CHCS CHCS Primary Source Verification & Quality Management 1

Question 1

What is 'primary source verification' (PSV) in the credentialing process?

Accepted Answer

Confirming a practitioner's credentials directly with the originating institution or licensing body

Answer

PSV requires confirmation of a practitioner's credentials directly from the source that issued them, such as a medical school or licensing board.

Question 2

Which organization established the most widely recognized standards for primary source verification in credentialing, particularly for health plans?

Accepted Answer

NCQA (National Committee for Quality Assurance)

Answer

NCQA's credentialing standards define PSV requirements for health plans and are used as the benchmark for managed care credentialing.

Question 3

Under NCQA standards, which of the following elements requires primary source verification?

Accepted Answer

Current valid license to practice

Answer

Current, valid licensure is one of the core elements that must be verified at the primary source (state licensing board) under NCQA credentialing standards.

Question 4

The National Practitioner Data Bank (NPDB) must be queried during initial credentialing and at minimum how often thereafter?

Accepted Answer

Every 2 years

Answer

NPDB regulations require hospitals to query the databank at initial appointment and at least every two years at reappointment.

Question 5

Which type of NPDB report allows a hospital to continuously monitor practitioners between required queries?

Accepted Answer

Continuous query (proactive disclosure)

Answer

The NPDB's continuous query (proactive disclosure) service automatically notifies enrolled organizations when a new report is filed on a monitored practitioner.

CHCS - Certified Healthcare Credentialing Specialist Practice Test

CHCS - Certified Healthcare Credentialing Specialist Practice Test

CHCS CHCS Primary Source Verification & Quality Management 1