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Free CPCS Practice Questions

10 free, exam-style Certified Provider Credentialing Specialist (CPCS) practice questions with answers and explanations. No signup required. Work through them below, then take the full free CPCS practice test to study every exam domain.

Question 1

A new applicant submits a clear photocopy of their state medical license along with the application. To satisfy primary source verification (PSV), the credentialing specialist should:

  1. Accept the photocopy because the license number and expiration are legible
  2. Verify the license directly with the issuing state licensing board
  3. Accept it once the practitioner signs an attestation confirming it is current
  4. File the copy and verify only if the committee raises a question
Show answer & explanation

Correct answer: B - Verify the license directly with the issuing state licensing board

Question 2

To verify completion of residency training for a U.S. allopathic (MD) physician, which of the following is an acceptable designated equivalent source?

  1. The training certificate supplied by the applicant
  2. A letter of recommendation from the program director
  3. The AMA Physician Masterfile
  4. The state medical licensing board
Show answer & explanation

Correct answer: C - The AMA Physician Masterfile

Question 3

An applicant attended medical school outside the United States and Canada. Which organization verifies the credentials this international medical graduate needs to enter U.S. graduate medical education?

  1. The Federation of State Medical Boards (FSMB)
  2. The American Board of Medical Specialties, which verifies board status
  3. The Educational Commission for Foreign Medical Graduates (ECFMG)
  4. The American Medical Association (AMA)
Show answer & explanation

Correct answer: C - The Educational Commission for Foreign Medical Graduates (ECFMG)

Question 4

Under federal requirements, how often must a hospital query the National Practitioner Data Bank (NPDB) on a practitioner who remains continuously on its medical staff?

  1. Annually, at each performance review
  2. Every two years
  3. Only when a complaint or claim is filed
  4. Once at appointment; no further query is required
Show answer & explanation

Correct answer: B - Every two years

Question 5

A nationally recognized, board-certified surgeon with 20 years of experience is granted new privileges at the hospital. Regarding Focused Professional Practice Evaluation (FPPE), the organization must:

  1. Waive FPPE because board certification documents current competence
  2. Waive FPPE based on the surgeon's documented experience and reputation
  3. Conduct FPPE only if a performance concern is later reported
  4. Conduct FPPE on the newly granted privileges
Show answer & explanation

Correct answer: D - Conduct FPPE on the newly granted privileges

Question 6

Before temporary privileges are granted to a practitioner to meet an important patient-care need, which step is REQUIRED?

  1. Completion of the full Focused Professional Practice Evaluation
  2. Confirmation that the practitioner's license is current and unrestricted only
  3. A query of the NPDB and a check of the OIG exclusion list
  4. Final approval of the application by the full governing body
Show answer & explanation

Correct answer: C - A query of the NPDB and a check of the OIG exclusion list

Question 7

A credentialing specialist works for both a hospital (Joint Commission accredited) and the hospital's affiliated health plan (NCQA accredited). What is the MAXIMUM reappointment/recredentialing interval that applies in EACH setting?

  1. 24 months for the hospital; 36 months for the health plan
  2. 36 months for the hospital; 24 months for the health plan
  3. 24 months for both the hospital and the health plan
  4. 36 months for both the hospital and the health plan
Show answer & explanation

Correct answer: A - 24 months for the hospital; 36 months for the health plan

Question 8

A hospital restricts a physician's clinical privileges as the result of a professional review action. The restriction must be reported to the NPDB when it adversely affects the physician's privileges for a period longer than:

  1. 15 days
  2. 30 days
  3. 60 days
  4. 90 days
Show answer & explanation

Correct answer: B - 30 days

Question 9

Ongoing Professional Practice Evaluation (OPPE) differs from FPPE primarily because OPPE is:

  1. A one-time, time-limited evaluation triggered whenever a new privilege is first requested
  2. A focused review performed only when a specific performance concern is raised about a practitioner
  3. The continuous evaluation of all privileged practitioners
  4. Required by NCQA for health plans rather than by the Joint Commission
Show answer & explanation

Correct answer: C - The continuous evaluation of all privileged practitioners

Question 10

A health plan signs a delegation agreement allowing a large medical group to perform credentialing on its behalf. Under this arrangement, ultimate accountability for the credentialing program rests with the:

  1. Medical group, because it now performs the verifications
  2. Credentials verification organization used by the group
  3. Health plan, which retains oversight and accountability
  4. State licensing board that issues the practitioners' licenses
Show answer & explanation

Correct answer: C - Health plan, which retains oversight and accountability

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