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HCCA - CHPC STUDY QUESTIONS (MASTER FLASHCARDS) QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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HCCA - CHPC STUDY QUESTIONS (MASTER FLASHCARDS) QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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HCCA - CHPC STUDY QUESTIONS(MASTER FLASHCARDS) QUESTIONS
AND ANSWERS WITH SOLUTIONS 2024
WhatHisHtheHpurposeHofHHIPAA?H-HANSWERHH•HProtectHPHIHfromHunauthorizedHdisclosure/use;
•HPreventHfraud,HwasteHandHabuseH(viaHAdministrativeHSimplification);
•HMakeHhealthHinsuranceHportableHunderHERISA;
•HMoveHhealthHcareHontoHaHnationallyHstandardizedHelectronicHbillingHplatform
Ref.Hhttps://quizlet.com/6202453/hcca-chpc-overview-flash-cards/
MoreHonHHIPAA:Hhttps://www.hhs.gov/hipaa/index.html
HIPAAHresidesHinHwhichHCFRHsection?H-HANSWERHH45HCFRHsectionsH164.102HthroughH164.534
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
WhatHareHtheHsubpartsHofHHIPAAHpartH164?H-HANSWERHHHIPAAH-H45HCFRH164,Hsubparts:
SubpartHAH-HGeneralHrules
SubpartHCH-HSecurity
SubpartHDH-HBreachHnotification
SubpartHEH-HPrivacy
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
HowHdoHyouHdetermineHifHanHorganizationHisHaH"CoveredHEntity"?H-
HANSWERHH1.HcompareHifHtheHorganizationHmeetsHoneHofHtheH3HtypesHofHCEH(provider,HhealthHplan,Hclearin
ghouse)
and
2.HdetermineHifHtheHorganizationHelectronicallyHtransmitsHoneHofHtheH9HdefinedHtransactions:
•HHealthHclaimsHorHequivalentHencounterHinformation
,•HHealthHclaimsHattachments
•HEnrollmentHandHdisenrollmentHinHaHhealthHplan
•HEligibilityHforHaHhealthHplan
•HHealthHcareHpaymentHandHremittanceHadvice
•HHealthHplanHpremiumHpayments
•HFirstHreportHofHinjury
•HHealthHclaimHstatus
•HReferralHcertificationHandHauthorization
InHaddition,HbusinessHassociatesHofHcoveredHentitiesHmustHfollowHpartsHofHtheHHIPAAHregulations.
https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
ThisHActHestablishedHinH1974HwasHcreatedHforHgovernmentHagenciesHplacingHrestrictionsHonHhowHtheHgove
rnmentHcanHshareHtheHinformationHmaintainedHinHFederalHsystemsHofHrecordsHthatHmightHinfringeHonHanHi
ndividual'sHprivacyHrightsHwithHotherHindividualsHandHagencies.H-HANSWERHHTheHPrivacyHActHofH1974
WhichHofHtheHfollowingHisHnotHconsideredHaHHIPAAHEntityHDesignation:
1.HAffiliatedHcoveredHentity
2.HEntityHthatHperformsHhealthcareHandHnon-
healthcareHcomponentHactivitiesHincludingHbothHcoveredHandHnon-coveredHfunctions
3.HAHgroupHhealthHplan
4.HContractHarrangementHwithHFEDEXHcarrierH-HANSWERHH4.HContractHarrangementHwithHFEDEXHcarrier
WhatHisHGramm-Leach-BlileyHActH(GLBA)?H-HANSWERHHGramm-Leach-
BlileyHActH(GLBA),HalsoHknownHasHtheHFinancialHServicesHModernizationHActHofH1999,HincludesHTheHFinanci
alHPrivacyHRuleHandHTheHSafeguardsHRuleHrequiresHallHfinancialHinstitutionsHtoHprotectHcustomer'sHpersona
lHfinancialHinformation.
WhatHisHanHOHCA?H-
HANSWERHHOHCAH(OrganizedHHealthHCareHArrangement)Hit'sHaHclinicallyHintegratedHcareHsettingHwhereHind
ividualsHreceiveHhealthHcareHfromHmoreHthanHoneHprovider.H
,TheseHareHjointHarrangements/activitiesHandHhaveHanHIntegratedHDeliveryHSystemHforHeasyHexchangeHofHP
HIHdata.HSeeH45HCFRH160.103.HOHCAsHcanHalsoHutilizeHaHjointHNPP.HSeeH45HCFRH§H164.520(d).
ACEH(AffiliatedHCoveredHEntity)HdoHnotHhaveHanHIntegratedHDeliveryHSystemHbecauseHtheseHareHlegallyHsep
arateHcoveredHentitiesHthatHareHassociatedHinHbusiness,HorHaffiliatedHasHaHresultHofHsomeHcommonHcontrolH
orHownership.
BothHtheHOHCAHandHtheHACEHwouldHallowHsharingHofHPHIHacrossHparticipatingHentityHlinesHforHtreatment,H
payment,HoperationsHpurposesH(TPO).
What'sHanHACE?H-HANSWERHHACEH(AffiliatedHCoveredHEntity)
LegallyHseparateHcoveredHentitiesHthatHshareHcommonHcontrol/ownershipHandHdesignateHthemselvesHasHa
HsingleHCEHforHtheHpurposeHofHcomplyingHwithHtheHHIPAAHPrivacyHstandards.
ACEsHdoHnotHhaveHanHIntegratedHDeliveryHSystem,HwhileHOHCAHdo,HandHcanHshareHaHsingleHNPP.HSeeH45HCF
RH§H164.520(d)
ACEHexample:HaHhealthHsystemHcomposedHonHseveralHaffiliatedHhospitals.
BothHtheHOHCAHandHtheHACEHwouldHallowHsharingHofHPHIHacrossHparticipatingHentityHlinesHforHtreatment,H
payment,HoperationsHpurposesH(TPO).
What'sHaHHybridHEntity?H-HANSWERHHEntityHthatHconductsHbothHcoveredHfunctionsH(orHhealthcare-
functions)HandHnon-coveredHfunctionsH(otherHbiz/non-
healthcareHfunctions)HtoHelectHtoHbeHaH"hybridHentity."
ForHinstance,HaHUniversityHSystemHthatHhasHaHresearchHlaboratoryHorHacademicHmedicalHcenter.
TheHpost-secondaryHfunctionsH(non-healthcareHcomponents)HdoHNOTHneedHtoHcomplyHwithHHIPAA.
TheHresearchHlab/medHcenterHfunctionsH(healthcareHcomponent)HneedsHtoHcomplyHwithHHIPAAHprovisions
HtoHprotectHtheHuse/disclosureHofHPHIHinvolved.
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%20healt
h%20care%20component.
https://privacyruleandresearch.nih.gov/pr_06.asp
TheHtransmissionHofHinformationHbetweenHtwoHpartiesHtoHcarryHoutHfinancialHorHadministrativeHactivitiesHr
elatedHtoHhealthHcareHisHcalled:H-HANSWERHHTransactionH(healthcareHtransaction).
FewHexamplesHofHhealthcareHtransactions:
healthcareHclaims;
coordinationHofHbenefits;
healthHplanHpremiumHpayments;
remittanceHadviceH(orHETF,HelectronicHfundHtransfer);
referralHcertificationHandHauthorization
WhatHareHexamplesHofHaHBA?H-HANSWERHHBAH(BusinessHAssociate)H-
HperformsHfunctionsHorHactivitiesHonHbehalfHofHaHcoveredHentityHthatHinvolveHaccessHbyHtheHbusinessHassoc
iateHtoHprotectedHhealthHinformation.
Examples:
claimsHprocessing
dataHanalysis
billing
benefitHmanagement
qualityHassurance
qualityHimprovement
practiceHmanagement
legal
actuarial
accounting
accreditation
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