Basic Flashcards
7 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 7 Basic flashcards as text
Which of the following credentials would a Certified Registered Nurse Anesthetist (CRNA) need verified that a general RN would NOT?
Answer: CRNA certification from the NBCRNA
CRNAs must hold specialty certification from the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA), which is specific to their advanced practice role.
What is the key difference between credentialing and privileging?
Answer: Credentialing verifies qualifications; privileging grants specific clinical rights based on those qualifications
Credentialing is the process of verifying a practitioner's education, training, and experience, while privileging uses those verified credentials to determine what specific clinical activities the practitioner may perform.
A physician applies for credentials but discloses a malpractice suit that was settled five years ago. The credentialing committee should:
Answer: Review the circumstances of the case before making a determination
A settled malpractice case is a red flag that must be reviewed in context — the committee must assess the nature of the case, the provider's explanation, and any pattern of behavior before deciding.
Which statement about the Healthcare Integrity and Protection Data Bank (HIPDB) is most accurate as of 2013?
Answer: It was merged into the NPDB, creating a single data bank
In 2013, the HIPDB was merged into the NPDB to create a single, comprehensive federal data bank accessible to eligible organizations for credentialing and fraud prevention purposes.
When verifying board certification, the credentialing specialist should contact:
Answer: The specialty board that issued the certification
Primary source verification of board certification requires contacting the specific specialty board (e.g., ABIM, ABS) that issued the certification, not the physician or other intermediaries.
A credentialing file is considered 'complete' when:
Answer: All required primary source verifications are obtained and the application meets the organization's completeness criteria
A complete file requires all required verifications to be received and all application elements to meet the organization's defined completeness standards before it can be presented to the credentialing committee.
Which of the following best describes 'focused professional practice evaluation' (FPPE)?
Answer: A time-limited, defined period of monitoring granted to new practitioners or those with identified performance concerns
FPPE is a structured, time-limited evaluation of a practitioner's clinical performance, used for new appointees or when performance concerns are identified, before granting or modifying privileges.