Certified Provider Credentialing Specialist (CPCS) Practice Exam

The governing body or board of an organization holds ultimate authority over credentialing processes according to CMS guidelines. This entity is responsible for establishing credentials policies and ensuring that the credentialing process aligns with the organization's standards, regulations, and overall mission. Their decisions reflect a comprehensive oversight that ensures qualified providers are granted the necessary credentials to practice within the organization.

While other individuals or committees, such as the credentialing committee or a department chairperson, may perform evaluations or make recommendations regarding credentialing applications, the final authority and decision-making power resides with the governing body or board. This structure ensures accountability and that all decisions regarding credentialing are made in accordance with regulatory and institutional standards.