Credentialing and Accreditation Exam
2026/2027 | 190 Practice Questions for
CPCS CPMSM | Joint Commission NCQA
HFAP URAC AAAHC CMS
Description:
Master credentialing standards for 2026/2027 with 190 exam-style questions covering
Joint Commission, NCQA, HFAP, URAC, AAAHC, and CMS. Includes NPDB
reporting, verification timeframes, attestation requirements, and privileging rules.
Perfect for CPCS and CPMSM certification candidates.
Download the complete 2026/2027 study guide now and pass your exam on the first attempt.
, CPCS CPMSM Exam Prep 2026/2027: 190 Questions
Section 1: Accreditation Standards for Medical Staff Membership
Question 1
Which two accrediting bodies explicitly state that a hospital may not rely solely on board
certification when considering a practitioner for medical staff membership?
A. The Joint Commission and NCQA
B. HFAP and CMS
C. URAC and AAAHC
D. CMS and The Joint Commission
Answer: B. HFAP and CMS
Explanation: Both HFAP and CMS require hospitals to evaluate multiple qualifications
including competence, character, judgment, experience, and training beyond board
certification alone.
Question 2
According to The Joint Commission and HFAP, which four sources are approved primary
source verification options for medical education?
A. Medical School, AMA, ECFMG, AOA
B. Medical School, FSMB, NBME, ABMS
C. Medical School, State Licensing Board, NPDB, OIG
D. Medical School, ACGME, ABMS, AMA
Answer: A. Medical School, AMA, ECFMG, AOA
Explanation: The Joint Commission and HFAP recognize the American Medical
Association, Educational Commission for Foreign Medical Graduates, and American
Osteopathic Association as approved primary sources for verifying medical education.
Question 3
According to NCQA standards, within how many days must a practitioner be notified of a
credentialing decision?
A. 30 days
B. 45 days
,C. 60 days
D. 90 days
Answer: C. 60 days
Explanation: NCQA requires that managed care organizations notify practitioners of
credentialing decisions within 60 calendar days from the date of the credentials committee
decision.
Question 4
The Department of Health and Human Services mails a copy of the NPDB report to the
named provider. If the provider wishes to dispute the report's accuracy, the provider has how
many days to do so?
A. 30 days
B. 45 days
C. 60 days
D. 90 days
Answer: C. 60 days
Explanation: The provider has 60 calendar days from receipt of the NPDB report to dispute
the accuracy of any information contained in the report.
Question 5
According to URAC standards, within how many days must the practitioner be notified of
credentialing decisions?
A. 5 days
B. 7 days
C. 10 days
D. 14 days
Answer: C. 10 days
Explanation: URAC requires written notification to providers within 10 calendar days of the
credentialing determination being made by the credentials committee.
, Question 6
Which accrediting body requires a five-year verification of malpractice history for
practitioners?
A. The Joint Commission
B. HFAP
C. NCQA
D. URAC
Answer: C. NCQA
Explanation: NCQA mandates that organizations review and verify malpractice claims
history for the most recent five-year period prior to initial credentialing.
Question 7
What is the most commonly used source for verifying a practitioner's malpractice history?
A. State licensing boards
B. Professional liability insurers
C. National Practitioner Data Bank
D. Credentialing Verification Organization
Answer: C. National Practitioner Data Bank
Explanation: The NPDB is the primary repository for medical malpractice payments and
adverse actions, making it the most frequently utilized source for verifying malpractice
history.
Section 2: Fair Hearing and Appeals Processes
Question 8
According to The Joint Commission, a fair hearing and appeals process as described in the
medical staff bylaws is available to which individuals?
A. Medical staff members only
B. Non-members holding clinical privileges only
C. Medical staff members and non-members holding clinical privileges
D. All licensed independent practitioners in the facility
2026/2027 | 190 Practice Questions for
CPCS CPMSM | Joint Commission NCQA
HFAP URAC AAAHC CMS
Description:
Master credentialing standards for 2026/2027 with 190 exam-style questions covering
Joint Commission, NCQA, HFAP, URAC, AAAHC, and CMS. Includes NPDB
reporting, verification timeframes, attestation requirements, and privileging rules.
Perfect for CPCS and CPMSM certification candidates.
Download the complete 2026/2027 study guide now and pass your exam on the first attempt.
, CPCS CPMSM Exam Prep 2026/2027: 190 Questions
Section 1: Accreditation Standards for Medical Staff Membership
Question 1
Which two accrediting bodies explicitly state that a hospital may not rely solely on board
certification when considering a practitioner for medical staff membership?
A. The Joint Commission and NCQA
B. HFAP and CMS
C. URAC and AAAHC
D. CMS and The Joint Commission
Answer: B. HFAP and CMS
Explanation: Both HFAP and CMS require hospitals to evaluate multiple qualifications
including competence, character, judgment, experience, and training beyond board
certification alone.
Question 2
According to The Joint Commission and HFAP, which four sources are approved primary
source verification options for medical education?
A. Medical School, AMA, ECFMG, AOA
B. Medical School, FSMB, NBME, ABMS
C. Medical School, State Licensing Board, NPDB, OIG
D. Medical School, ACGME, ABMS, AMA
Answer: A. Medical School, AMA, ECFMG, AOA
Explanation: The Joint Commission and HFAP recognize the American Medical
Association, Educational Commission for Foreign Medical Graduates, and American
Osteopathic Association as approved primary sources for verifying medical education.
Question 3
According to NCQA standards, within how many days must a practitioner be notified of a
credentialing decision?
A. 30 days
B. 45 days
,C. 60 days
D. 90 days
Answer: C. 60 days
Explanation: NCQA requires that managed care organizations notify practitioners of
credentialing decisions within 60 calendar days from the date of the credentials committee
decision.
Question 4
The Department of Health and Human Services mails a copy of the NPDB report to the
named provider. If the provider wishes to dispute the report's accuracy, the provider has how
many days to do so?
A. 30 days
B. 45 days
C. 60 days
D. 90 days
Answer: C. 60 days
Explanation: The provider has 60 calendar days from receipt of the NPDB report to dispute
the accuracy of any information contained in the report.
Question 5
According to URAC standards, within how many days must the practitioner be notified of
credentialing decisions?
A. 5 days
B. 7 days
C. 10 days
D. 14 days
Answer: C. 10 days
Explanation: URAC requires written notification to providers within 10 calendar days of the
credentialing determination being made by the credentials committee.
, Question 6
Which accrediting body requires a five-year verification of malpractice history for
practitioners?
A. The Joint Commission
B. HFAP
C. NCQA
D. URAC
Answer: C. NCQA
Explanation: NCQA mandates that organizations review and verify malpractice claims
history for the most recent five-year period prior to initial credentialing.
Question 7
What is the most commonly used source for verifying a practitioner's malpractice history?
A. State licensing boards
B. Professional liability insurers
C. National Practitioner Data Bank
D. Credentialing Verification Organization
Answer: C. National Practitioner Data Bank
Explanation: The NPDB is the primary repository for medical malpractice payments and
adverse actions, making it the most frequently utilized source for verifying malpractice
history.
Section 2: Fair Hearing and Appeals Processes
Question 8
According to The Joint Commission, a fair hearing and appeals process as described in the
medical staff bylaws is available to which individuals?
A. Medical staff members only
B. Non-members holding clinical privileges only
C. Medical staff members and non-members holding clinical privileges
D. All licensed independent practitioners in the facility
