CPCS Basic 4

Question 1

A credentialing specialist discovers a physician's state medical license expired two months ago. What is the most appropriate immediate action?

Accepted Answer

Place the credentialing file on hold and notify the medical staff office

Answer

An expired license is a critical credential deficiency; the file should be placed on hold and the appropriate stakeholders notified so the physician can resolve the issue before any privileges or panel status are continued.

Question 2

Which credentialing process allows a provider to begin seeing patients before the full credentialing review is complete?

Accepted Answer

Provisional credentialing

Answer

Provisional credentialing grants limited, time-bound privileges to practitioners while their full credentialing file is being processed, often used to address urgent staffing needs.

Question 3

What is the standard timeframe within which a hospital must report a practitioner's voluntary resignation while under investigation to the NPDB?

Accepted Answer

30 days

Answer

Hospitals must report to the NPDB within 30 days when a practitioner surrenders or has restrictions placed on clinical privileges while under investigation or in return for not conducting an investigation.

Question 4

A credentialing coordinator receives a hostile response when contacting a previous employer for a reference. The best course of action is to:

Accepted Answer

Document the attempt and try an alternate contact at the same organization

Answer

The credentialing specialist should document all verification attempts and pursue alternate contacts within the same organization to ensure thorough primary source verification.

Question 5

Which element is NOT typically required in a standard provider credentialing application?

Accepted Answer

Personal financial statements

Answer

Personal financial statements are not part of credentialing applications, which focus on education, training, licensure, malpractice history, and professional conduct.

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS Basic 4