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These 10 free CPCS questions are organized by exam domain, so you can see how each part of the Certified Provider Credentialing Specialist blueprint is tested. Reveal the answer and explanation under each question.
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:
Correct answer: B - Verify the license directly with the issuing state licensing board
To verify completion of residency training for a U.S. allopathic (MD) physician, which of the following is an acceptable designated equivalent source?
Correct answer: C - The AMA Physician Masterfile
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?
Correct answer: C - The Educational Commission for Foreign Medical Graduates (ECFMG)
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?
Correct answer: B - Every two years
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:
Correct answer: D - Conduct FPPE on the newly granted privileges
Before temporary privileges are granted to a practitioner to meet an important patient-care need, which step is REQUIRED?
Correct answer: C - A query of the NPDB and a check of the OIG exclusion list
A specialist supports a Joint Commission-accredited hospital and its NCQA-accredited health plan. Neither setting has a shorter interval required by law, regulation or organizational policy. What is the maximum routine reappointment/recredentialing interval for each?
Correct answer: D - 36 months for both the hospital and the health plan
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:
Correct answer: B - 30 days
Ongoing Professional Practice Evaluation (OPPE) differs from FPPE primarily because OPPE is:
Correct answer: C - The continuous evaluation of all privileged practitioners
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:
Correct answer: C - Health plan, which retains oversight and accountability
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