HCCA - CHPC Overview Exam With
100% Complete Solution
HIPAA became law - Correct Answer-1996
What is the purpose of HIPAA? - Correct 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 - Correct 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 - Correct Answer-45 CFR sections
164.102 through 164.534
Identify the four sections in the CFR by location and topic - Correct
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 - Correct 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"
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,What are the different types of CEs - Correct Answer-- Provider
- Health Plan
- Clearing House
- Other Types
How is a Provider defined - Correct 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 - Correct
Answer-NO
What does "Health Plan" mean? - Correct 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
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, • The Indian Health Service Program
• The Federal Employees Health Benefit Plan
.
What is a Clearinghouse - Correct 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 - Correct Answer-Hybrid, Business
Associate
Organized Health Care Arrangement
Affiliated Covered Entity
What is a Hybrid Entity? - Correct Answer-single legal entity,
where
only some of its divisions or programs meet the
CE definitions and is typical of large entities
What is Organized Health Care Arrangement (OHCA)? - Correct
Answer-clinically integrated care setting where individuals receive
health care from more than one health care provider.
What is Affiliated Covered Entity? - Correct Answer-legally distinct
entities that share common control or common ownership and
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? - Correct Answer-Be
treated as a single CE. Must agree to follow a standard policy and
procedure
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100% Complete Solution
HIPAA became law - Correct Answer-1996
What is the purpose of HIPAA? - Correct 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 - Correct 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 - Correct Answer-45 CFR sections
164.102 through 164.534
Identify the four sections in the CFR by location and topic - Correct
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 - Correct 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"
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,What are the different types of CEs - Correct Answer-- Provider
- Health Plan
- Clearing House
- Other Types
How is a Provider defined - Correct 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 - Correct
Answer-NO
What does "Health Plan" mean? - Correct 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
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, • The Indian Health Service Program
• The Federal Employees Health Benefit Plan
.
What is a Clearinghouse - Correct 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 - Correct Answer-Hybrid, Business
Associate
Organized Health Care Arrangement
Affiliated Covered Entity
What is a Hybrid Entity? - Correct Answer-single legal entity,
where
only some of its divisions or programs meet the
CE definitions and is typical of large entities
What is Organized Health Care Arrangement (OHCA)? - Correct
Answer-clinically integrated care setting where individuals receive
health care from more than one health care provider.
What is Affiliated Covered Entity? - Correct Answer-legally distinct
entities that share common control or common ownership and
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? - Correct Answer-Be
treated as a single CE. Must agree to follow a standard policy and
procedure
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