Certified Provider Credentialing Specialist (CPCS) Practice Exam 2025 - Free CPCS Practice Questions and Study Guide

Question: 1 / 400

According to NCQA, which sources can be queried for verification of Medicare/Medicaid sanctions?

Only state agencies

AMA, FSMB, HIPDB, OIG Sanctions Report, NPDB, State Agency

The correct answer is based on the fact that the National Committee for Quality Assurance (NCQA) recommends using specific, authoritative sources for verifying Medicare and Medicaid sanctions. The inclusion of the American Medical Association (AMA), Federation of State Medical Boards (FSMB), Health Integrity and Protection Data Bank (HIPDB), Office of Inspector General (OIG) Sanctions Report, the National Practitioner Data Bank (NPDB), and state agencies provides a comprehensive approach to verifying disciplinary actions.

Using these multiple sources ensures thoroughness and accuracy in verifying a provider's sanctions history. Each of these organizations maintains records that can serve as valuable references, offering vital information regarding any sanctions, licenses, or disciplinary measures against healthcare providers. This multifaceted approach aligns with best practices for provider credentialing and enhances patient safety by ensuring that all relevant data is taken into account.

In contrast, limiting the verification process to only state agencies or a single source like the NPDB would increase the risk of incomplete data and potentially overlook crucial disciplinary actions. The other options either suggest an inadequate methodology or an overly broad and less reliable approach by proposing any online database.

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Any online database

Only the NPDB

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