CPCS 2025 Study Guide & Practice Questions
AAAHC - correct answer ✔✔Education is verified with primary or secondary source on initial
appointment
A. NCQA
B. DNV
C. AAAHC
D. URAC
NCQA - correct answer ✔✔For this standard if a physician is board certified, verification of
board certification meets this element because specialty boards verify education and training.
Residency is considered the highest level of training, not fellowship.
A.ACHC
B.NCQA
C.URAC
D.TJC
ACHC - correct answer ✔✔PSV is required and includes AMA
A.ACHC
B.NCQA
C.AAAHC
D.TJC
,URAC - correct answer ✔✔History of education and professional training must be included on
the credentialing application.
A.DNV
B.ACHC
C.URAC
D.AAAHC
NCQA - correct answer ✔✔The application must include a statement regarding felony
convictions.
A.NCQA
B.DNV
C.ACHC
D.URAC
TJC, DNV, URAC, CMS - correct answer ✔✔Which 4 standards do not address felony convictions:
A.ACHC, URAC, AAAHC, TJC
B.TJC, DNV, URAC, CMS
C.NCQA, DNV, ACHC, URAC
ACHC - correct answer ✔✔The application requests information regarding any criminal history
and a criminal background investigation is conducted based on information provided in the
application or as required by Federal and State regulations.
A.NCQA
B.DNV
,C.ACHC
D.URAC
AAAHC - correct answer ✔✔The applicant must provide information regarding criminal
convictions other than minor traffic violations.
A.DNV
B.AAAHC
C.TJC
D.NCQA
DNV - correct answer ✔✔MS bylaws describe the qualifications to be met by a candidate in
order for the medical staff to recommend that the governing body appoint the candidate.
A.NCQA
B.DNV
C.ACHC
D.URAC
NCQA - correct answer ✔✔Must confirm that the practitioner holds a valid, current license, in
effect at the time of the Credentialing Committee's decision. Only required to verify license(s) in
the state(s) where the practitioner provides care for organization members.
A.ACHC
B.URAC
C.NCQA
D.DNV
, TJC - correct answer ✔✔Licensure is verified with PSV at the time of appointment, initial
granting of privileges, reappointment, renewal, revision of privileges and on expiration.
A.NCQA
B.DNV
C.ACHC
D.TJC
TJC, DNV, CMS, URAC - correct answer ✔✔Which four (4) accrediting bodies do not specifically
address
felony convictions?
A. TJC, NCQA, AAAHC, CMS
B. TJC, DNV, HFAP, CMS
C. TJC, DNV, CMS, URAC
Federal and State law - correct answer ✔✔According to ACHC/HFAP, information regarding
criminal background history, is conducted based on information provided on the application and
is required by who?
A. Medical Staff
B. Federal and State law
C. Governing body
NCQA, URAC - correct answer ✔✔What two bodies have time limits for licensures?
A. NCQA, URAC
B. HFAP, NCQA
AAAHC - correct answer ✔✔Education is verified with primary or secondary source on initial
appointment
A. NCQA
B. DNV
C. AAAHC
D. URAC
NCQA - correct answer ✔✔For this standard if a physician is board certified, verification of
board certification meets this element because specialty boards verify education and training.
Residency is considered the highest level of training, not fellowship.
A.ACHC
B.NCQA
C.URAC
D.TJC
ACHC - correct answer ✔✔PSV is required and includes AMA
A.ACHC
B.NCQA
C.AAAHC
D.TJC
,URAC - correct answer ✔✔History of education and professional training must be included on
the credentialing application.
A.DNV
B.ACHC
C.URAC
D.AAAHC
NCQA - correct answer ✔✔The application must include a statement regarding felony
convictions.
A.NCQA
B.DNV
C.ACHC
D.URAC
TJC, DNV, URAC, CMS - correct answer ✔✔Which 4 standards do not address felony convictions:
A.ACHC, URAC, AAAHC, TJC
B.TJC, DNV, URAC, CMS
C.NCQA, DNV, ACHC, URAC
ACHC - correct answer ✔✔The application requests information regarding any criminal history
and a criminal background investigation is conducted based on information provided in the
application or as required by Federal and State regulations.
A.NCQA
B.DNV
,C.ACHC
D.URAC
AAAHC - correct answer ✔✔The applicant must provide information regarding criminal
convictions other than minor traffic violations.
A.DNV
B.AAAHC
C.TJC
D.NCQA
DNV - correct answer ✔✔MS bylaws describe the qualifications to be met by a candidate in
order for the medical staff to recommend that the governing body appoint the candidate.
A.NCQA
B.DNV
C.ACHC
D.URAC
NCQA - correct answer ✔✔Must confirm that the practitioner holds a valid, current license, in
effect at the time of the Credentialing Committee's decision. Only required to verify license(s) in
the state(s) where the practitioner provides care for organization members.
A.ACHC
B.URAC
C.NCQA
D.DNV
, TJC - correct answer ✔✔Licensure is verified with PSV at the time of appointment, initial
granting of privileges, reappointment, renewal, revision of privileges and on expiration.
A.NCQA
B.DNV
C.ACHC
D.TJC
TJC, DNV, CMS, URAC - correct answer ✔✔Which four (4) accrediting bodies do not specifically
address
felony convictions?
A. TJC, NCQA, AAAHC, CMS
B. TJC, DNV, HFAP, CMS
C. TJC, DNV, CMS, URAC
Federal and State law - correct answer ✔✔According to ACHC/HFAP, information regarding
criminal background history, is conducted based on information provided on the application and
is required by who?
A. Medical Staff
B. Federal and State law
C. Governing body
NCQA, URAC - correct answer ✔✔What two bodies have time limits for licensures?
A. NCQA, URAC
B. HFAP, NCQA
