Primary Source Verification Flashcards
7 cards from real CPCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Primary Source Verification flashcards as text
Which organization is considered the primary source for verifying a physician's board certification status?
Answer: The American Board of Medical Specialties (ABMS)
ABMS member boards are primary sources for verifying board certification because they directly issue and maintain certification records.
When performing primary source verification for a foreign medical graduate's education, which resource is most appropriate?
Answer: The Educational Commission for Foreign Medical Graduates (ECFMG)
ECFMG verifies the credentials of international medical graduates who want to practice in the United States.
A credential file shows a provider's DEA registration expired 30 days ago. What is the FIRST action a credentialing specialist should take?
Answer: Notify the medical staff office and request updated documentation
The first action is to notify the appropriate parties and request current documentation so the issue can be resolved promptly.
Which of the following best describes 'attestation' in the credentialing process?
Answer: A provider's sworn statement confirming the accuracy of their application
Attestation is when the applicant personally affirms the truthfulness and completeness of information provided on their application.
Under NCQA standards, how frequently must primary source verification be repeated for re-credentialing?
Answer: Every three years
NCQA requires re-credentialing, including primary source verification, at least every three years.
A provider's malpractice insurance certificate lists a coverage amount below the organization's minimum requirement. What should the credentialing specialist do?
Answer: Contact the malpractice carrier directly to verify coverage and amount
The specialist should verify directly with the malpractice carrier to confirm actual coverage terms and amounts.
Which federal database must be queried as part of primary source verification before granting clinical privileges?
Answer: The National Practitioner Data Bank (NPDB)
The NPDB must be queried for all practitioners applying for clinical privileges as required by federal law.