Certified Provider Credentialing Specialist (CPCS) Practice Exam

At the time of recredentialing, the National Committee for Quality Assurance (NCQA) requires the verification of current malpractice insurance and state licensing. This requirement ensures that healthcare providers maintain their legal authorization to practice and that they are covered by malpractice insurance, which is critical for protecting both patients and the institution.

The focus on verifying malpractice and state license reflects the role of these credentials in ensuring the ongoing competency and lawful practice of providers. Maintaining an active state license is essential for providers to legally offer their services, while current malpractice insurance provides a safeguard for both providers and patients, ensuring that practitioners are compliant with professional liability requirements.

In contrast, while board certification, educational credentials, and criminal background checks are also important elements of a provider's qualifications, they do not have the same priority for verification at the time of recredentialing according to NCQA standards. This specific focus reflects the ongoing need for legal and liability coverage in the healthcare field.