Certified Provider Credentialing Specialist (CPCS) Practice Exam

The ultimate authority in credentialing decisions according to NCQA is the board of directors. This body holds the responsibility for making final decisions regarding the appointment and reappointment of healthcare providers, ensuring that all credentialing processes comply with regulatory and accreditation standards.

While the credentials committee plays a vital role in reviewing applications and making recommendations, and the medical director may be involved in evaluating the clinical aspects of provider qualifications, the board's oversight is essential for maintaining accountability and governance in credentialing practices. This comprehensive authority reflects a system of checks and balances designed to uphold quality and safety in healthcare services.