Certified Provider Credentialing Specialist (CPCS) Practice Exam

The governing body or board is the entity that holds the ultimate authority in credentialing decisions according to The Joint Commission (TJC). This is because the governing body is responsible for overall organizational management and must ensure that the organization meets the regulatory and accrediting standards for credentialing health care professionals.

The governing body has the final say in the approval of credentials and privileges, ensuring that the competencies of practitioners align with the needs of the facility and that all processes adhere to legal and ethical standards. It is their duty to review recommendations from the credentialing committee and take the necessary actions based on the provided information.

While other entities, such as medical staff and credentialing committees, play important roles in the credentialing process by evaluating qualifications and making recommendations, their authority is limited to the scope defined by the policies established by the governing body. The state licensing board typically oversees licensure requirements but does not have authority over the specific credentialing decisions made within individual health care organizations, which is the exclusive responsibility of the governing body or board.