions/Exclusions:\n Requirement by JC - ANSWER ✔
Not addressed
5. Medicare/Medicaid Sanctions/Exclusions:\n Requirement by HFAP - ANSWER
✔ Sanctions or disciplinary actions must be reviewed at initial &
reappointment.\nThe application requests information regarding disciplinary
actions taken or investigations pending by Medicare/Medicaid.
6. Medicare/Medicaid Sanctions/Exclusions:\n Requirement by NCQA - ANSWER
✔ Organizations are responsible for ongoing monitoring of Medicare/Medicaid
sanctions between recredentialing cycles.
,7. NCQA requires a query of Medicare/Medicaid Sanctions by a query from: -
ANSWER ✔ Federal Employees Health Benefits
Plan\nFSMB\nNPDB/HIPDB\nList of Excluded individuals and entities
(maintained by OIG)\nMedicare and Medicaid Sanctions and Reinstatement
Report\nState Medicaid agency or Medicare Intermediary
8. Medicare/Medicaid Sanctions Exclusions:\n Requirement by URAC - ANSWER
✔ Required to be reported on application
9. Medicare/Medicaid Sanctions Exclusions:\n Requirement by AAAHC - ANSWER
✔ Disclosed and evaluated on initial and reapplication
10.What is Current Competence? - ANSWER ✔ A determination of an individual's
capability to perform up to defined expectations
11.Current competence is determined by the JC how? - ANSWER ✔ Through peer
references\nIt is recommended but not required that hospitals base
evaluations on the six areas of General Competencies adopted by ACGME and
ABMS
12.Current competence is determined by HFAP how? - ANSWER ✔ Information
obtained from residency or facilities where the applicant has been
practicing\nLow volume may require review of procedure logs and competency
from other facilities
,13.Current competence is determined by NCQA how? - ANSWER ✔ Not addressed
14.Current competence is determined by URAC how? - ANSWER ✔ Not addressed
15.Current competence is determined by AAAHC how? - ANSWER ✔ On initial
application. Obtained from peers
16.Attestation time limit for NCQA: - ANSWER ✔ 365\n305 For CVO
17.Attestation time limit for NCQA Medicare Advantage Deeming Surveys: -
ANSWER ✔ 180\n120 for CVO
18.Which accreditation standards address consent and release for credentialing? -
ANSWER ✔ None
19.The release form should permit release of: - ANSWER ✔ 1. Professional
evaluations \n2. Information from Insurance Carriers\n3. Information from
hospitals licensure boards, certification boards, insurance plans, etc.
20.According to NCQA practitioners must be notified of credentialing decision
within how many days? - ANSWER ✔ 60 Days
21.How long does a named provider have to dispute the accuracy of an NPDB
report? - ANSWER ✔ 60 Days
, 22.According to URAC, within how many days must the practitioner be notified of
credentialing decisions? - ANSWER ✔ 10 Days
23.How many days does a practitioner have to dispute an NPDB report accuracy? -
ANSWER ✔ 60 Days
24.Which accrediting body requires five year verification of malpractice history? -
ANSWER ✔ NCQA
25.What is the commonly used source for verifying malpractice history? -
ANSWER ✔ NPDB
26.According to the JC, a fair hearing and appeals process as described in the
medical staff bylaws is available to whom? - ANSWER ✔ Medical staff members
and non-members holding clinical privileges
27.Who requires only the highest level of training be verified? - ANSWER ✔ NCQA
28.According to the Joint Commission a peer recommendation should address
what 6 competencies? - ANSWER ✔ Medical knowledge\nTechnical
skills\nClinical judgment\ninterpersonal skills\ncommunication
skills\nprofessionalism
29.A hospital that does not query the databank as required by HCQIA is - ANSWER
✔ Legally liable for knowledge of any information reported
