HCCA CHPC STUDY GUIDE QUESTIONS
AND CORRECT ANSWERS COMPLETE
REVIEW RESOURCE GRADED A+
⩥ What is the purpose of HIPAA?.
Answer: 1. Protect individuals' PHI
2. Promote high quality healthcare
3. Protect the public's health and well being
⩥ 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)
⩥ 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
AND CORRECT ANSWERS COMPLETE
REVIEW RESOURCE GRADED A+
⩥ What is the purpose of HIPAA?.
Answer: 1. Protect individuals' PHI
2. Promote high quality healthcare
3. Protect the public's health and well being
⩥ 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)
⩥ 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
