CPCS Ethics & Professional Communication 4

Question 1

A practitioner submits a credentialing application with an unexplained 18-month gap in their employment history. The MOST appropriate next step is:

Accepted Answer

Request a written explanation from the practitioner and verify the information provided

Answer

Unexplained gaps require follow-up with the practitioner for a written explanation, which is then verified as part of due diligence.

Question 2

Effective professional communication in credentialing requires that written notices to practitioners be:

Accepted Answer

Clear, concise, complete, and delivered in a timely manner

Answer

Professional credentialing communications must be clear, concise, complete, and timely to ensure practitioners receive actionable information.

Question 3

A credentialing specialist who knowingly approves an application despite red flags to avoid additional work is violating which ethical principle?

Accepted Answer

Diligence (due care)

Answer

Diligence (due care) requires that credentialing professionals perform thorough, careful reviews of all applications, regardless of workload pressures.

Question 4

When a credentialing specialist must communicate a sensitive finding to the medical staff office, they should FIRST:

Accepted Answer

Confirm whether the information is accurate and review applicable confidentiality policies

Answer

Before communicating any sensitive finding, the specialist must confirm accuracy and review confidentiality policies to ensure proper handling.

Question 5

Privileged peer review information is generally protected from discovery in legal proceedings in order to:

Accepted Answer

Encourage candid, quality-focused peer review without fear of litigation

Answer

Peer review privilege exists to foster honest, candid quality improvement discussions without fear that opinions will be used against participants in lawsuits.

(CPCS) Certified Professional Credentialing Specialist Practice Test

(CPCS) Certified Professional Credentialing Specialist Practice Test

CPCS Ethics & Professional Communication 4