CPCS Exam Questions and Answers

CPCS Exam Questions and Answers (Graded A)

Question : Why is it important to check that the practitioner is

not currently excluded, suspended, debarred, or ineligible to participate in Federal health care programs?

Correct answer: c. The facility won't get paid for treating

patients unless service is provided by an authorized provider.

Question : Which of the following credentials must be tracked

on an ongoing basis?

Correct answer: c. Licensure.

Question : According to NCQA standards, an organization

that discovers sanction information, complaints, or adverse events regarding a practitioner must take what action?

Correct answer: a. Determine if there is evidence of poor

quality that could affect the health and safety of its members.

Question : What is the name of the entity that was established

through the Health Care Quality Improvement Act of 1986 to restrict the ability of incompetent practitioners to move from

state to state without disclosure or discovery of previous medical malpractice payment and adverse action history?

Correct answer: b. The National Practitioner Data Bank.

Question : When developing clinical privileging criteria,

which of the following is important to evaluate?

Correct answer: b. Established standards of practice, such as

specialty board recommendations.

Question : What is the main reason for periodically assessing

appropriateness of clinical privileges of each specialty?

Correct answer: c. To protect patient safety by ensuring

current competency, relevance to the facility, and accepted standards of care.

Question : Which of the following specialists is most likely to

perform a PTCA?

• OB/GYN
• Urologist
• Interventional Cardiologist.

(PTCA = Percutaneous transluminal coronary angioplasty aka stent placement)

Correct answer: c. Interventional Cardiologist.

Question : The Joint Commission hospital standards require

that clinical privileges are hospital specific and...

Correct answer: a. Based on the individual's demonstrated

current competence and the procedures the hospital can support.

Question : Which of the following would be routinely

performed by a cardiologist?

• Hysterectomy
• Transesophageal Echocardiography.
• Urethral dilation

Correct answer: b. Transesophageal Echocardiography.

Question : Which NCQA-required committee makes

recommendations regarding credentialing decisions?

Correct answer: c. Credentialing Committee.

Question : HFAP standards require which three medical staff

committees to be delineated in the medical staff structure?

• Medical Executive Committee.
• Utilization of Osteopathic Methods & Concepts

Committee. (required for hospitals with ten or more DOs who admit patients and provide direct patient care)

• Utilization Review Committee.
• Credentials Committee
• Investigational Review Board

Correct answer: a. Medical Executive Committee.

• Credentials Committee
• Utilization Review Committee.

Question : How often does NCQA require that delegation

reports be evaluated by the health plan?

Correct answer: c. Semi-Annually.

Question : Peer references should be obtained from: