CPCS FREE CPCS MCQ Questions and Answers 3

Question 1

What is the standard term of appointment for medical staff membership at most hospitals under TJC standards?

Accepted Answer

2 years

Answer

Under TJC standards, medical staff appointments are for a maximum of 2 years, requiring reappointment at intervals not to exceed two years.

Question 2

Which of the following best describes the function of 'CAQH ProView' in the credentialing process?

Accepted Answer

A universal credentialing application repository where practitioners maintain a single profile used by multiple health plans and hospitals

Answer

CAQH ProView is an industry-wide repository maintained by the Council for Affordable Quality Healthcare where practitioners maintain a single credentialing profile that multiple health plans and hospitals can access, reducing duplicative data submission.

Question 3

A credentialing specialist receives an inquiry from a practitioner asking why their initial credentialing has taken 90 days. The specialist responds that processing is on schedule and will be complete before the URAC-required 120-day deadline. Which of the following is most accurate?

Accepted Answer

The specialist is correct, URAC allows up to 120 days for initial credentialing completion

Answer

URAC credentialing standards require that the initial credentialing process be completed within 120 days of receiving a completed application, so 90 days into the process is within the allowed timeframe.

Question 4

Under NCQA credentialing standards, peer references for initial credentialing must be obtained from individuals meeting which requirement?

Accepted Answer

They must have directly observed the applicant's clinical work within the past 3 years

Answer

NCQA requires peer references to be from practitioners who have directly observed the applicant's clinical work within the past 3 years. They can be from any location or institution.

Question 5

What does 'adverse action' mean in the context of medical staff credentialing?

Accepted Answer

A formal action that negatively affects a practitioner's appointment status, clinical privileges, or professional standing

Answer

An adverse action is a formal action that negatively affects a practitioner's medical staff appointment, clinical privileges, or professional standing, typically involving reductions, restrictions, suspensions, or revocations of privileges or appointment.

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS FREE CPCS MCQ Questions and Answers 3