CPCS Primary Source Verification (PSV) Standards and Procedures 3

Question 1

A practitioner's medical school closed and no successor organization can be found. What is the most appropriate action for the credentialing specialist?

Accepted Answer

Research alternative verification sources such as state licensing board records or AMA profiles, document all efforts, and follow organizational policy

Answer

Waive the PSV requirement entirely since the school no longer exists

Answer

Accept the practitioner's copy of the diploma as sufficient verification

Answer

Automatically deny the application due to inability to verify

Question 2

Which scenario represents a failed Primary Source Verification that requires escalation?

Accepted Answer

A training institution cannot confirm that a practitioner completed the residency they claimed on their application

Answer

A state licensing board confirms a license is active but notes a prior suspension now lifted

Answer

The ABMS database shows board certification as current and unrestricted

Answer

A DEA registration is confirmed as valid through the DEA verification portal

Question 3

What is the required action when a discrepancy is discovered between a practitioner's attestation and Primary Source Verification findings?

Accepted Answer

Document the discrepancy and refer the matter to the credentials committee per organizational policy

Answer

Immediately terminate the application without further investigation

Answer

Ignore minor discrepancies if they do not appear to affect clinical competency directly

Answer

Contact the practitioner to allow correction of the information before any documentation occurs

Question 4

Under The Joint Commission standards, which elements must be verified both at initial appointment AND at reappointment?

Accepted Answer

Current licensure, relevant training or experience, current competence, and ability to perform requested privileges

Answer

Medical school graduation date only

Answer

Criminal background checks and malpractice history only

Answer

Medicare and Medicaid enrollment status

Question 5

A hospital delegates PSV to a Credentials Verification Organization (CVO). Which statement is TRUE regarding the hospital's accountability?

Accepted Answer

The hospital remains fully accountable for ensuring PSV is completed appropriately and meets accreditation standards

Answer

The hospital has no further credentialing responsibility once a CVO is engaged

Answer

The CVO assumes complete legal liability for any errors that occur during verification

Answer

Using a CVO eliminates the need for medical staff committee review of credentials

Question 6

Which element must be verified through Primary Source Verification for every practitioner seeking privileges, according to CMS Conditions of Participation?

Accepted Answer

A current, valid license to practice in the state

Answer

National Provider Identifier (NPI) number

Answer

Professional liability insurance coverage limits

Answer

Complete employment history for the past 10 years

Question 7

Which best describes the role of the National Association Medical Staff Services (NAMSS) in relation to Primary Source Verification standards?

Accepted Answer

NAMSS provides best practice guidance and position statements to help credentialing professionals conduct and document PSV appropriately

Answer

NAMSS publishes legally binding PSV requirements that supersede Joint Commission standards

Answer

NAMSS certifies CVOs to perform PSV on behalf of accredited hospitals

Answer

NAMSS replaces The Joint Commission as the primary accreditation authority for hospital credentialing