CPCS Allied Health Professional Credentialing and Privileging Flashcards
6 cards from real CPCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 CPCS Allied Health Professional Credentialing and Privileging flashcards as text
Which of the following allied health professionals is classified as a 'licensed independent practitioner' (LIP) under Joint Commission standards?
Answer: Advanced Practice Registered Nurse with independent practice authority
An APRN with independent practice authority meets the TJC LIP definition because they are permitted by law and the organization to provide care without physician direction.
A respiratory therapist's state license has lapsed. The credentialing specialist discovers this during a routine re-credentialing cycle. What is the CORRECT immediate action?
Answer: Notify the department director and suspend privileges until the license is reinstated
A lapsed license is a patient safety issue requiring immediate suspension of privileges and notification to leadership per accreditation standards.
Which database is the MOST reliable primary source for verifying the licensure of an allied health professional in the United States?
Answer: The relevant state licensing board's online verification system
State licensing board websites are primary sources because they contain real-time, authoritative licensure status directly from the issuing authority.
An occupational therapist requests privileges at a hospital in a state that does not specifically regulate their scope of practice by statute. How should the credentialing specialist proceed?
Answer: Use nationally recognized professional association scope-of-practice guidelines as a benchmark
When state law is silent, national professional association standards provide an authoritative benchmark for defining appropriate scope of practice.
A hospital is credentialing a podiatrist. Which source would provide the MOST accurate primary source verification of their board certification?
Answer: American Board of Podiatric Medicine (ABPM) or American Board of Foot and Ankle Surgery (ABFAS)
ABPM and ABFAS are the recognized certifying bodies for podiatrists, making them the authoritative primary sources for board certification verification.
Under NCQA standards for credentialing, what is the maximum allowable age of a primary source verification at the time a credentialing decision is made?
Answer: 180 days
NCQA credentialing standards require that primary source verifications used for a credentialing decision be no older than 180 days.