HCCA - CHPC Study Guide Latest Update 2023/2024 - 296 Questions And Answers
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HCCA - CHPC
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HCCA - CHPC
What is the purpose of HIPAA? - CORRECT 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 pla...
HCCA -
CHPC
Study
Guide
Latest
Update
2023/2024
- 296 Questions
And
Answers What is the purpose of HIPAA? - CORRECT 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? - CORRECT ANSWER - 45 CFR sections 164.102 through 164.534
https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164
What are the subparts of HIPAA part 164? - CORRECT 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"? - CORRECT 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
• 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. - CORRECT 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
3.A group health plan
4.Contract arrangement with FEDEX carrier - CORRECT ANSWER - 4. Contract arrangement with FEDEX carrier
What is Gramm-Leach-Bliley Act (GLBA)? - CORRECT 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? - CORRECT 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.
Both the OHCA and the ACE would allow sharing of PHI across participating entity lines for treatment, payment, operations purposes (TPO).
What's an ACE? - CORRECT ANSWER - 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 standards.
ACEs do not have an Integrated Delivery 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.
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