CPCS UPDATED COMPREHENSIVE PAPER QUESTIONS
AND ANSWERS SURE A+
✔✔NCQA requires MCO's to recredential practitioners every: - ✔✔3 years
✔✔What six criteria are observed in an initial site visit by NCQA? - ✔✔1. Physical
accessibility\n2. Physical apperance\n3. Adequacy of waiting and exam rooms\n4.
Appointment availability\n5. Adequacy of treatment\n6. Record keeping processes
✔✔According to JC what should be used to verify current competence? - ✔✔Hospital
verification
✔✔According to NCQA who has ultimate authority in credentialing decisions? -
✔✔Credentials committee or medical director if it is clean file
✔✔Name the six general competencies according to the ACGME & ABMS - ✔✔1.
Patient care\n2. Medical/Clinical knowledge\n3. Practice based learning and
improvement\n4. Interpersonal & communication skills\n5. Professionalism\n6. System
based practice
✔✔According to NCQA application, PSV must be dated within ????? days of the
credentialing decisions? - ✔✔180 days
✔✔According to NCQA what credential must be verified at the time of recredentialing? -
✔✔Current malpractice\nState Licensure
✔✔According to NCQA, how long is the board certification good for? - ✔✔180 days
✔✔Professional societies must report adverse actions or payouts within how many days
to the NPDB? - ✔✔15 days
✔✔Hospitals and healthcare entities must report adverse actions within how many days
to the NPDB? - ✔✔15 days
✔✔State Licensing board must report adverse actions within how many days to the
NPDB? - ✔✔30 days
✔✔Malpractice payors must report adverse actions or payouts within how many days to
the NPDB? - ✔✔30 days
✔✔Name 3 sources of verification of education of a podiatrist according to NCQA? -
✔✔1. School\n2. Specialty board\n3. State Licensing agency
, ✔✔DEA Registration: High abuse Potential - No medical Use - ✔✔I
✔✔Which JC terminology references the new and revised elements of the accreditation
and survey process? - ✔✔New pathways
✔✔According to NCQA a set of standardized measures used to compare health plans
is??? - ✔✔HEDIS
✔✔NCQA grants a CVO certification of a period of? - ✔✔2 years
✔✔The medical staff is actively involved in measuring, assessing, and improving what?
- ✔✔Patient safety data
✔✔DEA: High abuse potential with dependence liability - ✔✔II
✔✔Who/what is the highest level of authority for URAC? - ✔✔The Credentials
Committee - \nMay delegate "clean" applications to Senior clinical staff person"
✔✔DEA: Less abuse potential, moderate dependence? - ✔✔III
✔✔What is a committee of the whole? - ✔✔The medical staff as a whole carries out the
governance functions.
✔✔When did the organized medical staff get it's start? - ✔✔1917
✔✔Who published the "Hospital Standards"? - ✔✔American College of Surgeons
✔✔Per NCQA Standards what is the time limit for provisional credentialing? - ✔✔60
days
✔✔According to HFAP standards temporary privileges may be granted in what cases? -
✔✔1. For time of emergency or disaster\n2. Locum tenens\n3. During review and
consideration of application\n4. For care of specific patients
✔✔Per URAC Standards, who has final authority to approve/disapprove applications? -
✔✔Credentials Committee
✔✔EMTALA - ✔✔Emergency Treatment and Active Labor Act
✔✔According to URAC how is the recredentialing cycle calculated? - ✔✔MM/YY to
MM/YY
AND ANSWERS SURE A+
✔✔NCQA requires MCO's to recredential practitioners every: - ✔✔3 years
✔✔What six criteria are observed in an initial site visit by NCQA? - ✔✔1. Physical
accessibility\n2. Physical apperance\n3. Adequacy of waiting and exam rooms\n4.
Appointment availability\n5. Adequacy of treatment\n6. Record keeping processes
✔✔According to JC what should be used to verify current competence? - ✔✔Hospital
verification
✔✔According to NCQA who has ultimate authority in credentialing decisions? -
✔✔Credentials committee or medical director if it is clean file
✔✔Name the six general competencies according to the ACGME & ABMS - ✔✔1.
Patient care\n2. Medical/Clinical knowledge\n3. Practice based learning and
improvement\n4. Interpersonal & communication skills\n5. Professionalism\n6. System
based practice
✔✔According to NCQA application, PSV must be dated within ????? days of the
credentialing decisions? - ✔✔180 days
✔✔According to NCQA what credential must be verified at the time of recredentialing? -
✔✔Current malpractice\nState Licensure
✔✔According to NCQA, how long is the board certification good for? - ✔✔180 days
✔✔Professional societies must report adverse actions or payouts within how many days
to the NPDB? - ✔✔15 days
✔✔Hospitals and healthcare entities must report adverse actions within how many days
to the NPDB? - ✔✔15 days
✔✔State Licensing board must report adverse actions within how many days to the
NPDB? - ✔✔30 days
✔✔Malpractice payors must report adverse actions or payouts within how many days to
the NPDB? - ✔✔30 days
✔✔Name 3 sources of verification of education of a podiatrist according to NCQA? -
✔✔1. School\n2. Specialty board\n3. State Licensing agency
, ✔✔DEA Registration: High abuse Potential - No medical Use - ✔✔I
✔✔Which JC terminology references the new and revised elements of the accreditation
and survey process? - ✔✔New pathways
✔✔According to NCQA a set of standardized measures used to compare health plans
is??? - ✔✔HEDIS
✔✔NCQA grants a CVO certification of a period of? - ✔✔2 years
✔✔The medical staff is actively involved in measuring, assessing, and improving what?
- ✔✔Patient safety data
✔✔DEA: High abuse potential with dependence liability - ✔✔II
✔✔Who/what is the highest level of authority for URAC? - ✔✔The Credentials
Committee - \nMay delegate "clean" applications to Senior clinical staff person"
✔✔DEA: Less abuse potential, moderate dependence? - ✔✔III
✔✔What is a committee of the whole? - ✔✔The medical staff as a whole carries out the
governance functions.
✔✔When did the organized medical staff get it's start? - ✔✔1917
✔✔Who published the "Hospital Standards"? - ✔✔American College of Surgeons
✔✔Per NCQA Standards what is the time limit for provisional credentialing? - ✔✔60
days
✔✔According to HFAP standards temporary privileges may be granted in what cases? -
✔✔1. For time of emergency or disaster\n2. Locum tenens\n3. During review and
consideration of application\n4. For care of specific patients
✔✔Per URAC Standards, who has final authority to approve/disapprove applications? -
✔✔Credentials Committee
✔✔EMTALA - ✔✔Emergency Treatment and Active Labor Act
✔✔According to URAC how is the recredentialing cycle calculated? - ✔✔MM/YY to
MM/YY
