CPCS Primary Source Verification (PSV) Standards and Procedures 1 — Questions and Answers
Question 1: What is the primary purpose of Primary Source Verification (PSV) in the credentialing process?
- To reduce administrative costs in the credentialing department
- To confirm the accuracy of a practitioner's credentials directly from the issuing source (Correct answer)
- To evaluate a practitioner's clinical performance outcomes
- To establish salary benchmarks for medical staff
Correct answer: To confirm the accuracy of a practitioner's credentials directly from the issuing source
PSV confirms credential accuracy by obtaining verification directly from the original issuing organization, such as a medical school or licensing board, rather than relying on applicant-supplied copies.
Question 2: Which organization's accreditation standards most directly define Primary Source Verification requirements for hospital credentialing?
- American Medical Association (AMA)
- Centers for Medicare & Medicaid Services (CMS) only
- The Joint Commission (TJC) (Correct answer)
- American Hospital Association (AHA)
Correct answer: The Joint Commission (TJC)
The Joint Commission sets detailed credentialing standards—including PSV requirements—for accredited hospitals through its Medical Staff chapter.
Question 3: Which of the following credentials requires Primary Source Verification and cannot be accepted solely from an applicant-submitted document?
- A photocopy of a malpractice insurance certificate
- A personal reference letter from a colleague
- Board certification status (Correct answer)
- A curriculum vitae listing prior employers
Correct answer: Board certification status
Board certification must be verified through the issuing certifying board because applicant-supplied documents are secondary sources and do not constitute PSV.
Question 4: What constitutes an 'acceptable equivalent' to direct Primary Source Verification under Joint Commission standards?
- A notarized copy of the credential provided by the applicant
- Verification performed by an NCQA-certified Credentials Verification Organization (CVO) (Correct answer)
- A sworn affidavit from the practitioner attesting to credential accuracy
- Confirmation from the practitioner's previous hospital employer
Correct answer: Verification performed by an NCQA-certified Credentials Verification Organization (CVO)
A CVO certified by NCQA or an equivalent body is recognized as an acceptable equivalent to direct PSV because it meets defined quality and accuracy standards.
Question 5: Under The Joint Commission standards, verification of a practitioner's medical education (degree) must be obtained from:
- The practitioner's current hospital employer of record
- The American Medical Association physician database
- The medical school or equivalent institution that granted the degree (Correct answer)
- The state medical licensing board
Correct answer: The medical school or equivalent institution that granted the degree
TJC requires medical education to be verified directly from the degree-granting institution because that institution is the primary source of that credential.
Question 6: Which of the following is the correct primary source for verifying a physician's state medical license?
- The physician's curriculum vitae
- The state medical licensing board (Correct answer)
- The National Practitioner Data Bank (NPDB)
- The hospital's existing credentialing file from a prior appointment
Correct answer: The state medical licensing board
The state medical licensing board is the issuing authority for medical licenses, making it the primary source for license verification.
Question 7: What should a credentialing specialist do when the primary source cannot be reached for verification despite multiple documented attempts?
- Accept the practitioner's self-attestation as sufficient and proceed
- Deny the application immediately without further review
- Document all attempts thoroughly and follow organizational policy, escalating to the credentials committee as required (Correct answer)
- Use internet searches or public databases as substitute verification
Correct answer: Document all attempts thoroughly and follow organizational policy, escalating to the credentials committee as required
When PSV cannot be completed, credentialing professionals must document every attempt and defer to organizational policy and bylaws, which typically require credentials committee involvement.
CPCS Primary Source Verification (PSV) Standards and Procedures 1
What is the primary purpose of Primary Source Verification (PSV) in the credentialing process?