HCCA CHPC Study Guide (Latest 2026 /
2027) Complete Questions and 100%
Correct Answers (Verified Pass)
• 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 -✓✓- 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
, -- 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 -✓✓may be a public or private entity that processes
or facilitates the processing of nonstandard data elements of health information
into standard data
elements.
• What are other HIPAA Entities -✓✓Hybrid, Business Associate
Organized Health Care Arrangement
Affiliated Covered Entity
• What is a Hybrid Entity? -✓✓single legal entity, where
only some of its divisions or programs meet the
CE definitions and is typical of large entities
• What is Organized Health Care Arrangement (OHCA)? -✓✓clinically integrated
care setting where individuals receive health care from more than one health care
provider.
• What is Affiliated Covered Entity? -✓✓legally distinct entities that share
common control or common ownership and choose to designate themselves as one
affiliated CE for the purposes of complying with the HIPAA Privacy standard
, • What must a Affiliated Entity agree to? -✓✓Be treated as a single CE. Must
agree to follow a standard policy and procedure
• What is a Business Associate? -✓✓- CE to either get "assurances" for privacy
and security standards from their business partners or to include a BA amendment
to a contract.
- where a separate legal entity uses or discloses Individually Identifiable
Information on behalf of the CE.
• What are examples of a BA? -✓✓claims processing
data analysis
billing
benefit management
quality assurance
quality improvement
practice management
legal
actuarial
accounting
accreditation
other administrative services
• What has been the main complaint with holding a BA accountable under the 2000
Privacy Rule? -✓✓- lack of penalties for non-compliance
- federal penalties could only be levied against the CE
• Which new regulation corrected shot comings of the HIPAA 2000 regulation
concerning BAs? -✓✓Health Information Technology
for Economic and Clinical Health (HITECH)
• Who is know responsible for privacy and security of BAs? -✓✓The Business
Associate, legal liability for violations, and possible penalties, flow directly to the
entity that violates.
• What nine transaction are used to determine if a organization is a CE? -✓✓•
Health claims or equivalent encounter
information
• Health claims attachments
• Enrollment and disenrollment in a health plan
2027) Complete Questions and 100%
Correct Answers (Verified Pass)
• 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 -✓✓- 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
, -- 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 -✓✓may be a public or private entity that processes
or facilitates the processing of nonstandard data elements of health information
into standard data
elements.
• What are other HIPAA Entities -✓✓Hybrid, Business Associate
Organized Health Care Arrangement
Affiliated Covered Entity
• What is a Hybrid Entity? -✓✓single legal entity, where
only some of its divisions or programs meet the
CE definitions and is typical of large entities
• What is Organized Health Care Arrangement (OHCA)? -✓✓clinically integrated
care setting where individuals receive health care from more than one health care
provider.
• What is Affiliated Covered Entity? -✓✓legally distinct entities that share
common control or common ownership and choose to designate themselves as one
affiliated CE for the purposes of complying with the HIPAA Privacy standard
, • What must a Affiliated Entity agree to? -✓✓Be treated as a single CE. Must
agree to follow a standard policy and procedure
• What is a Business Associate? -✓✓- CE to either get "assurances" for privacy
and security standards from their business partners or to include a BA amendment
to a contract.
- where a separate legal entity uses or discloses Individually Identifiable
Information on behalf of the CE.
• What are examples of a BA? -✓✓claims processing
data analysis
billing
benefit management
quality assurance
quality improvement
practice management
legal
actuarial
accounting
accreditation
other administrative services
• What has been the main complaint with holding a BA accountable under the 2000
Privacy Rule? -✓✓- lack of penalties for non-compliance
- federal penalties could only be levied against the CE
• Which new regulation corrected shot comings of the HIPAA 2000 regulation
concerning BAs? -✓✓Health Information Technology
for Economic and Clinical Health (HITECH)
• Who is know responsible for privacy and security of BAs? -✓✓The Business
Associate, legal liability for violations, and possible penalties, flow directly to the
entity that violates.
• What nine transaction are used to determine if a organization is a CE? -✓✓•
Health claims or equivalent encounter
information
• Health claims attachments
• Enrollment and disenrollment in a health plan
