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HCCA - CHPC Overview Questions and Correct Answers | Latest Update

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  • Module
  • HCCA
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  • HCCA

HIPAA became law ~~>1996 What is the purpose of HIPAA? ~~>• 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 ~~>purpose of this subtitle to i...

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  • September 10, 2024
  • 36
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • HCCA
  • HCCA
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1 | P a g e | © copyright 2024/2025 | Grade A+




HCCA - CHPC Overview Questions and
Correct Answers | Latest Update
HIPAA became law


✓ ~~>1996




What is the purpose of HIPAA?


✓ ~~>• 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


✓ ~~>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




Master01 | September, 2024/2025 | Latest update

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✓ ~~>45 CFR sections 164.102 through 164.534




Identify the four sections in the CFR by location and topic


✓ ~~>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


✓ ~~>- 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




Master01 | September, 2024/2025 | Latest update

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✓ ~~>- Provider

- Health Plan


- Clearing House


- Other Types




How is a Provider defined


✓ ~~>- "a provider of services (as defined in section 1395x (u) of title XIX)

- a provider of medical or other health services (as defined in section 1395x

(s) of title XIX)


- any other person furnishing health care services or supplies.




Does a provider need a standing facility to be considered a CE


✓ ~~>NO




What does "Health Plan" mean?


✓ ~~>An individual or group plan that provides, or pays the cost of,

medical care




• A group health plan, but only if the plan:


-- has 50 or more participants



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-- is administered by an entity other than the employer who established and

maintains the plan.


• A health insurance issuer


• A health maintenance organization


• The Medicaid program under title XIX.


• A Medicare supplemental policy


• A long-term care policy, including a nursing


home fixed indemnity policy


• An employee welfare benefit plan providing health benefits to the

employees of 2 or more employers.


• The health care program for active military


• The veteran's health care program .


• The Civilian Health and Medical Program


• The Indian Health Service Program


• The Federal Employees Health Benefit Plan


.




What is a Clearinghouse




Master01 | September, 2024/2025 | Latest update

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