CPCS Reappointment and Recredentialing 2

Question 1

A hospital's medical staff bylaws state that reappointment applications must be submitted 120 days before privileges expire. A physician submits her application 60 days before expiration. What is the most appropriate action?

Accepted Answer

Notify the physician of the late submission and follow the bylaw's late-submission policy

Answer

The credentialing office should notify the physician and apply the late-submission policy outlined in the medical staff bylaws.

Question 2

Which of the following best describes 'lapse in privileges' during the recredentialing process?

Accepted Answer

A gap in clinical privileges that occurs when reappointment is not completed before the expiration date

Answer

A lapse in privileges occurs when the reappointment process is not finalized before the provider's current privilege period ends.

Question 3

During recredentialing, a physician's NPDB query reveals a malpractice payment made since the last appointment. What is the FIRST step the credentials committee should take?

Accepted Answer

Request a detailed explanation from the physician

Answer

The committee should first request a detailed explanation from the physician before making any determination about reappointment.

Question 4

A telehealth provider seeking reappointment at a distant site hospital relies on credentialing by proxy. The credentialing is based on the originating site's credentials. What document must the originating site provide?

Accepted Answer

An attestation that the provider is currently credentialed and privileged at the originating site in good standing

Answer

CMS and accreditation standards require the originating site to provide an attestation of current good standing for telemedicine credentialing by proxy.

Question 5

An organization's recredentialing cycle is every two years. A provider who was appointed 18 months ago voluntarily resigns. If they reapply 10 months later, how should the organization treat this application?

Accepted Answer

As an initial appointment requiring full primary source verification

Answer

A voluntary resignation followed by reapplication is treated as a new initial appointment requiring complete primary source verification regardless of prior credentialing.

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS Reappointment and Recredentialing 2