HCCA CHPC Exam Prep Questions!
HCCA CHPC Exam Prep Questions &
Answers | CHPC Certification 2026/2027
What date did HIPAA became law
1996
What is the purpose of HIPAA?
1. Protect individuals' PHI
2. Promote high quality healthcare
3. Protect the public's health and well being
HIPAA resides in what CFR section
45 CFR sections 164.102 through 164.534
Identify the four sections in the CFR by location and topic
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
Page 1 of 32
,HCCA CHPC Exam Prep Questions!
compare the functions of the entity to the three principal types of "covered entities" (CE)
What are the different types of CEs
- Provider
- Health Plan
- Clearing House
- Other Types
How is a Provider defined
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
No, a provider does not need a standing facility to be considered a CE
What is a Health Plan
(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
(1) processes health information from a nonstandard data elements of health information into standard
data
elements
(2) includes billing services, health information systems, etc
Page 2 of 32
,HCCA CHPC Exam Prep Questions!
(3) does NOT include Third Party Administrations ( TPAs)
What are the three Organizational Arrangements
Organized Health Care Arrangement (OHCA)
Affiliated Covered Entities (ACE)
Hybrid Covered Entity (HCE)
What is a Hybrid Covered Entity (HCE)
single covered entity with non-health care components
What is an Organized Health Care Arrangement (OHCA)?
clinically integrated care setting where individuals receive health care from more than one covered
entity
What is an Affiliated Covered Entity (ACE)?
(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?
Be treated as a single CE. Must agree to follow a standard policy and procedure
What is a Business Associate?
Page 3 of 32
, HCCA CHPC Exam Prep Questions!
(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?
(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?
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?
- lack of penalties for non-compliance
- federal penalties could only be levied against the CE
Page 4 of 32
HCCA CHPC Exam Prep Questions &
Answers | CHPC Certification 2026/2027
What date did HIPAA became law
1996
What is the purpose of HIPAA?
1. Protect individuals' PHI
2. Promote high quality healthcare
3. Protect the public's health and well being
HIPAA resides in what CFR section
45 CFR sections 164.102 through 164.534
Identify the four sections in the CFR by location and topic
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
Page 1 of 32
,HCCA CHPC Exam Prep Questions!
compare the functions of the entity to the three principal types of "covered entities" (CE)
What are the different types of CEs
- Provider
- Health Plan
- Clearing House
- Other Types
How is a Provider defined
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
No, a provider does not need a standing facility to be considered a CE
What is a Health Plan
(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
(1) processes health information from a nonstandard data elements of health information into standard
data
elements
(2) includes billing services, health information systems, etc
Page 2 of 32
,HCCA CHPC Exam Prep Questions!
(3) does NOT include Third Party Administrations ( TPAs)
What are the three Organizational Arrangements
Organized Health Care Arrangement (OHCA)
Affiliated Covered Entities (ACE)
Hybrid Covered Entity (HCE)
What is a Hybrid Covered Entity (HCE)
single covered entity with non-health care components
What is an Organized Health Care Arrangement (OHCA)?
clinically integrated care setting where individuals receive health care from more than one covered
entity
What is an Affiliated Covered Entity (ACE)?
(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?
Be treated as a single CE. Must agree to follow a standard policy and procedure
What is a Business Associate?
Page 3 of 32
, HCCA CHPC Exam Prep Questions!
(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?
(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?
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?
- lack of penalties for non-compliance
- federal penalties could only be levied against the CE
Page 4 of 32
