CPCS CPCS Allied Health Professional Credentialing and Privileging 2 — Questions and Answers
Question 1: Which of the following allied health professionals is classified as a 'licensed independent practitioner' (LIP) under Joint Commission standards?
- Advanced Practice Registered Nurse with independent practice authority (Correct answer)
- Medical assistant operating under physician supervision
- Physical therapist assistant
- Surgical technologist
Correct 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.
Question 2: 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?
- Notify the department director and suspend privileges until the license is reinstated (Correct answer)
- Quietly extend the credentialing timeline to allow renewal
- Issue a corrective action plan and allow continued practice
- Update the file and proceed with re-credentialing
Correct 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.
Question 3: Which database is the MOST reliable primary source for verifying the licensure of an allied health professional in the United States?
- The relevant state licensing board's online verification system (Correct answer)
- The National Practitioner Data Bank (NPDB)
- The American Hospital Association directory
- The practitioner's curriculum vitae
Correct 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.
Question 4: 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?
- Use nationally recognized professional association scope-of-practice guidelines as a benchmark (Correct answer)
- Deny the application due to lack of regulatory guidance
- Grant full privileges without restriction
- Defer to the practitioner's personal judgment on scope
Correct 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.
Question 5: A hospital is credentialing a podiatrist. Which source would provide the MOST accurate primary source verification of their board certification?
- American Board of Podiatric Medicine (ABPM) or American Board of Foot and Ankle Surgery (ABFAS) (Correct answer)
- American Medical Association physician finder
- National Practitioner Data Bank only
- The practitioner's diploma from podiatric medical school
Correct 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.
Question 6: Under NCQA standards for credentialing, what is the maximum allowable age of a primary source verification at the time a credentialing decision is made?
- 180 days (Correct answer)
- 90 days
- 1 year
- 30 days
Correct answer: 180 days
NCQA credentialing standards require that primary source verifications used for a credentialing decision be no older than 180 days.
CPCS CPCS Allied Health Professional Credentialing and Privileging 2
Which of the following allied health professionals is classified as a 'licensed independent practitioner' (LIP) under Joint Commission standards?