HCCA - CHPC Study Questions 2026 Exam
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demonstrates their understanding of business principles.1.4. Preparing for Business ExamsPreparing for business exams involves mastering both conceptual understanding and
practical application. Students are encouraged to study theories and frameworks
Terms in this set (302)
What is the purpose of HIPAA? • Protect PHI from unauthorized disclosure/use;
• Prevent fraud, waste and abuse (via Administrative
Simplification);
• Make health insurance portable under ERISA;
• Move health care onto a nationally standardized
electronic billing platform
Ref. https://quizlet.com/6202453/hcca-chpc-
overview-flash-cards/
More on HIPAA:
https://www.hhs.gov/hipaa/index.html
HIPAA resides in which CFR section? 45 CFR sections 164.102 through 164.534
https://www.ecfr.gov/current/title-45/subtitle-
A/subchapter-C/part-164
, What are the subparts of HIPAA part HIPAA - 45 CFR 164, subparts:
164? Subpart A - General rules
Subpart C - Security
Subpart D - Breach notification
Subpart E - Privacy
https://www.ecfr.gov/current/title-45/subtitle-
A/subchapter-C/part-164
How do you determine if an 1. compare if the organization meets one of the 3
organization is a "Covered Entity"? types of CE (provider, health plan, clearinghouse)
and
2. determine if the organization electronically
transmits one of the 9 defined transactions:
• Health claims or equivalent encounter information
• Health claims attachments
• Enrollment and disenrollment in a health plan
• Eligibility for a health plan
• Health care payment and remittance advice
• Health plan premium payments
• First report of injury
• Health claim status
• Referral certification and authorization
In addition, business associates of covered entities
must follow parts of the HIPAA regulations.
https://www.hhs.gov/hipaa/for-
individuals/guidance-materials-for-
consumers/index.html
demonstrates their understanding of business principles.1.4. Preparing for Business
ExamsPreparing for business exams involves mastering both conceptual understanding and practical application. Students are encouraged to study theories and frameworks
, This Act established in 1974 was The Privacy Act of 1974
created for government agencies
placing restrictions on how the
government can share the
information maintained in Federal
systems of records that might
infringe on an individual's privacy
rights with other individuals and
agencies.
Which of the following is not 4. Contract arrangement with FEDEX carrier
considered a HIPAA Entity
Designation:
1. Affiliated covered entity
2. Entity that performs healthcare
and non-healthcare component
activities including both covered and
non-covered functions
3. A group health plan
4. Contract arrangement with FEDEX
carrier
What is Gramm-Leach-Bliley Act Gramm-Leach-Bliley Act (GLBA), also known as the
(GLBA)? Financial Services Modernization Act of 1999,
includes The Financial Privacy Rule and The
Safeguards Rule requires all financial institutions to
protect customer's personal financial information.
demonstrates their understanding of business principles.1.4. Preparing for Business ExamsPreparing for
business exams involves mastering both conceptual understanding and practical application. Students are encouraged to study theories and frameworks
, What is an OHCA? OHCA (Organized Health Care Arrangement) it's a
clinically integrated care setting where individuals
receive health care from more than one provider.
These are joint arrangements/activities and have an
Integrated Delivery System for easy exchange of
PHI data. See 45 CFR 160.103. OHCAs can also
utilize a joint NPP. See 45 CFR § 164.520(d).
ACE (Affiliated Covered Entity) do not have an
Integrated Delivery System because these are
legally separate covered entities that are
associated in business, or affiliated as a result of
some common control or ownership.
Both the OHCA and the ACE would allow sharing
of PHI across participating entity lines for
treatment, payment, operations purposes (TPO).
What's an ACE? ACE (Affiliated Covered Entity)
Legally separate covered entities that share
common control/ownership and designate
themselves as a single CE for the purpose of
complying with the HIPAA Privacy standards.
ACEs do not have an Integrated Delivery System,
while OHCA do, and can share a single NPP. See
45 CFR § 164.520(d)
ACE example: a health system composed on
several affiliated hospitals.
Both the OHCA and the ACE would allow sharing
of PHI across participating entity lines for
treatment, payment, operations purposes (TPO).
demonstrates their understanding of business principles.1.4. Preparing for Business ExamsPreparing for business
exams involves mastering both conceptual understanding and practical application. Students are encouraged to study theories and frameworks
comprehensive questions | FREQUENTLY MOST
TESTED QUESTIONS AND VERIFIED SOLUTIONS
Save
demonstrates their understanding of business principles.1.4. Preparing for Business ExamsPreparing for business exams involves mastering both conceptual understanding and
practical application. Students are encouraged to study theories and frameworks
Terms in this set (302)
What is the purpose of HIPAA? • Protect PHI from unauthorized disclosure/use;
• Prevent fraud, waste and abuse (via Administrative
Simplification);
• Make health insurance portable under ERISA;
• Move health care onto a nationally standardized
electronic billing platform
Ref. https://quizlet.com/6202453/hcca-chpc-
overview-flash-cards/
More on HIPAA:
https://www.hhs.gov/hipaa/index.html
HIPAA resides in which CFR section? 45 CFR sections 164.102 through 164.534
https://www.ecfr.gov/current/title-45/subtitle-
A/subchapter-C/part-164
, What are the subparts of HIPAA part HIPAA - 45 CFR 164, subparts:
164? Subpart A - General rules
Subpart C - Security
Subpart D - Breach notification
Subpart E - Privacy
https://www.ecfr.gov/current/title-45/subtitle-
A/subchapter-C/part-164
How do you determine if an 1. compare if the organization meets one of the 3
organization is a "Covered Entity"? types of CE (provider, health plan, clearinghouse)
and
2. determine if the organization electronically
transmits one of the 9 defined transactions:
• Health claims or equivalent encounter information
• Health claims attachments
• Enrollment and disenrollment in a health plan
• Eligibility for a health plan
• Health care payment and remittance advice
• Health plan premium payments
• First report of injury
• Health claim status
• Referral certification and authorization
In addition, business associates of covered entities
must follow parts of the HIPAA regulations.
https://www.hhs.gov/hipaa/for-
individuals/guidance-materials-for-
consumers/index.html
demonstrates their understanding of business principles.1.4. Preparing for Business
ExamsPreparing for business exams involves mastering both conceptual understanding and practical application. Students are encouraged to study theories and frameworks
, This Act established in 1974 was The Privacy Act of 1974
created for government agencies
placing restrictions on how the
government can share the
information maintained in Federal
systems of records that might
infringe on an individual's privacy
rights with other individuals and
agencies.
Which of the following is not 4. Contract arrangement with FEDEX carrier
considered a HIPAA Entity
Designation:
1. Affiliated covered entity
2. Entity that performs healthcare
and non-healthcare component
activities including both covered and
non-covered functions
3. A group health plan
4. Contract arrangement with FEDEX
carrier
What is Gramm-Leach-Bliley Act Gramm-Leach-Bliley Act (GLBA), also known as the
(GLBA)? Financial Services Modernization Act of 1999,
includes The Financial Privacy Rule and The
Safeguards Rule requires all financial institutions to
protect customer's personal financial information.
demonstrates their understanding of business principles.1.4. Preparing for Business ExamsPreparing for
business exams involves mastering both conceptual understanding and practical application. Students are encouraged to study theories and frameworks
, What is an OHCA? OHCA (Organized Health Care Arrangement) it's a
clinically integrated care setting where individuals
receive health care from more than one provider.
These are joint arrangements/activities and have an
Integrated Delivery System for easy exchange of
PHI data. See 45 CFR 160.103. OHCAs can also
utilize a joint NPP. See 45 CFR § 164.520(d).
ACE (Affiliated Covered Entity) do not have an
Integrated Delivery System because these are
legally separate covered entities that are
associated in business, or affiliated as a result of
some common control or ownership.
Both the OHCA and the ACE would allow sharing
of PHI across participating entity lines for
treatment, payment, operations purposes (TPO).
What's an ACE? ACE (Affiliated Covered Entity)
Legally separate covered entities that share
common control/ownership and designate
themselves as a single CE for the purpose of
complying with the HIPAA Privacy standards.
ACEs do not have an Integrated Delivery System,
while OHCA do, and can share a single NPP. See
45 CFR § 164.520(d)
ACE example: a health system composed on
several affiliated hospitals.
Both the OHCA and the ACE would allow sharing
of PHI across participating entity lines for
treatment, payment, operations purposes (TPO).
demonstrates their understanding of business principles.1.4. Preparing for Business ExamsPreparing for business
exams involves mastering both conceptual understanding and practical application. Students are encouraged to study theories and frameworks
