CPCS Basic 5

Question 1

Which of the following credentials would a Certified Registered Nurse Anesthetist (CRNA) need verified that a general RN would NOT?

Accepted Answer

CRNA certification from the NBCRNA

Answer

CRNAs must hold specialty certification from the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA), which is specific to their advanced practice role.

Question 2

What is the key difference between credentialing and privileging?

Accepted Answer

Credentialing verifies qualifications; privileging grants specific clinical rights based on those qualifications

Answer

Credentialing is the process of verifying a practitioner's education, training, and experience, while privileging uses those verified credentials to determine what specific clinical activities the practitioner may perform.

Question 3

A physician applies for credentials but discloses a malpractice suit that was settled five years ago. The credentialing committee should:

Accepted Answer

Review the circumstances of the case before making a determination

Answer

A settled malpractice case is a red flag that must be reviewed in context — the committee must assess the nature of the case, the provider's explanation, and any pattern of behavior before deciding.

Question 4

Which statement about the Healthcare Integrity and Protection Data Bank (HIPDB) is most accurate as of 2013?

Accepted Answer

It was merged into the NPDB, creating a single data bank

Answer

In 2013, the HIPDB was merged into the NPDB to create a single, comprehensive federal data bank accessible to eligible organizations for credentialing and fraud prevention purposes.

Question 5

When verifying board certification, the credentialing specialist should contact:

Accepted Answer

The specialty board that issued the certification

Answer

Primary source verification of board certification requires contacting the specific specialty board (e.g., ABIM, ABS) that issued the certification, not the physician or other intermediaries.

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS Basic 5