CPCS Primary Source Verification (PSV) Standards and Procedures 2 — Questions and Answers
Question 1: Which database is an acceptable primary source for verifying a physician's board certification according to The Joint Commission?
- The AMA DoctorFinder database
- Healthgrades or a similar public consumer website
- The applicable American Board of Medical Specialties (ABMS) member board (Correct answer)
- The hospital's previously completed credentialing file
Correct answer: The applicable American Board of Medical Specialties (ABMS) member board
ABMS member boards are the issuing authorities for specialty board certifications and are therefore the recognized primary source for verification.
Question 2: How frequently must Primary Source Verification be conducted for medical staff reappointment under typical Joint Commission standards?
- Every five years
- At least every two years, coinciding with each reappointment cycle (Correct answer)
- Only at initial appointment; reappointment requires only self-attestation
- Every ten years unless credentials change
Correct answer: At least every two years, coinciding with each reappointment cycle
TJC standards require credentials to be re-verified through primary sources at each reappointment, which must occur at least every two years.
Question 3: The Federation of State Medical Boards (FSMB) Physician Data Center is an acceptable primary source for verifying which type of credential?
- Board certification status across specialties
- Medical school degree and graduation date
- State medical licensure across multiple states (Correct answer)
- Graduate medical education (residency) completion
Correct answer: State medical licensure across multiple states
The FSMB Physician Data Center aggregates licensure data from member state boards, making it an acceptable source for verifying state medical licenses.
Question 4: When verifying completion of graduate medical education (residency), what is the correct primary source?
- The American Board of Medical Specialties (ABMS) database
- A training program director's letter held in the hospital's own credentialing file
- The graduate medical education (GME) office of the institution where training was completed (Correct answer)
- The American Medical Association physician profile
Correct answer: The graduate medical education (GME) office of the institution where training was completed
The GME office of the training institution is the issuing authority for residency completion records and therefore serves as the primary source.
Question 5: Which of the following is NOT considered Primary Source Verification?
- Calling a state licensing board directly to confirm licensure status
- Accessing the ABMS certification verification website
- Reviewing a photocopy of a diploma submitted by the applicant (Correct answer)
- Accessing the DEA Diversion Control Division registration verification portal
Correct answer: Reviewing a photocopy of a diploma submitted by the applicant
A document submitted by the applicant is a secondary source; PSV requires confirmation from the original issuing entity, not from the applicant.
Question 6: What is the role of CAQH ProView in the Primary Source Verification process?
- It serves as a primary source for all credential types
- It provides a centralized practitioner-self-reported repository that facilitates data collection, but PSV must still be obtained from issuing sources (Correct answer)
- It replaces the requirement for primary source verification under CMS rules
- It conducts malpractice history checks that satisfy PSV requirements
Correct answer: It provides a centralized practitioner-self-reported repository that facilitates data collection, but PSV must still be obtained from issuing sources
CAQH ProView centralizes practitioner-supplied data and streamlines the application process, but the practitioner data is self-reported and does not replace PSV from actual issuing sources.
Question 7: Under NCQA standards, how often must a Credentials Verification Organization (CVO) be recertified to maintain its recognized status?
- Every year
- Every two years
- Every three years (Correct answer)
- Every five years
Correct answer: Every three years
NCQA CVO certification is valid for three years, after which organizations must undergo a full recertification review to maintain their recognized status.
CPCS Primary Source Verification (PSV) Standards and Procedures 2
Which database is an acceptable primary source for verifying a physician's board certification according to The Joint Commission?