HCCA - CHPC STUDY QUESTIONS 2025 QUESTIONS AND ANSWERS

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HCCA - CHPC STUDY QUESTIONS 2025
QUESTIONS AND ANSWERS.




Whata1isa1thea1purposea1ofa1HIPAA?a1-a1solutiona1-
a1•a1Protecta1PHIa1froma1unauthorizeda1disclosure/use;


• Preventa1fraud,a1wastea1anda1abusea1(viaa1Administrativea1Simplification);
• Makea1healtha1insurancea1portablea1undera1ERISA;
• Movea1healtha1carea1ontoa1aa1nationallya1standardizeda1electronica1billinga1platf
orm


Ref.a1https://quizlet.com/6202453/hcca-chpc-overview-flash-
cards/a1Morea1ona1HIPAA:a1https://www.hhs.gov/hipaa/index.html




HIPAAa1residesa1ina1whicha1CFRa1section?a1-a1solutiona1-a145a1CFRa1sections
164.102a1througha1164.534


https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164




Whata1area1thea1subpartsa1ofa1HIPAAa1parta1164?a1-a1solutiona1-a1HIPAAa1-
a145a1CFRa1164,a1subparts:


Subparta1Aa1-
Generala1rulesa1Subparta1Ca1-
a1


a1 Security

, P a g e a 1 |a12

Subparta1Da1-
Breacha1notificationa1Subparta1E
a1


a1 a1- Privacy


https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164




Howa1doa1youa1determinea1ifa1ana1organizationa1isa1aa1"Covereda1Entity"?a1-
a1solution

-
a11.a1comparea1ifa1thea1organizationa1meetsa1onea1ofa1thea13a1typesa1ofa1CEa1(pro

vider,a1healtha1plan,a1clearinghouse)
and
2. determinea1ifa1thea1organizationa1electronicallya1transmitsa1onea1ofa1thea19a1
defineda1transactions:
• Healtha1claimsa1ora1equivalenta1encountera1information
• Healtha1claimsa1attachments
• Enrollmenta1anda1disenrollmenta1ina1aa1healtha1plan
• Eligibilitya1fora1aa1healtha1plan
• Healtha1carea1paymenta1anda1remittancea1advice
• Healtha1plana1premiuma1payments
• Firsta1reporta1ofa1injury
• Healtha1claima1status
• Referrala1certificationa1anda1authorization


Ina1addition,a1businessa1associatesa1ofa1covereda1entitiesa1musta1followa1partsa1of
a1thea1HIPAAa1regulations.


https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-
a1consumers/index.html

, P a g e a 2 |a23



Thisa1Acta1establisheda1ina11974a1wasa1createda1fora1governmenta1agenciesa1
placinga1restrictionsa1ona1howa1thea1governmenta1cana1sharea1thea1informatio
na1maintaineda1ina1Federala1systemsa1ofa1recordsa1thata1mighta1infringea1ona1
ana1individual'sa1privacya1rightsa1witha1othera1individualsa1anda1agencies.a1-
a1solutiona1-a1Thea1Privacya1Acta1ofa11974




Whicha1ofa1thea1followinga1isa1nota1considereda1aa1HIPAAa1Entitya1Designation:
1. Affiliateda1covereda1entity
2. Entitya1thata1performsa1healthcarea1anda1non-
healthcarea1componenta1activitiesa1includinga1botha1covereda1anda1non-
covereda1functions
3. Aa1groupa1healtha1plan
4. Contracta1arrangementa1witha1FEDEXa1carriera1-a1solutiona1-
a14.a1Contracta1arrangementa1witha1FEDEXa1carrier




Whata1isa1Gramm-Leach-Blileya1Acta1(GLBA)?a1-a1solutiona1-a1Gramm-
Leach-
a1Blileya1Acta1(GLBA),a1alsoa1knowna1asa1thea1Financiala1Servicesa1Moderniza

tiona1Acta1ofa11999,a1includesa1Thea1Financiala1Privacya1Rulea1anda1Thea1Saf
eguardsa1Rulea1requiresa1alla1financiala1institutionsa1toa1protecta1customer'sa1
personala1financiala1information.




Whata1isa1ana1OHCA?a1-a1solutiona1-
a1OHCAa1(Organizeda1Healtha1Carea1Arrangement)a1it'sa1aa1clinicallya1in

tegrateda1carea1settinga1wherea1individualsa1receivea1healtha1carea1from
a1morea1thana1onea1provider.

, P a g e a 2 |a24

Thesea2area2jointa2arrangements/activitiesa2anda2havea2ana2Integrateda2Deliv
erya2Systema2fora2easya2exchangea2ofa2PHIa2data.a2Seea245a2CFRa2160.103.a2
OHCAsa2cana2alsoa2utilizea2aa2jointa2NPP.a2Seea245a2CFRa2§a2164.520(d).


ACEa2(Affiliateda2Covereda2Entity)a2doa2nota2havea2ana2Integrateda2Deliverya2
Systema2becausea2thesea2area2legallya2separatea2covereda2entitiesa2thata2ar
ea2associateda2ina2business,a2ora2affiliateda2asa2aa2resulta2ofa2somea2commo
na2controla2ora2ownership.


Botha2thea2OHCAa2anda2thea2ACEa2woulda2allowa2sharinga2ofa2PHIa2acr
ossa2participatinga2entitya2linesa2fora2treatment,a2payment,a2operationsa2
purposesa2(TPO).




What'sa2ana2ACE?a2-a2solutiona2-a2ACEa2(Affiliateda2Covereda2Entity)
Legallya2separatea2covereda2entitiesa2thata2sharea2commona2control/owners
hipa2anda2designatea2themselvesa2asa2aa2singlea2CEa2fora2thea2purposea2ofa2c
omplyinga2witha2thea2HIPAAa2Privacya2standards.
ACEsa2doa2nota2havea2ana2Integrateda2Deliverya2System,a2whilea2OHCAa2do,a2an
da2cana2sharea2aa2singlea2NPP.a2Seea245a2CFRa2§a2164.520(d)


ACEa2example:a2aa2healtha2systema2composeda2ona2severala2affiliateda2hospitals
.


Botha2thea2OHCAa2anda2thea2ACEa2woulda2allowa2sharinga2ofa2PHIa2acr
ossa2participatinga2entitya2linesa2fora2treatment,a2payment,a2operationsa2
purposesa2(TPO).