HCCA CHPC STUDY FINAL STUDY GUIDE
2026 QUESTIONS WITH ANSWERS GRADED
A+
⩥ How do you determine if organization is a CE. Answer: compare the
functions of the entity to the three principal types of "covered entities"
(CE)
⩥ What are the different types of CEs. Answer: - Provider
- Health Plan
- Clearing House
- Other Types
⩥ How is a Provider defined. 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.
Answer: No, a provider does not need a standing facility to be
considered a CE
⩥ What is a Health Plan. 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. 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. Answer: Organized
Health Care Arrangement (OHCA)
Affiliated Covered Entities (ACE)
Hybrid Covered Entity (HCE)
⩥ What is a Hybrid Covered Entity (HCE). Answer: single covered
entity with non-health care components
⩥ What is an Organized Health Care Arrangement (OHCA)?. Answer:
clinically integrated care setting where individuals receive health care
from more than one covered entity
⩥ What is an Affiliated Covered Entity (ACE)?. 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?. Answer: Be treated as a
single CE. Must agree to follow a standard policy and procedure
⩥ What is a Business Associate?. 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?. 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?. 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?. Answer: - lack of penalties for non-
compliance
- federal penalties could only be levied against the CE
⩥ Which new regulation corrected shortcomings of the HIPAA 2000
regulation concerning BAs?. Answer: Health Information Technology
for Economic and Clinical Health (HITECH)
⩥ Who is responsible for privacy and security of BAs?. Answer: The CE
has legal liability for violations, and possible penalties for the BA.
⩥ What is Health Information?. Answer: any information, whether oral
or recorded in any form or medium, that is created or received by a
health care provider, health plan, public health authority, employer, life
insurer, school or university, or health care clearinghouse, and relates to
the past, present, or future physical or mental health or condition of an
2026 QUESTIONS WITH ANSWERS GRADED
A+
⩥ How do you determine if organization is a CE. Answer: compare the
functions of the entity to the three principal types of "covered entities"
(CE)
⩥ What are the different types of CEs. Answer: - Provider
- Health Plan
- Clearing House
- Other Types
⩥ How is a Provider defined. 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.
Answer: No, a provider does not need a standing facility to be
considered a CE
⩥ What is a Health Plan. 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. 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. Answer: Organized
Health Care Arrangement (OHCA)
Affiliated Covered Entities (ACE)
Hybrid Covered Entity (HCE)
⩥ What is a Hybrid Covered Entity (HCE). Answer: single covered
entity with non-health care components
⩥ What is an Organized Health Care Arrangement (OHCA)?. Answer:
clinically integrated care setting where individuals receive health care
from more than one covered entity
⩥ What is an Affiliated Covered Entity (ACE)?. 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?. Answer: Be treated as a
single CE. Must agree to follow a standard policy and procedure
⩥ What is a Business Associate?. 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?. 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?. 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?. Answer: - lack of penalties for non-
compliance
- federal penalties could only be levied against the CE
⩥ Which new regulation corrected shortcomings of the HIPAA 2000
regulation concerning BAs?. Answer: Health Information Technology
for Economic and Clinical Health (HITECH)
⩥ Who is responsible for privacy and security of BAs?. Answer: The CE
has legal liability for violations, and possible penalties for the BA.
⩥ What is Health Information?. Answer: any information, whether oral
or recorded in any form or medium, that is created or received by a
health care provider, health plan, public health authority, employer, life
insurer, school or university, or health care clearinghouse, and relates to
the past, present, or future physical or mental health or condition of an
