CPCS 2026 EXAMINATION SET QUESTIONS AND
ANSWERS SURE A+
✔✔In order for a healthcare facility to participate in the Medicare and Medicaid
programs it must comply with the: - ✔✔a. Medicare Conditions of Participation.
b. The Joint Commission of Accreditation of Healthcare Organizations standards
c. National Committee for Quality Assurance (NCQA) standards
✔✔According to The Joint Commission hospital standards, which of the following is an
element of a self-governing medical staff? - ✔✔a. The hospital's board of directors
determines the criteria for granting medical staff privileges
b. There can be any number of medical staffs as long as they are approved by the
governing body
c. The medical staff determines the mechanism for establishing and enforcing criteria
for assigning oversight responsibility to practitioners with independent privileges.
✔✔Robert's Rules of order is an example of: - ✔✔a. executive privilege
b. Parliamentary procedure.
c. a code of conduct
✔✔The medical staff application should provide a chronological history of: - ✔✔a. The
applicant's education, training and work history.
b. CME activities and completion of residency
c. Leadership activities
✔✔In order to participate in a health plan, a provider must be accepted to the plan's: -
✔✔a. Medical team
b. Provider panel.
c. Point of service plan
✔✔In order for a physician to practice medicine in any state in the United States, he/she
must possess: - ✔✔a. Appropriate board certification
b. Membership on the provider panel of the majority of the state's major health plans
c. Current state licensure.
✔✔Which of the following is considered post-graduate education? - ✔✔a. Medical
school
b. Board certifications
c. Residency training.
✔✔Which of the following elements may not be used to evaluate credentials of
applicants? - ✔✔a. Gender.
b. Licensure
c. Post-graduate training
, ✔✔The release of liability statement signed by the applicant for medical staff
appointment should include: - ✔✔a. The name of the department chairman for all past
hospital appointments
b. A statement providing immunity to those who respond in good faith to requests for
information.
c. Primary source verification
✔✔Primary source verification is: - ✔✔a. Required by the Healthcare Quality
Improvement Act
b. Receiving information directly from the issuing source.
c. Delegated credentialing
✔✔Unexplained delays between graduation and medical school, incomplete training,
and unexplained lapses in professional practice are examples of: - ✔✔a. Red flags.
b. Professional liability actions
c. Events reportable to the National Practitioner Data Bank
✔✔When documenting a telephone conversation regarding primary source verification
what should be documented? - ✔✔a. The date and time of the call only
b. Who answered the call
c. Name of the person and organization contacted, date of call, what was discussed and
who conducted the interview.
✔✔According to HFAP standards, when confirming malpractice coverage the
organization must: - ✔✔a. Query the NPDB
b. Obtain the claim history with each carrier over the last five years
c. Have evidence of professional liability insurance, which includes certificate showing
amounts of coverage.
✔✔Which of the following providers is considered a primary care physician (PCP)? -
✔✔a. General surgeon
b. Family medicine practitioner.
c. Gastroenterologist
✔✔Which body has the obligation to the community to assure that only appropriately
education, trained and currently competent practitioners are granted medical staff
membership and clinical privileges? - ✔✔a. Medical Staff
b. Governing Body.
c. The Joint Commission on Accreditation of Healthcare Organizations
✔✔When credentialing and privileging practitioners, it is appropriate to - ✔✔a. Handle
each applicant on a case-by-case basis
b. Follow a routine process for each applicant.
ANSWERS SURE A+
✔✔In order for a healthcare facility to participate in the Medicare and Medicaid
programs it must comply with the: - ✔✔a. Medicare Conditions of Participation.
b. The Joint Commission of Accreditation of Healthcare Organizations standards
c. National Committee for Quality Assurance (NCQA) standards
✔✔According to The Joint Commission hospital standards, which of the following is an
element of a self-governing medical staff? - ✔✔a. The hospital's board of directors
determines the criteria for granting medical staff privileges
b. There can be any number of medical staffs as long as they are approved by the
governing body
c. The medical staff determines the mechanism for establishing and enforcing criteria
for assigning oversight responsibility to practitioners with independent privileges.
✔✔Robert's Rules of order is an example of: - ✔✔a. executive privilege
b. Parliamentary procedure.
c. a code of conduct
✔✔The medical staff application should provide a chronological history of: - ✔✔a. The
applicant's education, training and work history.
b. CME activities and completion of residency
c. Leadership activities
✔✔In order to participate in a health plan, a provider must be accepted to the plan's: -
✔✔a. Medical team
b. Provider panel.
c. Point of service plan
✔✔In order for a physician to practice medicine in any state in the United States, he/she
must possess: - ✔✔a. Appropriate board certification
b. Membership on the provider panel of the majority of the state's major health plans
c. Current state licensure.
✔✔Which of the following is considered post-graduate education? - ✔✔a. Medical
school
b. Board certifications
c. Residency training.
✔✔Which of the following elements may not be used to evaluate credentials of
applicants? - ✔✔a. Gender.
b. Licensure
c. Post-graduate training
, ✔✔The release of liability statement signed by the applicant for medical staff
appointment should include: - ✔✔a. The name of the department chairman for all past
hospital appointments
b. A statement providing immunity to those who respond in good faith to requests for
information.
c. Primary source verification
✔✔Primary source verification is: - ✔✔a. Required by the Healthcare Quality
Improvement Act
b. Receiving information directly from the issuing source.
c. Delegated credentialing
✔✔Unexplained delays between graduation and medical school, incomplete training,
and unexplained lapses in professional practice are examples of: - ✔✔a. Red flags.
b. Professional liability actions
c. Events reportable to the National Practitioner Data Bank
✔✔When documenting a telephone conversation regarding primary source verification
what should be documented? - ✔✔a. The date and time of the call only
b. Who answered the call
c. Name of the person and organization contacted, date of call, what was discussed and
who conducted the interview.
✔✔According to HFAP standards, when confirming malpractice coverage the
organization must: - ✔✔a. Query the NPDB
b. Obtain the claim history with each carrier over the last five years
c. Have evidence of professional liability insurance, which includes certificate showing
amounts of coverage.
✔✔Which of the following providers is considered a primary care physician (PCP)? -
✔✔a. General surgeon
b. Family medicine practitioner.
c. Gastroenterologist
✔✔Which body has the obligation to the community to assure that only appropriately
education, trained and currently competent practitioners are granted medical staff
membership and clinical privileges? - ✔✔a. Medical Staff
b. Governing Body.
c. The Joint Commission on Accreditation of Healthcare Organizations
✔✔When credentialing and privileging practitioners, it is appropriate to - ✔✔a. Handle
each applicant on a case-by-case basis
b. Follow a routine process for each applicant.
