Cpcs - Certified Provider Credentialing Specialist 96 Questions And Answers

What is the verification time limit for verification of Medicare/Medicaid sanctions according to NCQA? {Ans: 180 days}According to TJC, what source may be used to evaluate malpractice history? {Ans: NPDB}According to TJC, who has the ultimate authority in credentialing decisions? {Ans: Governing body/board.}According to NCQA, how long is the signature on the attestation good for? {Ans: 365 days}What is the time limit on PSV of current licensure according to NCQA? {Ans: 180 days}According to the NCQA what policy must an organization have in place to obtain approval to enter into a delegated agreement? {Ans: Credentialing policies}According to TJC, what committee is required to review and make recommendations regarding credentialing applications? {Ans: MEC}If the physician is notified of an adverse recommendation and requests a hearing what is required in the notice? {Ans: Place, time and date, hearing date within 30 days from date of notice, list of witnesses}When must hospitals query the NPDB? {Ans: Initial appointment, granting of privileges, every two years.}No accreditation body requires verification of malpractice insurance. (T/F) {Ans: True}Who is required to query the NPDB? {Ans: Hospitals}Telemedicine - according to TJC, what two options are available for