HCCA – CHPC Exam Study Guide |
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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
What is a Business Associate? - Correct Answer - - CE to either get
"assurances" for privacy and security standards from their business
partners or to include a BA amendment to a contract.
,- where a separate legal entity uses or discloses Individually Identifiable
Information on behalf of the CE.
What are examples of a BA? - Correct Answer - claims processing
data analysis
billing
benefit management
quality assurance
quality improvement
practice management
legal
actuarial
accounting
accreditation
other administrative services
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"
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)
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