HCCA - CHPC Study Questions (MASTER FLASHCARDS) Test with Verified Answers Graded A+
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HCCA - CHPC
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HCCA - CHPC
HCCA - CHPC Study Questions (MASTER FLASHCARDS) Test with
Verified Answers Graded A+
1. What is the purpose of
HIPAA?
2. HIPAA resides in which CFR
section?
3. What are the subparts of
HIPAA part 164?
4. How do you determine if an
organization is a "Covered
Entity"?
• Protect PHI from ...
HCCA - CHPC Study Questions (MASTER FLASHCARDS) Test with
Verified Answers Graded A+
1. What is the purpose of • Protect PHI from unauthorized disclo-
HIPAA? sure/use;
• Prevent fraud, waste and abuse (via Ad-
ministrative Simplification);
• Make health insurance portable under
ERISA;
• Move health care onto a nationally stan-
dardized electronic billing platform
Ref.
https://qui-
zlet.com/6202453/hcca-chpc-overview-flash-c
More on HIPAA:
https://www.hhs.gov/hipaa/index.html
2. HIPAA resides in which CFR 45 CFR sections 164.102 through 164.534
section?
https://www.ecfr.gov/current/title-45/subti-
tle-A/subchapter-C/part-164
3. What are the subparts of HIPAA - 45 CFR 164, subparts:
HIPAA part 164? Subpart A - General rules
Subpart C - Security
Subpart D - Breach notification
Subpart E - Privacy
4. How do you determine if an 1. compare if the organization meets one
organization is a "Covered of the 3 types of CE (provider, health plan,
Entity"? clearinghouse)
and
2. determine if the organization electronical-
ly transmits one of the 9 defined transac-
tions:
• Health claims or equivalent encounter in-
formation
• Health claims attachments
, HCCA - CHPC Study Questions (MASTER FLASHCARDS) Test with
Verified Answers Graded A+
• Enrollment and disenrollment in a health
plan
• Eligibility for a health plan
• Health care payment and remittance ad-
vice
• 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 reg-
ulations.
https://www.hhs.gov/hipaa/for-individu-
als/guidance-materials-for-consumers/in-
dex.html
5. This Act established in 1974 The Privacy Act of 1974
was created for government
agencies placing restrictions
on how the government can
share the information main-
tained in Federal systems of
records that might infringe
on an individual's privacy
rights with other individuals
and agencies.
6. Which of the following is not 4. Contract arrangement with FEDEX carrier
considered a HIPAA Entity
Designation:
1. Affiliated covered entity
2. Entity that performs
healthcare and non-health-
care component activities in-
cluding both covered and
non-covered functions
3. A group health plan
, HCCA - CHPC Study Questions (MASTER FLASHCARDS) Test with
Verified Answers Graded A+
4. Contract arrangement with
FEDEX carrier
7. What is Gramm-Leach-Bliley Gramm-Leach-Bliley Act (GLBA), also
Act (GLBA)? known as the Financial Services Modern-
ization Act of 1999, includes The Financial
Privacy Rule and The Safeguards Rule re-
quires all financial institutions to protect cus-
tomer's personal financial information.
8. What is an OHCA? OHCA (Organized Health Care Arrange-
ment) 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 own-
ership.
Both the OHCA and the ACE would allow
sharing of PHI across participating entity
lines for treatment, payment, operations pur-
poses (TPO).
9. What's an ACE? ACE (Affiliated Covered Entity)
Legally separate covered entities that share
common control/ownership and designate
themselves as a single CE for the purpose
of complying with the HIPAA Privacy stan-
dards.
ACEs do not have an Integrated Delivery
, HCCA - CHPC Study Questions (MASTER FLASHCARDS) Test with
Verified Answers Graded A+
System, while OHCA do, and can share a
single NPP. See 45 CFR § 164.520(d)
ACE example: a health system composed
on several affiliated hospitals.
Both the OHCA and the ACE would allow
sharing of PHI across participating entity
lines for treatment, payment, operations pur-
poses (TPO).
10. What's a Hybrid Entity? Entity that conducts both covered functions
(or healthcare-functions) and non-covered
functions (other biz/non-healthcare func-
tions) to elect to be a "hybrid entity."
For instance, a University System that has
a research laboratory or academic medical
center.
The post-secondary functions (non-health-
care components) do NOT need to comply
with HIPAA.
The research lab/med center functions
(healthcare component) needs to comply
with HIPAA provisions to protect the use/dis-
closure of PHI involved.
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