CPCS/CPMSM Exam Questions With
100% Correct Answers 2025 Latest
Update
Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable
to the NPDB? - --PRECISE ANS--Yes
According to the Joint Commission, who may amend the medical staff bylaws? - --
PRECISE ANS--Governing Body
Failure to meet the established qualifications and criteria for appointment should be
reported to whom? - --PRECISE ANS--The applicant
NCQA requires the MCO to obtain a minimum of ???? years of work history? - Correct
Answer-5 years
According to NCQA what policy must an organization have in place to obtain approval to
enter into a delegated agreement? - --PRECISE ANS--Credentialing policies
How often does the OIG report to the NPDB? - --PRECISE ANS--Monthly
Hospitals must query the NPDB when: - --PRECISE ANS--Initial appt, granting of
privileges, every two years
NCQA requires verifications must be less than how many days old? - --PRECISE ANS--
180 days
What is the verification time limit on malpractice history according to the NCQA? - --
PRECISE ANS--180 days
Time limited credential must be verified by the CVO within how many days prior to
submission to the client? - --PRECISE ANS--120 days
According to AAAHC, for initial appointments, in addition to licensure and education,
what verification is required? - --PRECISE ANS--Experience and hospital affiliation
What accreditation body states "the NPDB is an acceptable source for sanctions or
limitations on licensure, Medicaid/Medicare sanctions and malpractice history? - --
PRECISE ANS--NCQA
Who is required to query the NPDB? - --PRECISE ANS--Hospitals
Is disciplinary action taken against the license of a dentist reportable to the NPDB? - --
PRECISE ANS--Yes
, Under HCQIA, a hospital failure to report an adverse privilege action lasting longer than
30 days may cause the organization to lose HCQIA immunity for how many years? - --
PRECISE ANS--3 years
According to NCQA, verification of Medicare/Medicaid sanctions can be queried by any
of what sources? - --PRECISE ANS--AMA, FSMB, HIPDB, OIG, Sanctions Report, NPDB,
Sate Agency
According to NCQA, how often must an organization conduct an audit of the
credentialing process delegated to another organization? - --PRECISE ANS--Annually
How far back does the Joint Commission require evaluation of malpractice history?
What source may be used? - --PRECISE ANS--Back to medical school. NPDB.
Is an internet verification from a website not contracted by the primary source that
attests to the accuracy and timeliness of the information considered a complete
verification by NCQA? - --PRECISE ANS--No
What accreditation bodies require privileges to be distributed to essential department
personnel? - --PRECISE ANS--Joint Commission/CMS
T/F - The Joint Commission and NCQA do not require criminal background checks. - --
PRECISE ANS--True - the only organization that requires background checks is HFAP.
Is a payment made by an insurance company reportable to the NPDB? - --
PRECISE ANS--Yes
Who is the best person to consult when releasing adverse information in a verification
request from another organization? - --PRECISE ANS--Legal Counsel
According to CMS, who in the organization may make decisions regarding approval of
credentialing applications? - --PRECISE ANS--Governing Board
What are the six elements of a written delegation agreement? - --PRECISE ANS--1.
Mutually agreed upon
2. Describes responsibilities of organization and delegated entity
3. Describes delegated activities
4. Requires semi-annual reporting to the organization
5. Describes the process by which the organization evaluates the delegated entities
performance
6. Describes remedies available to the organization if the delegated entity does not fulfil
its obligations including revocation of delegated agreement
100% Correct Answers 2025 Latest
Update
Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable
to the NPDB? - --PRECISE ANS--Yes
According to the Joint Commission, who may amend the medical staff bylaws? - --
PRECISE ANS--Governing Body
Failure to meet the established qualifications and criteria for appointment should be
reported to whom? - --PRECISE ANS--The applicant
NCQA requires the MCO to obtain a minimum of ???? years of work history? - Correct
Answer-5 years
According to NCQA what policy must an organization have in place to obtain approval to
enter into a delegated agreement? - --PRECISE ANS--Credentialing policies
How often does the OIG report to the NPDB? - --PRECISE ANS--Monthly
Hospitals must query the NPDB when: - --PRECISE ANS--Initial appt, granting of
privileges, every two years
NCQA requires verifications must be less than how many days old? - --PRECISE ANS--
180 days
What is the verification time limit on malpractice history according to the NCQA? - --
PRECISE ANS--180 days
Time limited credential must be verified by the CVO within how many days prior to
submission to the client? - --PRECISE ANS--120 days
According to AAAHC, for initial appointments, in addition to licensure and education,
what verification is required? - --PRECISE ANS--Experience and hospital affiliation
What accreditation body states "the NPDB is an acceptable source for sanctions or
limitations on licensure, Medicaid/Medicare sanctions and malpractice history? - --
PRECISE ANS--NCQA
Who is required to query the NPDB? - --PRECISE ANS--Hospitals
Is disciplinary action taken against the license of a dentist reportable to the NPDB? - --
PRECISE ANS--Yes
, Under HCQIA, a hospital failure to report an adverse privilege action lasting longer than
30 days may cause the organization to lose HCQIA immunity for how many years? - --
PRECISE ANS--3 years
According to NCQA, verification of Medicare/Medicaid sanctions can be queried by any
of what sources? - --PRECISE ANS--AMA, FSMB, HIPDB, OIG, Sanctions Report, NPDB,
Sate Agency
According to NCQA, how often must an organization conduct an audit of the
credentialing process delegated to another organization? - --PRECISE ANS--Annually
How far back does the Joint Commission require evaluation of malpractice history?
What source may be used? - --PRECISE ANS--Back to medical school. NPDB.
Is an internet verification from a website not contracted by the primary source that
attests to the accuracy and timeliness of the information considered a complete
verification by NCQA? - --PRECISE ANS--No
What accreditation bodies require privileges to be distributed to essential department
personnel? - --PRECISE ANS--Joint Commission/CMS
T/F - The Joint Commission and NCQA do not require criminal background checks. - --
PRECISE ANS--True - the only organization that requires background checks is HFAP.
Is a payment made by an insurance company reportable to the NPDB? - --
PRECISE ANS--Yes
Who is the best person to consult when releasing adverse information in a verification
request from another organization? - --PRECISE ANS--Legal Counsel
According to CMS, who in the organization may make decisions regarding approval of
credentialing applications? - --PRECISE ANS--Governing Board
What are the six elements of a written delegation agreement? - --PRECISE ANS--1.
Mutually agreed upon
2. Describes responsibilities of organization and delegated entity
3. Describes delegated activities
4. Requires semi-annual reporting to the organization
5. Describes the process by which the organization evaluates the delegated entities
performance
6. Describes remedies available to the organization if the delegated entity does not fulfil
its obligations including revocation of delegated agreement
