HCCA: CHPC Overview Test Questions
with Actual Answers 2026 Edition.
HIPAA became law - Answer 1996
What is the purpose of HIPAA? - Answer • To make health insurance portable under ERISA;
• To move health care onto a nationally standardized electronic billing platform; and
• To prevent fraud, waste and abuse
Intent - Answer 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.
HIPAA resides in what CFR section - Answer 45 CFR sections 164.102 through 164.534
Identify the four sections in the CFR by location and topic - Answer Section One: 164.102 -
164.318 and 164.530 - 164-534 Organizational Requirements
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
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),
- determine if the entity electronically transmits one of the nine defined transactions"
What are the different types of CEs - Answer - Provider
- Health Plan
- Clearing House
- Other Types
How is a Provider defined - Answer - "a provider of services (as defined in section 1395x (u)
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 supplies.
Does a provider need a standing facility to be considered a CE - Answer NO
What does "Health Plan" mean? - Answer An individual or group plan that provides, or pays
the cost of, medical care
• 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 benefits 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
.
What is a Clearinghouse - Answer may be a public or private entity that processes
or facilitates the processing of nonstandard data elements of health information into standard
data
elements.
What are other HIPAA Entities - Answer Hybrid, Business Associate
Organized Health Care Arrangement
Affiliated Covered Entity
with Actual Answers 2026 Edition.
HIPAA became law - Answer 1996
What is the purpose of HIPAA? - Answer • To make health insurance portable under ERISA;
• To move health care onto a nationally standardized electronic billing platform; and
• To prevent fraud, waste and abuse
Intent - Answer 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.
HIPAA resides in what CFR section - Answer 45 CFR sections 164.102 through 164.534
Identify the four sections in the CFR by location and topic - Answer Section One: 164.102 -
164.318 and 164.530 - 164-534 Organizational Requirements
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
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),
- determine if the entity electronically transmits one of the nine defined transactions"
What are the different types of CEs - Answer - Provider
- Health Plan
- Clearing House
- Other Types
How is a Provider defined - Answer - "a provider of services (as defined in section 1395x (u)
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 supplies.
Does a provider need a standing facility to be considered a CE - Answer NO
What does "Health Plan" mean? - Answer An individual or group plan that provides, or pays
the cost of, medical care
• 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 benefits 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
.
What is a Clearinghouse - Answer may be a public or private entity that processes
or facilitates the processing of nonstandard data elements of health information into standard
data
elements.
What are other HIPAA Entities - Answer Hybrid, Business Associate
Organized Health Care Arrangement
Affiliated Covered Entity
