CPCS FREE CPCS MCQ Questions and Answers 3

Question 1

What is the standard term of appointment for medical staff membership at most hospitals under TJC standards?

Accepted Answer

2 years

Answer

1 year

Answer

3 years

Answer

5 years

Question 2

Which of the following best describes the function of 'CAQH ProView' in the credentialing process?

Accepted Answer

A universal credentialing application repository where practitioners maintain a single profile used by multiple health plans and hospitals

Answer

A primary source verification database maintained by the federal government

Answer

A database that tracks malpractice payments and adverse actions

Answer

An accreditation program for credentialing organizations

Question 3

A credentialing specialist receives an inquiry from a practitioner asking why their initial credentialing has taken 90 days. The specialist responds that processing is on schedule and will be complete before the URAC-required 120-day deadline. Which of the following is most accurate?

Accepted Answer

The specialist is correct, URAC allows up to 120 days for initial credentialing completion

Answer

The specialist is wrong, URAC requires completion within 60 days

Answer

URAC has no standard for credentialing timelines

Answer

The 120-day standard applies only to recredentialing

Question 4

Under NCQA credentialing standards, peer references for initial credentialing must be obtained from individuals meeting which requirement?

Accepted Answer

They must have directly observed the applicant's clinical work within the past 3 years

Answer

They must be licensed in the same state as the applicant

Answer

They must be employed by the same health plan or hospital

Answer

They must hold ABMS board certification

Question 5

What does 'adverse action' mean in the context of medical staff credentialing?

Accepted Answer

A formal action that negatively affects a practitioner's appointment status, clinical privileges, or professional standing

Answer

Any malpractice lawsuit filed against a practitioner

Answer

A negative patient satisfaction survey response

Answer

Failure to complete required continuing medical education

Question 6

Which of the following is the BEST definition of 'credentialing' as it applies to healthcare organizations?

Accepted Answer

The process of collecting, verifying, and assessing qualifications of practitioners to determine if they meet an organization's standards for appointment or participation

Answer

The process of negotiating fee schedules with network providers

Answer

The process of billing insurance companies for medical services rendered

Answer

The process of issuing medical licenses to physicians