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HCCA - CHPC Study Questions with Correct Answers 100% Pass Guaranteed

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HCCA - CHPC Study Questions with Correct Answers 100% Pass Guaranteed What is the purpose of HIPAA? - ANSWER-• Protect PHI from unauthorized disclosure/use; • Prevent fraud, waste and abuse (via Administrative Simplification); • Make health insurance portable under ERISA; • Move heal...

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  • November 19, 2024
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What is the purpose of HIPAA? - ANSWER✔✔-• Protect PHI from unauthorized

disclosure/use;


• Prevent fraud, waste and abuse (via Administrative Simplification);


• Make health insurance portable under ERISA;


• Move health care onto a nationally standardized electronic billing platform




Ref. https://quizlet.com/6202453/hcca-chpc-overview-flash-cards/


More on HIPAA: https://www.hhs.gov/hipaa/index.html


HIPAA resides in which CFR section? - ANSWER✔✔-45 CFR sections 164.102 through

164.534




https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164



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,What are the subparts of HIPAA part 164? - ANSWER✔✔-HIPAA - 45 CFR 164,

subparts:


Subpart A - General rules


Subpart C - Security


Subpart D - Breach notification


Subpart E - Privacy




https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164


How do you determine if an organization is a "Covered Entity"? - ANSWER✔✔-1.

compare if the organization meets one of the 3 types of CE (provider, health plan,

clearinghouse)


and


2. determine if the organization electronically transmits one of the 9 defined

transactions:


• Health claims or equivalent encounter information


• Health claims attachments


• Enrollment and disenrollment in a health plan


• Eligibility for a health plan


Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 2/119

,• Health care payment and remittance advice


• Health plan premium payments


• First report of injury


• Health claim status


• Referral certification and authorization




In addition, business associates of covered entities must follow parts of the HIPAA

regulations.


https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-

consumers/index.html


This Act established in 1974 was created for government agencies placing restrictions

on how the government can share the information maintained in Federal systems of

records that might infringe on an individual's privacy rights with other individuals and

agencies. - ANSWER✔✔-The Privacy Act of 1974


Which of the following is not considered a HIPAA Entity Designation:


1. Affiliated covered entity


2. Entity that performs healthcare and non-healthcare component activities including

both covered and non-covered functions



Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 3/119

, 3. A group health plan


4. Contract arrangement with FEDEX carrier - ANSWER✔✔-4. Contract arrangement

with FEDEX carrier


What is Gramm-Leach-Bliley Act (GLBA)? - ANSWER✔✔-Gramm-Leach-Bliley Act

(GLBA), also known as the Financial Services Modernization Act of 1999, includes The

Financial Privacy Rule and The Safeguards Rule requires all financial institutions to

protect customer's personal financial information.


What is an OHCA? - ANSWER✔✔-OHCA (Organized Health Care Arrangement) it's a

clinically integrated care setting where individuals receive health care from more than

one provider.


These are joint arrangements/activities and have an Integrated Delivery System for

easy exchange of PHI data. See 45 CFR 160.103. OHCAs can also utilize a joint NPP. See

45 CFR § 164.520(d).




ACE (Affiliated Covered Entity) do not have an Integrated Delivery System because

these are legally separate covered entities that are associated in business, or affiliated as

a result of some common control or ownership.




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