Credentialing Processes & Standards Flashcards
7 cards from real CHCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Credentialing Processes & Standards flashcards as text
Under The Joint Commission, temporary privileges to fulfill an important patient care need may not exceed how many days?
Answer: 120 days
Joint Commission standards limit temporary privileges to a maximum of 120 days.
Which verification is used to confirm a practitioner's authority to prescribe controlled substances federally?
Answer: DEA registration verification
Federal authority to prescribe controlled substances is confirmed through DEA registration.
An applicant answers 'no' to prior malpractice claims, but the NPDB report shows a paid claim. What is the best next step?
Answer: Flag the discrepancy and request an explanation from the applicant
Discrepancies between attestation and verified data must be investigated and explained before committee review.
What is the National Provider Identifier (NPI)?
Answer: A unique 10-digit identifier assigned by CMS through NPPES
The NPI is a unique 10-digit HIPAA standard identifier issued via NPPES.
Which concept best describes privileging?
Answer: Authorizing a practitioner to perform specific clinical services in a facility
Privileging grants a practitioner permission to perform specific procedures and services at a facility based on competence.
Under NCQA, which credential does NOT require primary source verification during initial credentialing?
Answer: The practitioner's hobbies and personal references
NCQA requires PSV for license, education/training and board certification, not personal information.
Which organization's database can confirm Medicare opt-out status of a practitioner?
Answer: CMS Medicare opt-out affidavit list
CMS publishes data on practitioners who have opted out of Medicare.
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