FREE CPCS Knowledge Questions and Answers

Question 1

AOA and AMA

Accepted Answer

PSV was approved by TJC for postgraduate study.

Answer

The Joint Commission (TJC) recognizes the American Medical Association (AMA) and the American Osteopathic Association (AOA) as acceptable primary sources for verifying postgraduate medical education. This means that credentialing professionals can rely on documentation from these organizations to confirm a practitioner's residency or fellowship training. Utilizing these approved sources streamlines the verification process while maintaining the required level of accuracy and reliability.

Question 2

At the time of credentialing, the credentials information must be accurate, up to date, and no older than 365 calendar days.

Accepted Answer

NCQA deadlines for HP/MBHO professional liability and malpractice

Answer

NCQA standards for Health Plans (HP) and Managed Behavioral Healthcare Organizations (MBHO) specify strict deadlines for credentialing information. For professional liability and malpractice history, the information must be accurate, up-to-date, and no older than 365 calendar days at the time of credentialing. This requirement ensures that organizations have current and relevant data to assess a practitioner's professional conduct and risk profile.

Question 3

The State licensing board where the practitioner is asking privileges must verify the primary source.

Accepted Answer

confirmation of the license's current status per TJC

Answer

The Joint Commission (TJC) requires primary source verification of a practitioner's license directly from the state licensing board where the practitioner is seeking privileges. This verification confirms the current status of the license, including any restrictions or disciplinary actions. This critical step ensures that the practitioner is legally authorized and qualified to practice in that specific jurisdiction, safeguarding patient care.

Question 4

CMS does not say anything about reviewing a malpractice history, but it does mandate that companies abide by local, state, and federal laws.

Accepted Answer

confirmation of past malpractice claims, according CMS

Answer

While the Centers for Medicare & Medicaid Services (CMS) does not explicitly detail the process for reviewing a practitioner's malpractice history, it mandates that organizations comply with all applicable federal, state, and local laws. This implicitly requires organizations to consider malpractice history as part of their credentialing process, as state laws and other accrediting bodies often require it to ensure patient safety and quality of care for Medicare/Medicaid beneficiaries.

Question 5

The AOA, the ECFMG, and the AMA

Accepted Answer

PSV for medical education was accepted by TJC.

Answer

The Joint Commission (TJC) accepts primary source verification (PSV) for medical education from several recognized organizations. These include the American Medical Association (AMA), the American Osteopathic Association (AOA), and the Educational Commission for Foreign Medical Graduates (ECFMG). These organizations serve as reliable sources to confirm a practitioner's foundational medical training, ensuring the validity of their educational background.

CPCS - Certified Provider Credentialing Specialist Practice Test

CPCS - Certified Provider Credentialing Specialist Practice Test

FREE CPCS Knowledge Questions and Answers