CPCS - Certified Provider Credentialing Specialist CPCS-FREE Cpcs 1

Question 1

What triggers a Focused Professional Practice Evaluation (FPPE) for a licensed practitioner at a hospital?

Accepted Answer

A practitioner's initial appointment or the granting of new clinical privileges

Answer

FPPE is a time-limited monitoring process mandated by The Joint Commission (TJC) whenever a practitioner joins the medical staff for the first time or is granted a new privilege, allowing the hospital to confirm competency before granting full, unrestricted practice.

Question 2

Which federal database must credentialing professionals check specifically to determine whether a provider has been excluded from participation in Medicare, Medicaid, or other federal healthcare programs?

Accepted Answer

The OIG List of Excluded Individuals/Entities (LEIE)

Answer

The OIG LEIE is the authoritative list of individuals and entities excluded from federally funded healthcare programs. While the NPDB tracks malpractice payments and adverse actions, the LEIE is the specific tool for identifying federal program exclusions.

Question 3

Under CMS Conditions of Participation, what is the maximum length of a medical staff reappointment cycle?

Accepted Answer

2 years

Answer

CMS Conditions of Participation require that hospitals reappoint and re-evaluate medical staff members at least every two years. This ensures ongoing competency review and keeps practitioner information current.

Question 4

In the context of telemedicine credentialing, what is 'proxy credentialing'?

Accepted Answer

A CMS-approved process whereby an originating-site hospital relies on the credentialing and privileging decisions made by a distant-site hospital or telemedicine entity

Answer

Proxy credentialing, recognized by CMS, allows the originating site (where the patient is located) to grant telemedicine privileges based on the distant site's credentialing decisions, eliminating duplicative full verification and reducing administrative burden.

Question 5

Which organization administers the Certified Provider Credentialing Specialist (CPCS) certification examination?

Accepted Answer

The National Association Medical Staff Services (NAMSS)

Answer

NAMSS is the professional association for medical staff services professionals and is responsible for developing and administering both the CPCS and CPMSM (Certified Professional Medical Services Management) certification examinations.

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS - Certified Provider Credentialing Specialist CPCS-FREE Cpcs 1