CPCS CPCS - Certified Provider Credentialing Specialist Accreditation Standards and Compliance Questions and Answers 2

Question 1

Which accreditation organization requires a credentialing committee to include at least one physician member when making privileging recommendations?

Accepted Answer

The Joint Commission (TJC)

Answer

The Joint Commission requires that the medical staff credentialing and privileging process involve physician participation, including physician representation on credentialing committees.

Question 2

URAC's credentialing accreditation standard requires initial credentialing to be completed within how many days of receiving a completed application?

Accepted Answer

120 days

Answer

URAC standards generally require that the credentialing process be completed within 120 days of receiving a completed application to ensure timely provider credentialing.

Question 3

Which NCQA credentialing standard addresses the delegation of credentialing activities to another organization?

Accepted Answer

CR 9

Answer

NCQA CR 9 specifically addresses delegation of credentialing and recredentialing activities, outlining requirements for oversight of delegated functions.

Question 4

DNV GL Healthcare integrates which management system standard into its hospital accreditation program?

Accepted Answer

ISO 9001

Answer

DNV GL Healthcare integrates ISO 9001 quality management system requirements into its NIAHO accreditation program, distinguishing it from other accreditation bodies.

Question 5

Under NCQA standards, which of the following is considered an 'adverse action' that must be reported to the NPDB?

Accepted Answer

Voluntary surrender of privileges while under investigation

Answer

Voluntary surrender of privileges while under investigation or to avoid investigation is a reportable adverse action to the NPDB under NCQA credentialing standards and federal law.

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS CPCS - Certified Provider Credentialing Specialist Accreditation Standards and Compliance Questions and Answers 2