MCQ 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 MCQ flashcards as text
Under NCQA standards, how long may a credentialing file remain active before re-credentialing is required?
Answer: 36 months
NCQA requires re-credentialing of practitioners at least every 36 months.
Which federal act established the National Practitioner Data Bank (NPDB)?
Answer: Health Care Quality Improvement Act of 1986
The Health Care Quality Improvement Act of 1986 created the NPDB to track adverse actions against practitioners.
A provider's DEA registration is expiring in 45 days. What action should a credentialing specialist take first?
Answer: Notify the provider and initiate a renewal reminder
Proactively notifying the provider and initiating a renewal reminder ensures continuous compliance before expiration.
Which of the following best describes 'primary source verification' in credentialing?
Answer: Confirming credentials directly with the issuing organization
Primary source verification requires confirming credentials directly with the original issuing organization.
Which organization publishes the Credentials Verification Organization (CVO) certification program?
Answer: NCQA
NCQA certifies CVOs through its CVO Certification program to standardize credentialing verification.
A practitioner reports a malpractice settlement that was not disclosed on the initial application. Which step is most appropriate?
Answer: Conduct a focused review of the omission and apply established policy
A focused review of the undisclosed settlement and application of established policy ensures fair and consistent handling.
Under the Americans with Disabilities Act (ADA), a healthcare organization's credentialing process must:
Answer: Not discriminate against qualified providers based on disability
The ADA prohibits discrimination against qualified individuals with disabilities, including during credentialing.