Page 1 of 61
CPCS EXAM NEWEST 2025 PACKAGE DEAL| 2
DIFFERENT VERSIONS WITH COMPLETE 1100 REAL
EXAM AND REVIEW QUESTIONS WITH CORRECT
VERIFIED ANSWERS/ ALREADY GRADED A+|
CERTIFIED PROVIDER CREDENTIALING SPECIALIST
FINAL EXAM PREP (MOST RECENT!!)
What two accreditors state: a hospital may not rely solely on
board certification when considering practitioner for medical
staff membership? .....ANSWER.....HFAP, CMS
According to JC & HFAP name four approved sources PSV for
Medical Education .....ANSWER.....Medical School, AMA, ECFMG,
AOA
According to NCQA practitioners must be notified of
credentialing decision within how many days? .....ANSWER.....60
Days
,Page 2 of 61
The DHHS mails a copy of the NPDB report to the named
provider. If the provider wishes to dispute the reports accuracy,
the provider has how many days to do so? .....ANSWER.....60
Days
According to URAQ, within how many days must the practitioner
be notified of credentialing decisions? .....ANSWER.....10 Days
How many days does a practitioner have to dispute an NPDB
report accuracy .....ANSWER.....60 Days
Which accrediting body requires five year verification of
malpractice history .....ANSWER.....NCQA
What is commonly used source for verifying malpractice history
.....ANSWER.....NPDB
According to the JC a fair hearing and appeals process as
described in the medical staff bylaws is available to whom?
.....ANSWER.....Medical staff members and non-members holding
clinical privileges
,Page 3 of 61
T/F Only the highest of training must be verified according to
NCQA .....ANSWER.....True
According to the Joint Commission a peer recommendation should
address what six competencies? .....ANSWER.....Medical
knowledge\nTechnical & clinical skill\nclinical
judgment\ninterpersonal skills\ncommunication
skills\nprofessionalism
Telemedicine - according to JC what two options are available
for credentialing a the original site? .....ANSWER.....Full
credentialing, use of the distant sites credentialing
According to JC what is included in the process of planning and
implementing privileges? .....ANSWER.....Develop & approve
procedure list\nProcess the application\nEvaluate applicant
specific information\nSubmit recommendations to governing
body for applicant specific delineated privileges\nNotify the
applicant, relevant personnel\nMonitor the use of privileges
, Page 4 of 61
Are payments made by a physician in a malpractice claim
reportable to the NPDB? .....ANSWER.....No
Who requires Peer References .....ANSWER.....JC, HFAP, AAAHC
Who reappoints .....ANSWER.....JC, HFAP, NCQA, URAC
Who requires an attestation? .....ANSWER.....NCQA, URAC,
AAAHC
Who requires education verification? .....ANSWER.....JC, HFAP,
URAC, AAAHC
Who requires statement regarding felony convictions?
.....ANSWER.....HFAP, NCQA, AAAHC
Attestation must state that the information submitted is complete
& correct .....ANSWER.....NCQA, AAAHC
Attestation must state that the information submitted is complete
& accurate .....ANSWER.....URAC
CPCS EXAM NEWEST 2025 PACKAGE DEAL| 2
DIFFERENT VERSIONS WITH COMPLETE 1100 REAL
EXAM AND REVIEW QUESTIONS WITH CORRECT
VERIFIED ANSWERS/ ALREADY GRADED A+|
CERTIFIED PROVIDER CREDENTIALING SPECIALIST
FINAL EXAM PREP (MOST RECENT!!)
What two accreditors state: a hospital may not rely solely on
board certification when considering practitioner for medical
staff membership? .....ANSWER.....HFAP, CMS
According to JC & HFAP name four approved sources PSV for
Medical Education .....ANSWER.....Medical School, AMA, ECFMG,
AOA
According to NCQA practitioners must be notified of
credentialing decision within how many days? .....ANSWER.....60
Days
,Page 2 of 61
The DHHS mails a copy of the NPDB report to the named
provider. If the provider wishes to dispute the reports accuracy,
the provider has how many days to do so? .....ANSWER.....60
Days
According to URAQ, within how many days must the practitioner
be notified of credentialing decisions? .....ANSWER.....10 Days
How many days does a practitioner have to dispute an NPDB
report accuracy .....ANSWER.....60 Days
Which accrediting body requires five year verification of
malpractice history .....ANSWER.....NCQA
What is commonly used source for verifying malpractice history
.....ANSWER.....NPDB
According to the JC a fair hearing and appeals process as
described in the medical staff bylaws is available to whom?
.....ANSWER.....Medical staff members and non-members holding
clinical privileges
,Page 3 of 61
T/F Only the highest of training must be verified according to
NCQA .....ANSWER.....True
According to the Joint Commission a peer recommendation should
address what six competencies? .....ANSWER.....Medical
knowledge\nTechnical & clinical skill\nclinical
judgment\ninterpersonal skills\ncommunication
skills\nprofessionalism
Telemedicine - according to JC what two options are available
for credentialing a the original site? .....ANSWER.....Full
credentialing, use of the distant sites credentialing
According to JC what is included in the process of planning and
implementing privileges? .....ANSWER.....Develop & approve
procedure list\nProcess the application\nEvaluate applicant
specific information\nSubmit recommendations to governing
body for applicant specific delineated privileges\nNotify the
applicant, relevant personnel\nMonitor the use of privileges
, Page 4 of 61
Are payments made by a physician in a malpractice claim
reportable to the NPDB? .....ANSWER.....No
Who requires Peer References .....ANSWER.....JC, HFAP, AAAHC
Who reappoints .....ANSWER.....JC, HFAP, NCQA, URAC
Who requires an attestation? .....ANSWER.....NCQA, URAC,
AAAHC
Who requires education verification? .....ANSWER.....JC, HFAP,
URAC, AAAHC
Who requires statement regarding felony convictions?
.....ANSWER.....HFAP, NCQA, AAAHC
Attestation must state that the information submitted is complete
& correct .....ANSWER.....NCQA, AAAHC
Attestation must state that the information submitted is complete
& accurate .....ANSWER.....URAC
