CPCS – CREDENTIALING AND PRIVILEGING EXAM
QUESTIONS AND VERIFIED ANSWERS
TJC Phone PSV - ANSWER Which accreditation can use the phone for PSV
for all information including licensure, education, training, experience,
competence and peer references
LIP - ANSWER any individual permitted by law and by the hospital to
provide patient care services w/o direction or supervision
LIP - ANSWER any person legally allowed and by the hospital authorized to
offer patient care services w/o management or supervision,
TJC - DNV - HFAP - ANSWER one of the accrediting agencies for hospitals
TJC - DNV - HFAP - ANSWER one of the accrediting agencies for hospitals
NCQA - URAC - ANSWER one of the accrediting agencies for MCO
NCQA whom to credential- ANSWER credentialing is required for all licensed
practitioners that is physicians and non physicians
NCQA - URAC - ANSWER Accreditation bodies for Managed Care
Organizations MCO
, NCQA not credentialed - ANSWER inpatient setting for organizational member
only - pharmacy benefits management - locum tenens unless over 90 days -
NCQA - ANSWER What accreditation requires credentialing for all licensed
practitioners, physicians and non physicians
URAC who to credential - ANSWER All participating providers as well as
facilities that provide covered health care services to consumers. All
practitioners listed in the directory must be credentialed
NCQA - ANSWER Which of the following accrediting organizations does not
require credentialing in these settings? Inpatient setting for organizational
member only - pharmacy benefits management - locum tenens unless over 90
days -
URAC Directory Criteria - ANSWER Quality of Care, Service, and business
need of organization
URAC - ANSWER What accreditation requires all participating providers as
well as facilities that provide covered health care services to consumers. All
practitioners listed in the directory must be credentialed
URAC Directory Criteria - ANSWER What accreditation required the
following criteria? Quality of Care, Service, and business need of organization
URAC - not credentialed - ANSWER Physicians who are employees of a
facility as hospitalists and who are not listed in the directory.
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