CPCS - Certified Provider Credentialing Specialist Accreditation Standards and Compliance Questions and Answers 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 - Certified Provider Credentialing Specialist Accreditation Standards and Compliance Questions and Answers flashcards as text
Which accreditation organization requires a credentialing committee to include at least one physician member when making privileging recommendations?
Answer: The Joint Commission (TJC)
The Joint Commission requires that the medical staff credentialing and privileging process involve physician participation, including physician representation on credentialing committees.
URAC's credentialing accreditation standard requires initial credentialing to be completed within how many days of receiving a completed application?
Answer: 120 days
URAC standards generally require that the credentialing process be completed within 120 days of receiving a completed application to ensure timely provider credentialing.
Which NCQA credentialing standard addresses the delegation of credentialing activities to another organization?
Answer: CR 9
NCQA CR 9 specifically addresses delegation of credentialing and recredentialing activities, outlining requirements for oversight of delegated functions.
DNV GL Healthcare integrates which management system standard into its hospital accreditation program?
Answer: ISO 9001
DNV GL Healthcare integrates ISO 9001 quality management system requirements into its NIAHO accreditation program, distinguishing it from other accreditation bodies.
Under NCQA standards, which of the following is considered an 'adverse action' that must be reported to the NPDB?
Answer: Voluntary surrender of privileges while under investigation
Voluntary surrender of privileges while under investigation or to avoid investigation is a reportable adverse action to the NPDB under NCQA credentialing standards and federal law.
Which accreditation body requires a 'deemed status' survey that satisfies Medicare Conditions of Participation?
Answer: TJC and DNV GL Healthcare
Both The Joint Commission and DNV GL Healthcare have CMS-approved deemed status authority, meaning their accreditation surveys satisfy Medicare Conditions of Participation requirements.