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HCCA - CHPC OVERVIEW QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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HCCA - CHPC OVERVIEW QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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HCCA - CHPC OVERVIEW QUESTIONSAND ANSWERS WITH SOLUTIONS 2024
HIPAARbecameRlawR-RANSWERRR1996
WhatRisRtheRpurposeRofRHIPAA?R-RANSWERRR•RToRmakeRhealthRinsuranceRportableRunderRERISA;R
•RToRmoveRhealthRcareRontoRaRnationallyRstandardizedRelectronicRbillingRplatform;RandR
•RToRpreventRfraud,RwasteRandRabuse
IntentR-
RANSWERRRpurposeRofRthisRsubtitleRtoRimproveRtheRMedicareRprogramRunderRtitleRXVIIIRofRtheRSocialRSecuri
tyRAct,RtheRMedicaidRprogramRunderRtitleRXIXRofRsuchRAct,RandRtheRefficiencyRandReffectivenessRofRtheRheal
thRcareRsystem,RbyRencouragingRtheRdevelopmentRofRaRhealthRinformationRsystemRthroughRtheRestablishm
entRofRstandardsRandRrequirementsRforRtheRelectronicRtransmissionRofRcertainRhealthRinformation.
HIPAARresidesRinRwhatRCFRRsectionR-RANSWERRR45RCFRRsectionsR164.102RthroughR164.534
IdentifyRtheRfourRsectionsRinRtheRCFRRbyRlocationRandRtopicR-RANSWERRRSectionROne:R164.102R-
R164.318RandR164.530R-R164-534ROrganizationalRRequirements
SectionRTwo:R164.500R-R164.514RUseRandRDisclosureRofRInformation
SectionRThree:R164.520R-R164.528RIndividual'sRRightsRandRPenaltiesR
SectionRFour:RInteractionRwithRtheRHIPAARSecurityRRule
HowRdoRyouRdetermineRifRorganizationRisRaRCER-RANSWERRR-
RcompareRtheRfunctionsRofRtheRentityRtoRtheRthreeRprincipalRtypesRofR"coveredRentities"R(CE),
-RdetermineRifRtheRentityRelectronicallyRtransmitsRoneRofRtheRnineRdefinedRtransactions"
WhatRareRtheRdifferentRtypesRofRCEsR-RANSWERRR-RProvider
,-RHealthRPlan
-RClearingRHouse
-ROtherRTypes
HowRisRaRProviderRdefinedR-RANSWERRR-
R"aRproviderRofRservicesR(asRdefinedRinRsectionR1395xR(u)RofRtitleRXIX)
-RaRproviderRofRmedicalRorRotherRhealthRservicesR(asRdefinedRinRsectionR1395xR(s)RofRtitleRXIX)
-RanyRotherRpersonRfurnishingRhealthRcareRservicesRorRsupplies.
DoesRaRproviderRneedRaRstandingRfacilityRtoRbeRconsideredRaRCER-RANSWERRRNO
WhatRdoesR"HealthRPlan"Rmean?R-
RANSWERRRAnRindividualRorRgroupRplanRthatRprovides,RorRpaysRtheRcostRof,RmedicalRcare
•RARgroupRhealthRplan,RbutRonlyRifRtheRplan:
R --RhasR50RorRmoreRparticipantsR
R --RisRadministeredRbyRanRentityRotherRthanRtheRemployerRwhoRestablishedRandRmaintainsRtheRplan.
•RARhealthRinsuranceRissuer
•RARhealthRmaintenanceRorganization
•RTheRMedicaidRprogramRunderRtitleRXIX.
•RARMedicareRsupplementalRpolicyR
•RARlong-termRcareRpolicy,RincludingRaRnursing
homeRfixedRindemnityRpolicyR
•RAnRemployeeRwelfareRbenefitRplanRprovidingRhealthRbenefitsRtoRtheRemployeesRofR2RorRmoreRemployers.
•RTheRhealthRcareRprogramRforRactiveRmilitary
•RTheRveteran'sRhealthRcareRprogramR.
•RTheRCivilianRHealthRandRMedicalRProgram
•RTheRIndianRHealthRServiceRProgram
•RTheRFederalREmployeesRHealthRBenefitRPlan
, .
WhatRisRaRClearinghouseR-RANSWERRRmayRbeRaRpublicRorRprivateRentityRthatRprocesses
orRfacilitatesRtheRprocessingRofRnonstandardRdataRelementsRofRhealthRinformationRintoRstandardRdata
elements.
WhatRareRotherRHIPAAREntitiesR-RANSWERRRHybrid,RBusinessRAssociate
OrganizedRHealthRCareRArrangement
AffiliatedRCoveredREntity
WhatRisRaRHybridREntity?R-RANSWERRRsingleRlegalRentity,Rwhere
onlyRsomeRofRitsRdivisionsRorRprogramsRmeetRthe
CERdefinitionsRandRisRtypicalRofRlargeRentities
WhatRisROrganizedRHealthRCareRArrangementR(OHCA)?R-
RANSWERRRclinicallyRintegratedRcareRsettingRwhereRindividualsRreceiveRhealthRcareRfromRmoreRthanRoneRhe
althRcareRprovider.
WhatRisRAffiliatedRCoveredREntity?R-
RANSWERRRlegallyRdistinctRentitiesRthatRshareRcommonRcontrolRorRcommonRownershipRandRchooseRtoRdesi
gnateRthemselvesRasRoneRaffiliatedRCERforRtheRpurposesRofRcomplyingRwithRtheRHIPAARPrivacyRstandard
WhatRmustRaRAffiliatedREntityRagreeRto?R-
RANSWERRRBeRtreatedRasRaRsingleRCE.RMustRagreeRtoRfollowRaRstandardRpolicyRandRprocedure
WhatRisRaRBusinessRAssociate?R-RANSWERRR-
RCERtoReitherRgetR"assurances"RforRprivacyRandRsecurityRstandardsRfromRtheirRbusinessRpartnersRorRtoRinclu
deRaRBARamendmentRtoRaRcontract.
-RwhereRaRseparateRlegalRentityRusesRorRdisclosesRIndividuallyRIdentifiableRInformationRonRbehalfRofRtheRCE.
WhatRareRexamplesRofRaRBA?R-RANSWERRRclaimsRprocessing
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