FREE CPCS Basic 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 FREE CPCS Basic Questions and Answers flashcards as text
In medical credentialing, what does the abbreviation 'LIP' stand for?
Answer: Licensed Independent Practitioner
LIP stands for Licensed Independent Practitioner, a practitioner licensed to practice independently and without supervision under state law.
What is the difference between 'certification' and 'licensure' in the context of healthcare practitioner credentials?
Answer: Licensure is mandatory government authorization to practice; certification is voluntary professional recognition of specialized knowledge or competency
Licensure is mandatory government permission to practice a profession within a state; certification is typically voluntary recognition by a professional body (such as an ABMS board) of specialized expertise or competency beyond basic licensure.
Which of the following is most accurate regarding the relationship between credentialing and patient safety?
Answer: Credentialing is a patient safety mechanism that helps ensure only qualified practitioners provide care
Credentialing is fundamentally a patient safety mechanism, by verifying practitioner qualifications and monitoring ongoing competence, it helps ensure that only qualified, competent practitioners provide care to patients.
What is 'delegated credentialing' in the context of health plan credentialing?
Answer: When a health plan authorizes another organization (such as a hospital or CVO) to perform credentialing activities on the plan's behalf
Delegated credentialing occurs when a health plan formally authorizes another qualified organization to perform credentialing activities on its behalf, subject to a delegation agreement and ongoing oversight.
Which of the following best describes the concept of 'tail coverage' in malpractice insurance?
Answer: Extended reporting period coverage that provides protection after a claims-made policy ends for incidents that occurred during the policy period
Tail coverage (extended reporting endorsement) extends the reporting period for a claims-made malpractice policy, allowing claims to be filed after the policy ends for incidents that occurred during the policy period.
A credentialing specialist has been asked to prepare summary statistics on the credentialing department's performance for the monthly quality report. Which of the following would be the most meaningful performance indicator?
Answer: Average number of days from receipt of completed application to committee review
Average processing time from completed application receipt to committee review is a meaningful process efficiency metric that can be benchmarked against standards and trended over time.