CPCS/CPMSM Sample Questions and
answers already passed
Yes - correct answer ✔✔Are limitations of the clinical privileges of a psychiatrist for more than
30 days reportable to the NPDB?
Governing Body - correct answer ✔✔According to the Joint Commission, who may amend the
medical staff bylaws?
The applicant - correct answer ✔✔Failure to meet the established qualifications and criteria for
appointment should be reported to whom?
5 years - correct answer ✔✔NCQA requires the MCO to obtain a minimum of ???? years of work
history?
Credentialing policies - correct answer ✔✔According to NCQA what policy must an organization
have in place to obtain approval to enter into a delegated agreement?
Monthly - correct answer ✔✔How often does the OIG report to the NPDB?
Initial appt, granting of privileges, every two years - correct answer ✔✔Hospitals must query
the NPDB when:
180 days - correct answer ✔✔NCQA requires verifications must be less than how many days
old?
,180 days - correct answer ✔✔What is the verification time limit on malpractice history
according to the NCQA?
120 days - correct answer ✔✔Time limited credential must be verified by the CVO within how
many days prior to submission to the client?
Experience and hospital affiliation - correct answer ✔✔According to AAAHC, for initial
appointments, in addition to licensure and education, what verification is required?
NCQA - correct answer ✔✔What accreditation body states "the NPDB is an acceptable source
for sanctions or limitations on licensure, Medicaid/Medicare sanctions and malpractice history?
Hospitals - correct answer ✔✔Who is required to query the NPDB?
Yes - correct answer ✔✔Is disciplinary action taken against the license of a dentist reportable to
the NPDB?
3 years - correct answer ✔✔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?
AMA, FSMB, HIPDB, OIG, Sanctions Report, NPDB, Sate Agency - correct answer ✔✔According
to NCQA, verification of Medicare/Medicaid sanctions can be queried by any of what sources?
Annually - correct answer ✔✔According to NCQA, how often must an organization conduct an
audit of the credentialing process delegated to another organization?
Back to medical school. NPDB. - correct answer ✔✔How far back does the Joint Commission
require evaluation of malpractice history? What source may be used?
, No - correct answer ✔✔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?
Joint Commission/CMS - correct answer ✔✔What accreditation bodies require privileges to be
distributed to essential department personnel?
True - the only organization that requires background checks is HFAP. - correct answer ✔✔T/F -
The Joint Commission and NCQA do not require criminal background checks.
Yes - correct answer ✔✔Is a payment made by an insurance company reportable to the NPDB?
Legal Counsel - correct answer ✔✔Who is the best person to consult when releasing adverse
information in a verification request from another organization?
Governing Board - correct answer ✔✔According to CMS, who in the organization may make
decisions regarding approval of credentialing applications?
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 - correct answer ✔✔What are the six
elements of a written delegation agreement?
answers already passed
Yes - correct answer ✔✔Are limitations of the clinical privileges of a psychiatrist for more than
30 days reportable to the NPDB?
Governing Body - correct answer ✔✔According to the Joint Commission, who may amend the
medical staff bylaws?
The applicant - correct answer ✔✔Failure to meet the established qualifications and criteria for
appointment should be reported to whom?
5 years - correct answer ✔✔NCQA requires the MCO to obtain a minimum of ???? years of work
history?
Credentialing policies - correct answer ✔✔According to NCQA what policy must an organization
have in place to obtain approval to enter into a delegated agreement?
Monthly - correct answer ✔✔How often does the OIG report to the NPDB?
Initial appt, granting of privileges, every two years - correct answer ✔✔Hospitals must query
the NPDB when:
180 days - correct answer ✔✔NCQA requires verifications must be less than how many days
old?
,180 days - correct answer ✔✔What is the verification time limit on malpractice history
according to the NCQA?
120 days - correct answer ✔✔Time limited credential must be verified by the CVO within how
many days prior to submission to the client?
Experience and hospital affiliation - correct answer ✔✔According to AAAHC, for initial
appointments, in addition to licensure and education, what verification is required?
NCQA - correct answer ✔✔What accreditation body states "the NPDB is an acceptable source
for sanctions or limitations on licensure, Medicaid/Medicare sanctions and malpractice history?
Hospitals - correct answer ✔✔Who is required to query the NPDB?
Yes - correct answer ✔✔Is disciplinary action taken against the license of a dentist reportable to
the NPDB?
3 years - correct answer ✔✔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?
AMA, FSMB, HIPDB, OIG, Sanctions Report, NPDB, Sate Agency - correct answer ✔✔According
to NCQA, verification of Medicare/Medicaid sanctions can be queried by any of what sources?
Annually - correct answer ✔✔According to NCQA, how often must an organization conduct an
audit of the credentialing process delegated to another organization?
Back to medical school. NPDB. - correct answer ✔✔How far back does the Joint Commission
require evaluation of malpractice history? What source may be used?
, No - correct answer ✔✔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?
Joint Commission/CMS - correct answer ✔✔What accreditation bodies require privileges to be
distributed to essential department personnel?
True - the only organization that requires background checks is HFAP. - correct answer ✔✔T/F -
The Joint Commission and NCQA do not require criminal background checks.
Yes - correct answer ✔✔Is a payment made by an insurance company reportable to the NPDB?
Legal Counsel - correct answer ✔✔Who is the best person to consult when releasing adverse
information in a verification request from another organization?
Governing Board - correct answer ✔✔According to CMS, who in the organization may make
decisions regarding approval of credentialing applications?
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 - correct answer ✔✔What are the six
elements of a written delegation agreement?
