HCCA CHC/CHPC COMPLIANCE Exam NEWEST
2025 COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW
VERSION!!
What are the different types of CEs - CORRECT ANSWER- - Provider
- Health Plan
- Clearing House
- Other Types
How is a Provider defined - CORRECT ANSWER- Supports medical or health services such as
SNFs, home health, hospitals, physician clinics, etc that transmit in electronic form
Does a provider need a standing facility to be considered a CE - CORRECT ANSWER- No, a
provider does not need a standing facility to be considered a CE
What is a Health Plan - CORRECT ANSWER- (1) A healthcare organization that provides or pays
the cost of medical care
(2) Includes Medicaid, Medicare, and self funded plans
,What is a Clearinghouse - CORRECT ANSWER- (1) processes health information from a
nonstandard data elements of health information into standard data
elements
(2) includes billing services, health information systems, etc
(3) does NOT include Third Party Administrations ( TPAs)
What are the three Organizational Arrangements - CORRECT ANSWER- Organized Health Care
Arrangement (OHCA)
Affiliated Covered Entities (ACE)
Hybrid Covered Entity (HCE)
What is a Hybrid Covered Entity (HCE) - CORRECT ANSWER- single covered entity with non-
health care components
What is an Organized Health Care Arrangement (OHCA)? - CORRECT ANSWER- clinically
integrated care setting where individuals receive health care from more than one covered
entity
What is an Affiliated Covered Entity (ACE)? - CORRECT ANSWER- (1) legally separate covered
entities that share common control or common ownership
(2) choose to designate themselves as one affiliated CE for the purposes of complying with the
HIPAA Privacy standard
What must a Affiliated Entity agree to? - CORRECT ANSWER- Be treated as a single CE. Must
agree to follow a standard policy and procedure
, What is a Business Associate? - CORRECT ANSWER- (1) Separate entity working on behalf of
the CE providing Treatment, Payment, and Healthcare Operations (TPO) and/or associated
activities requiring access and/or will create, receive, maintain, and/or transmit PHI
(2) Must have a business associate agreement
Who is allowed to access PHI? - CORRECT ANSWER- (1) Workforce: employees, volunteers,
trainees, and others under control of the CE
(2) Business Associates: Separate entity working on behalf of the CE providing Treatment,
Payment, and Healthcare Operations (TPO) and/or associated activities requiring access and/or
use of PHI
What is an example of a BA? - CORRECT ANSWER- claims processing
data analysis
billing
benefit management
quality assurance
quality improvement
practice management
legal
actuarial
accounting
accreditation
other administrative services
What has been the main complaint with holding a BA accountable under the 2000 Privacy Rule?
- CORRECT ANSWER- - lack of penalties for non-compliance
2025 COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+||BRAND NEW
VERSION!!
What are the different types of CEs - CORRECT ANSWER- - Provider
- Health Plan
- Clearing House
- Other Types
How is a Provider defined - CORRECT ANSWER- Supports medical or health services such as
SNFs, home health, hospitals, physician clinics, etc that transmit in electronic form
Does a provider need a standing facility to be considered a CE - CORRECT ANSWER- No, a
provider does not need a standing facility to be considered a CE
What is a Health Plan - CORRECT ANSWER- (1) A healthcare organization that provides or pays
the cost of medical care
(2) Includes Medicaid, Medicare, and self funded plans
,What is a Clearinghouse - CORRECT ANSWER- (1) processes health information from a
nonstandard data elements of health information into standard data
elements
(2) includes billing services, health information systems, etc
(3) does NOT include Third Party Administrations ( TPAs)
What are the three Organizational Arrangements - CORRECT ANSWER- Organized Health Care
Arrangement (OHCA)
Affiliated Covered Entities (ACE)
Hybrid Covered Entity (HCE)
What is a Hybrid Covered Entity (HCE) - CORRECT ANSWER- single covered entity with non-
health care components
What is an Organized Health Care Arrangement (OHCA)? - CORRECT ANSWER- clinically
integrated care setting where individuals receive health care from more than one covered
entity
What is an Affiliated Covered Entity (ACE)? - CORRECT ANSWER- (1) legally separate covered
entities that share common control or common ownership
(2) choose to designate themselves as one affiliated CE for the purposes of complying with the
HIPAA Privacy standard
What must a Affiliated Entity agree to? - CORRECT ANSWER- Be treated as a single CE. Must
agree to follow a standard policy and procedure
, What is a Business Associate? - CORRECT ANSWER- (1) Separate entity working on behalf of
the CE providing Treatment, Payment, and Healthcare Operations (TPO) and/or associated
activities requiring access and/or will create, receive, maintain, and/or transmit PHI
(2) Must have a business associate agreement
Who is allowed to access PHI? - CORRECT ANSWER- (1) Workforce: employees, volunteers,
trainees, and others under control of the CE
(2) Business Associates: Separate entity working on behalf of the CE providing Treatment,
Payment, and Healthcare Operations (TPO) and/or associated activities requiring access and/or
use of PHI
What is an example of a BA? - CORRECT ANSWER- claims processing
data analysis
billing
benefit management
quality assurance
quality improvement
practice management
legal
actuarial
accounting
accreditation
other administrative services
What has been the main complaint with holding a BA accountable under the 2000 Privacy Rule?
- CORRECT ANSWER- - lack of penalties for non-compliance
