Page 1 of 31
CPCS-Certified Provider Credentialing Specialist DC
Property Management License Exam Newest 2025
Actual Exam Test Bank| Complete Questions and
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Are limitations of the clinical privileges of a psychiatrist for more
than 30 days reportable to the NPDB? .....ANSWER..... Yes
According to TJC, who may amend the medical staff bylaws?
.....ANSWER..... Governing body/board.
Failure to meet the established qualifications and criteria for
appointment should be reported to whom? .....ANSWER..... The
applicant
NCQA requires the MCO to obtain a minimum of how may years
of work history? .....ANSWER..... Five years
,Page 2 of 31
According to the NCQA what policy must an organization have in
place to obtain approval to enter into a delegated agreement?
.....ANSWER..... Credentialing policies
How often does the OIG report to the NPDB? .....ANSWER.....
Monthly
When must hospitals query the NPDB? .....ANSWER..... Initial
appointment, granting of privileges, every two years.
NCQA requires verifications must be less than how many days
old? .....ANSWER..... 180 days
What is the verification time limit on malpractice history
according to the NCQA? .....ANSWER..... 180 days
Time limited credential must be verified by the CVO with how
may days prior to submission to the client? .....ANSWER..... 120
days
,Page 3 of 31
According the AAAHC, for initial appointments, in addition to
licensure and education, what verification is required?
.....ANSWER..... Experience and hospital affiliations.
What accreditation body states "The NPDB is an acceptable
source for sanctions or limitations on licensure, Medicaid/
Medicare sanctions and malpractice history? .....ANSWER.....
NCQA
Who is required to query the NPDB? .....ANSWER..... Hospitals
Is disciplinary action taken against the license of a dentist
reportable to the NPDB? .....ANSWER..... 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? .....ANSWER..... 3
years
, Page 4 of 31
According to NCQA, verification of Medicare/Medicaid
sanctions can be queried by any of what sources? .....ANSWER.....
AMA, FSMB, HIPDB, OIG Sanctions Report, NPDB, State Agency
According to NCQA, how often must an organization conduct an
audit of the credentialing process delegated to another
organization? .....ANSWER..... Annually
How far back does TJC require evaluation of malpractice
history? .....ANSWER..... Back to medical school
According to TJC, what source may be used to evaluate
malpractice history? .....ANSWER..... 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?
.....ANSWER..... No
What accreditation bodies require privileges to be distributed to
essential department personnel? .....ANSWER..... TJC, CMS
CPCS-Certified Provider Credentialing Specialist DC
Property Management License Exam Newest 2025
Actual Exam Test Bank| Complete Questions and
Correct Answers (Verified Answers) Already Graded
A+|| Brand New!!
Are limitations of the clinical privileges of a psychiatrist for more
than 30 days reportable to the NPDB? .....ANSWER..... Yes
According to TJC, who may amend the medical staff bylaws?
.....ANSWER..... Governing body/board.
Failure to meet the established qualifications and criteria for
appointment should be reported to whom? .....ANSWER..... The
applicant
NCQA requires the MCO to obtain a minimum of how may years
of work history? .....ANSWER..... Five years
,Page 2 of 31
According to the NCQA what policy must an organization have in
place to obtain approval to enter into a delegated agreement?
.....ANSWER..... Credentialing policies
How often does the OIG report to the NPDB? .....ANSWER.....
Monthly
When must hospitals query the NPDB? .....ANSWER..... Initial
appointment, granting of privileges, every two years.
NCQA requires verifications must be less than how many days
old? .....ANSWER..... 180 days
What is the verification time limit on malpractice history
according to the NCQA? .....ANSWER..... 180 days
Time limited credential must be verified by the CVO with how
may days prior to submission to the client? .....ANSWER..... 120
days
,Page 3 of 31
According the AAAHC, for initial appointments, in addition to
licensure and education, what verification is required?
.....ANSWER..... Experience and hospital affiliations.
What accreditation body states "The NPDB is an acceptable
source for sanctions or limitations on licensure, Medicaid/
Medicare sanctions and malpractice history? .....ANSWER.....
NCQA
Who is required to query the NPDB? .....ANSWER..... Hospitals
Is disciplinary action taken against the license of a dentist
reportable to the NPDB? .....ANSWER..... 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? .....ANSWER..... 3
years
, Page 4 of 31
According to NCQA, verification of Medicare/Medicaid
sanctions can be queried by any of what sources? .....ANSWER.....
AMA, FSMB, HIPDB, OIG Sanctions Report, NPDB, State Agency
According to NCQA, how often must an organization conduct an
audit of the credentialing process delegated to another
organization? .....ANSWER..... Annually
How far back does TJC require evaluation of malpractice
history? .....ANSWER..... Back to medical school
According to TJC, what source may be used to evaluate
malpractice history? .....ANSWER..... 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?
.....ANSWER..... No
What accreditation bodies require privileges to be distributed to
essential department personnel? .....ANSWER..... TJC, CMS
