HCCA - CHPC OVERVIEW EXAM WITH
QUESTIONS AND 100% CORRECT
ANSWERS 2025 NEW UPDATE.
1. When did HIPAA become law?
Answer: 1996
2. What is the purpose of HIPAA?
Answer:
• To make health insurance portable under ERISA
• To move health care onto a nationally standardized electronic billing platform
• To prevent fraud, waste, and abuse
3. What is the intent of HIPAA?
Answer: The purpose of this subtitle is 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.
4. HIPAA resides in what CFR section?
Answer: 45 CFR sections 164.102 through 164.534
5. Identify the four sections in the CFR by location and topic.
Answer:
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
, 6. How do you determine if an organization is a CE (Covered Entity)?
Answer: Compare the functions of the entity to the three principal types of "covered
entities" (CE), and determine if the entity electronically transmits one of the nine defined
transactions.
7. What are the different types of CEs?
Answer:
• Provider
• Health Plan
• Clearing House
• Other Types
8. How is a Provider defined?
Answer:
• 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.
9. Does a provider need a standing facility to be considered a CE?
Answer: NO
10. What does "Health Plan" mean?
Answer: An individual or group plan that provides, or pays the cost of, medical care.
Includes:
• A group health plan (with 50 or more participants and administered by an entity other
than the employer)
• A health insurance issuer
• A health maintenance organization
• The Medicaid program under title XIX
• A Medicare supplemental policy
QUESTIONS AND 100% CORRECT
ANSWERS 2025 NEW UPDATE.
1. When did HIPAA become law?
Answer: 1996
2. What is the purpose of HIPAA?
Answer:
• To make health insurance portable under ERISA
• To move health care onto a nationally standardized electronic billing platform
• To prevent fraud, waste, and abuse
3. What is the intent of HIPAA?
Answer: The purpose of this subtitle is 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.
4. HIPAA resides in what CFR section?
Answer: 45 CFR sections 164.102 through 164.534
5. Identify the four sections in the CFR by location and topic.
Answer:
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
, 6. How do you determine if an organization is a CE (Covered Entity)?
Answer: Compare the functions of the entity to the three principal types of "covered
entities" (CE), and determine if the entity electronically transmits one of the nine defined
transactions.
7. What are the different types of CEs?
Answer:
• Provider
• Health Plan
• Clearing House
• Other Types
8. How is a Provider defined?
Answer:
• 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.
9. Does a provider need a standing facility to be considered a CE?
Answer: NO
10. What does "Health Plan" mean?
Answer: An individual or group plan that provides, or pays the cost of, medical care.
Includes:
• A group health plan (with 50 or more participants and administered by an entity other
than the employer)
• A health insurance issuer
• A health maintenance organization
• The Medicaid program under title XIX
• A Medicare supplemental policy
