Exam (elaborations)
HCCA - CHPC STUDY QUESTIONS (MASTER FLASHCARDS) QUESTIONS AND ANSWERS
- Course
- Institution
HCCA - CHPC STUDY QUESTIONS (MASTER FLASHCARDS) QUESTIONS AND ANSWERS
[Show more]
Content preview
HCCA - CHPC STUDY QUESTIONS(MASTER FLASHCARDS) QUESTIONS
AND ANSWERS
WhatmismthempurposemofmHIPAA?m-mans✔✔•mProtectmPHImfrommunauthorizedmdisclosure/
use;
•mPreventmfraud,mwastemandmabusem(viamAdministrativemSimplification);
•mMakemhealthminsurancemportablemundermERISA;
•mMovemhealthmcaremontomamnationallymstandardizedmelectronicmbillingmplatform
Ref.mhttps://quizlet.com/6202453/hcca-chpc-overview-flash-cards/
MoremonmHIPAA:mhttps://www.hhs.gov/hipaa/index.html
HIPAAmresidesminmwhichmCFRmsection?m-
mans✔✔45mCFRmsectionsm164.102mthroughm164.534
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
WhatmaremthemsubpartsmofmHIPAAmpartm164?m-mans✔✔HIPAAm-m45mCFRm164,msubparts:
SubpartmAm-mGeneralmrules
SubpartmCm-mSecurity
SubpartmDm-mBreachmnotification
SubpartmEm-mPrivacy
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
Howmdomyoumdeterminemifmanmorganizationmismam"CoveredmEntity"?m-
mans✔✔1.mcomparemifmthemorganizationmmeetsmonemofmthem3mtypesmofmCEm(provider,mhealt
hmplan,mclearinghouse)
and
2.mdeterminemifmthemorganizationmelectronicallymtransmitsmonemofmthem9mdefinedmtransactio
ns:
•mHealthmclaimsmormequivalentmencounterminformation
•mHealthmclaimsmattachments
•mEnrollmentmandmdisenrollmentminmamhealthmplan
•mEligibilitymformamhealthmplan
•mHealthmcarempaymentmandmremittancemadvice
,•mHealthmplanmpremiummpayments
•mFirstmreportmofminjury
•mHealthmclaimmstatus
•mReferralmcertificationmandmauthorization
Inmaddition,mbusinessmassociatesmofmcoveredmentitiesmmustmfollowmpartsmofmthemHIPAAmreg
ulations.
https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
ThismActmestablishedminm1974mwasmcreatedmformgovernmentmagenciesmplacingmrestrictions
monmhowmthemgovernmentmcanmsharemtheminformationmmaintainedminmFederalmsystemsmofmr
ecordsmthatmmightminfringemonmanmindividual'smprivacymrightsmwithmothermindividualsmandma
gencies.m-mans✔✔ThemPrivacymActmofm1974
WhichmofmthemfollowingmismnotmconsideredmamHIPAAmEntitymDesignation:
1.mAffiliatedmcoveredmentity
2.mEntitymthatmperformsmhealthcaremandmnon-
healthcaremcomponentmactivitiesmincludingmbothmcoveredmandmnon-coveredmfunctions
3.mAmgroupmhealthmplan
4.mContractmarrangementmwithmFEDEXmcarrierm-
mans✔✔4.mContractmarrangementmwithmFEDEXmcarrier
WhatmismGramm-Leach-BlileymActm(GLBA)?m-mans✔✔Gramm-Leach-
BlileymActm(GLBA),malsomknownmasmthemFinancialmServicesmModernizationmActmofm1999,min
cludesmThemFinancialmPrivacymRulemandmThemSafeguardsmRulemrequiresmallmfinancialminsti
tutionsmtomprotectmcustomer'smpersonalmfinancialminformation.
WhatmismanmOHCA?m-
mans✔✔OHCAm(OrganizedmHealthmCaremArrangement) mit'smamclinicallymintegratedmcarems
ettingmwheremindividualsmreceivemhealthmcaremfrommmoremthanmonemprovider.m
Thesemaremjointmarrangements/
activitiesmandmhavemanmIntegratedmDeliverymSystemmformeasymexchangemofmPHImdata.mSee
m45mCFRm160.103.mOHCAsmcanmalsomutilizemamjointmNPP.mSeem45mCFRm§m164.520(d).
ACEm(AffiliatedmCoveredmEntity)mdomnotmhavemanmIntegratedmDeliverymSystemmbecausemth
esemaremlegallymseparatemcoveredmentitiesmthatmaremassociatedminmbusiness,mormaffiliatedm
asmamresultmofmsomemcommonmcontrolmormownership.
BothmthemOHCAmandmthemACEmwouldmallowmsharingmofmPHImacrossmparticipatingmentitymlin
esmformtreatment,mpayment,moperationsmpurposesm(TPO).
What'smanmACE?m-mans✔✔ACEm(AffiliatedmCoveredmEntity)
Legallymseparatemcoveredmentitiesmthatmsharemcommonmcontrol/
ownershipmandmdesignatemthemselvesmasmamsinglemCEmformthempurposemofmcomplyingmwit
hmthemHIPAAmPrivacymstandards.
,ACEsmdomnotmhavemanmIntegratedmDeliverymSystem,mwhilemOHCAmdo,mandmcanmsharemamsi
nglemNPP.mSeem45mCFRm§m164.520(d)
ACEmexample:mamhealthmsystemmcomposedmonmseveralmaffiliatedmhospitals.
BothmthemOHCAmandmthemACEmwouldmallowmsharingmofmPHImacrossmparticipatingmentitymlin
esmformtreatment,mpayment,moperationsmpurposesm(TPO).
What'smamHybridmEntity?m-
mans✔✔Entitymthatmconductsmbothmcoveredmfunctionsm(ormhealthcare-functions) mandmnon-
coveredmfunctionsm(othermbiz/non-healthcaremfunctions)mtomelectmtombemam"hybridmentity."
Forminstance,mamUniversitymSystemmthatmhasmamresearchmlaboratorymormacademicmmedical
mcenter.
Thempost-secondarymfunctionsm(non-
healthcaremcomponents)mdomNOTmneedmtomcomplymwithmHIPAA.
Themresearchmlab/
medmcentermfunctionsm(healthcaremcomponent)mneedsmtomcomplymwithmHIPAAmprovisionsm
tomprotectmthemuse/disclosuremofmPHIminvolved.
https://www.hhs.gov/hipaa/for-professionals/faq/315/when-does-a-covered-entity-have-
discretion-to-determine-covered-functions/index.html#:~:text=For%20example%2C
%20a%20hybrid%20entity,hybrid%20entity's%20health%20care%20component.
https://privacyruleandresearch.nih.gov/pr_06.asp
Themtransmissionmofminformationmbetweenmtwompartiesmtomcarrymoutmfinancialmormadministr
ativemactivitiesmrelatedmtomhealthmcaremismcalled:m-
mans✔✔Transactionm(healthcaremtransaction).
Fewmexamplesmofmhealthcaremtransactions:
healthcaremclaims;
coordinationmofmbenefits;
healthmplanmpremiummpayments;
remittancemadvicem(ormETF,melectronicmfundmtransfer);
referralmcertificationmandmauthorization
WhatmaremexamplesmofmamBA?m-mans✔✔BAm(BusinessmAssociate)m-
mperformsmfunctionsmormactivitiesmonmbehalfmofmamcoveredmentitymthatminvolvemaccessmbymth
embusinessmassociatemtomprotectedmhealthminformation.
Examples:
claimsmprocessing
datamanalysis
billing
benefitmmanagement
qualitymassurance
, qualitymimprovement
practicemmanagement
legal
actuarial
accounting
accreditation
othermadministrativemservices
https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/business-associates/
index.html
TruemormFalse:
Amhospitalmismnotmrequiredmtomhavemambusinessmassociatemcontractmwithmthemspecialistmtom
whommitmrefersmampatientmandmtransmitsmthempatient'smmedicalmchartmformtreatmentmpurpos
es.m-mans✔✔TRUE
Remember,musemandmdisclosuremofmPHImformpurposesmofmTPOmrequiresmnomspecificmautho
rization
TruemormFalse:
BusinessmAssociatesmAftermHITECH:
HITECHmmadembusinessmassociatesmdirectlymresponsiblemformHIPAAmcompliancemwithinmt
heirmindividualmbusinessesmthatmwouldmnotmotherwisembemsubjectmtomHIPAAmregulationsma
ndmpenaltiesm-mans✔✔TRUE
Evenmifmnomwrittenmcontractmexistsmbetweenmthemcoveredmentitymandmamcontractedmcompa
nymperformingmservicesmrelatedmtomhandlingmPHIminmsomemform,mthemcompanymismdeemedm
ambusinessmassociatembymlaw.mThismdeemedmstatusmessentiallymclassifiesmcontractedmven
dorsmormindividualsmasmbusinessmassociatesmsolelymbymthemnaturemofmthemservicesmtheympr
ovidemtomamcoveredmentity,mregardlessmofmwhethermtheymintendedmtombemclassifiedmasmbusi
nessmassociatesmormweremawaremofmtheirmstatusmasmsuch.mHIPAAmandmHITECHmmaymholdm
thesemvendorsmtombusinessmassociatemobligationsmasmlongmasmtheymactmasmbusinessmasso
ciates.
Likewise,mamsubcontractormthatmcreates,mreceives,mmaintains,mormtransmitsmPHImonmbehalf
mofmambusinessmassociatemismambusinessmassociate.mAmsubcontractormofmamsubcontractormi
smambusinessmassociatemasmwell,mandmsomonmdownmthemline.
Ref.m2023mHCCAmCompletemHealthcaremCompliancemManual
Ref.mHITECHmActmandmOCR'sm2013mfinalmrule
TruemormFalse:
UndermHIPAAmandmHITECH,mindividualsmormentitiesmwhomhavembeenmidentifiedmasmbusine
ssmassociatesmaremobligatedmtomentermintomambusinessmassociatemagreementmwithmtheirmco
ntractedmcoveredmentities.m-mans✔✔TRUE
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller AGRADEPROMASTER. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
79271 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now