HCCA-CHPC EXAM LATEST ACTUAL EXAM 80 QUESTIONS AND COR-
RECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|AGRADE
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1. HIPAA became 1996
law
2. What is the pur- • To make health insurance portable under ERISA;
pose of HIPAA? • To move health care onto a nationally standardized elec-
tronic billing platform; and
• To prevent fraud, waste and abuse
3. Intent purpose of this subtitle to improve the Medicare program
under title XVIII of the Social Security Act, the Medicaid
program under title XIX of such Act, and the efficiency and
effectiveness of the health care system, by encouraging
the development of a health information system through
the establishment of standards and requirements for the
electronic transmission of certain health information.
4. HIPAA resides in 45 CFR sections 164.102 through 164.534
what CFR sec-
tion
5. Identify the four Section One: 164.102 - 164.318 and 164.530 - 164-534
sections in the Organizational Requirements
CFR by location
and topic Section Two: 164.500 - 164.514 Use and Disclosure of
Information
Section Three: 164.520 - 164.528 Individual's Rights and
Penalties
Section Four: Interaction with the HIPAA Security Rule
6. How do you de- - compare the functions of the entity to the three principal
termine if organi- types of "covered entities" (CE),
zation is a CE - determine if the entity electronically transmits one of the
nine defined transactions"
7. - Provider
- Health Plan
, HCCA-CHPC EXAM LATEST ACTUAL EXAM 80 QUESTIONS AND COR-
RECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|AGRADE
Study online at https://quizlet.com/_fj0wif
What are the dif- - Clearing House
ferent types of - Other Types
CEs
8. How is a Provider - "a provider of services (as defined in section 1395x (u)
defined of title XIX)
- a provider of medical or other health services (as defined
in section 1395x (s) of title XIX)
- any other person furnishing health care services or sup-
plies.
9. Does a provider NO
need a standing
facility to be con-
sidered a CE
10. What does An individual or group plan that provides, or pays the cost
"Health Plan" of, medical care
mean?
• A group health plan, but only if the plan:
-- has 50 or more participants
-- is administered by an entity other than the employer
who established and maintains the plan.
• A health insurance issuer
• A health maintenance organization
• The Medicaid program under title XIX.
• A Medicare supplemental policy
• A long-term care policy, including a nursing
home fixed indemnity policy
• An employee welfare benefit plan providing health ben-
efits to the employees of 2 or more employers.
• The health care program for active military
• The veteran's health care program .
• The Civilian Health and Medical Program
• The Indian Health Service Program
• The Federal Employees Health Benefit Plan
.
, HCCA-CHPC EXAM LATEST ACTUAL EXAM 80 QUESTIONS AND COR-
RECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|AGRADE
Study online at https://quizlet.com/_fj0wif
11. What is a Clear- may be a public or private entity that processes
inghouse or facilitates the processing of nonstandard data elements
of health information into standard data
elements.
12. What are other Hybrid, Business Associate
HIPAA Entities Organized Health Care Arrangement
Affiliated Covered Entity
13. What is a Hybrid single legal entity, where
Entity? only some of its divisions or programs meet the
CE definitions and is typical of large entities
14. What is Or- clinically integrated care setting where individuals receive
ganized Health health care from more than one health care provider.
Care Arrange-
ment (OHCA)?
15. What is Affiliated legally distinct entities that share common control or com-
Covered Entity? mon ownership and choose to designate themselves as
one affiliated CE for the purposes of complying with the
HIPAA Privacy standard
16. What must a Affil- Be treated as a single CE. Must agree to follow a standard
iated Entity agree policy and procedure
to?
17. What is a Busi- - CE to either get "assurances" for privacy and security
ness Associate? standards from their business partners or to include a BA
amendment to a contract.
- where a separate legal entity uses or discloses Individu-
ally Identifiable Information on behalf of the CE.
18. What are exam- claims processing
ples of a BA? data analysis
billing
benefit management
quality assurance
RECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|AGRADE
Study online at https://quizlet.com/_fj0wif
1. HIPAA became 1996
law
2. What is the pur- • To make health insurance portable under ERISA;
pose of HIPAA? • To move health care onto a nationally standardized elec-
tronic billing platform; and
• To prevent fraud, waste and abuse
3. Intent purpose of this subtitle to improve the Medicare program
under title XVIII of the Social Security Act, the Medicaid
program under title XIX of such Act, and the efficiency and
effectiveness of the health care system, by encouraging
the development of a health information system through
the establishment of standards and requirements for the
electronic transmission of certain health information.
4. HIPAA resides in 45 CFR sections 164.102 through 164.534
what CFR sec-
tion
5. Identify the four Section One: 164.102 - 164.318 and 164.530 - 164-534
sections in the Organizational Requirements
CFR by location
and topic Section Two: 164.500 - 164.514 Use and Disclosure of
Information
Section Three: 164.520 - 164.528 Individual's Rights and
Penalties
Section Four: Interaction with the HIPAA Security Rule
6. How do you de- - compare the functions of the entity to the three principal
termine if organi- types of "covered entities" (CE),
zation is a CE - determine if the entity electronically transmits one of the
nine defined transactions"
7. - Provider
- Health Plan
, HCCA-CHPC EXAM LATEST ACTUAL EXAM 80 QUESTIONS AND COR-
RECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|AGRADE
Study online at https://quizlet.com/_fj0wif
What are the dif- - Clearing House
ferent types of - Other Types
CEs
8. How is a Provider - "a provider of services (as defined in section 1395x (u)
defined of title XIX)
- a provider of medical or other health services (as defined
in section 1395x (s) of title XIX)
- any other person furnishing health care services or sup-
plies.
9. Does a provider NO
need a standing
facility to be con-
sidered a CE
10. What does An individual or group plan that provides, or pays the cost
"Health Plan" of, medical care
mean?
• A group health plan, but only if the plan:
-- has 50 or more participants
-- is administered by an entity other than the employer
who established and maintains the plan.
• A health insurance issuer
• A health maintenance organization
• The Medicaid program under title XIX.
• A Medicare supplemental policy
• A long-term care policy, including a nursing
home fixed indemnity policy
• An employee welfare benefit plan providing health ben-
efits to the employees of 2 or more employers.
• The health care program for active military
• The veteran's health care program .
• The Civilian Health and Medical Program
• The Indian Health Service Program
• The Federal Employees Health Benefit Plan
.
, HCCA-CHPC EXAM LATEST ACTUAL EXAM 80 QUESTIONS AND COR-
RECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS)
|AGRADE
Study online at https://quizlet.com/_fj0wif
11. What is a Clear- may be a public or private entity that processes
inghouse or facilitates the processing of nonstandard data elements
of health information into standard data
elements.
12. What are other Hybrid, Business Associate
HIPAA Entities Organized Health Care Arrangement
Affiliated Covered Entity
13. What is a Hybrid single legal entity, where
Entity? only some of its divisions or programs meet the
CE definitions and is typical of large entities
14. What is Or- clinically integrated care setting where individuals receive
ganized Health health care from more than one health care provider.
Care Arrange-
ment (OHCA)?
15. What is Affiliated legally distinct entities that share common control or com-
Covered Entity? mon ownership and choose to designate themselves as
one affiliated CE for the purposes of complying with the
HIPAA Privacy standard
16. What must a Affil- Be treated as a single CE. Must agree to follow a standard
iated Entity agree policy and procedure
to?
17. What is a Busi- - CE to either get "assurances" for privacy and security
ness Associate? standards from their business partners or to include a BA
amendment to a contract.
- where a separate legal entity uses or discloses Individu-
ally Identifiable Information on behalf of the CE.
18. What are exam- claims processing
ples of a BA? data analysis
billing
benefit management
quality assurance
