HCCA – CHPC EXAM ACTUAL EXAM AND STUDY GUIDE LATEST COMPLETE 500+ QUESTIONS AND CORRECT DETAILED ANSWERS

HCCA CHPC/ HCCA CHPC Exam Study Questions from
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Actual Past Exam and 100% Correct Answers K K K K K K




What is the purpose of HIPAA? - ANSWER >> • Protect PHI from
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unauthorized disclosure/use; K



• Prevent fraud, waste and abuse (via Administrative
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Simplification);
• Make health insurance portable under ERISA;
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• Move health care onto a nationally standardized electronic
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billing platformK




Ref. https://quizlet.com/6202453/hcca-chpc-overview-flash-
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cards/
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More on HIPAA: https://www.hhs.gov/hipaa/index.html
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HIPAA resides in which CFR section? -
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ANSWER >> 45 CFRsections 164.102 through 164.534
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https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-
C/part-164
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What are the subparts of HIPAA part 164? - ANSWER >> HIPAA -
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45 CFR 164, subparts:
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Subpart A - K K



General rulesSubpart C -
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Security
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Subpart D - K K



Breach notificationSubpart E -
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Privacy
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,https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-
C/part-164
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How do you determine if an organization is a "Covered Entity"?
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-
ANSWER >> 1. compare if the organization meets one of the 3typ
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es of CE (provider, health plan, clearinghouse)
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and
2. determine if the organization electronically transmits one ofthe
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9 defined transactions:
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• Health claims or equivalent encounter information
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• Health claims attachments K K



• Enrollment and disenrollment in a health plan K K K K K K



• Eligibility for a health plan K K K K



• Health care payment and remittance advice K K K K K



• Health plan premium payments K K K



• First report of injury K K K



• Health claim status K K



• Referral certification and authorization K K K




In addition, business associates of covered entities must followpar
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ts of the HIPAA regulations.
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https://www.hhs.gov/hipaa/for-individuals/guidance-materials-
for-consumers/index.html
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This Act established in 1974 was created for government agencie
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s placing restrictions on how the government can sharethe infor
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mation maintained in Federal systems of records that might infri
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nge on an individual's privacy rights with other individuals and ag
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encies. - ANSWER >> The Privacy Act of 1974
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,Which of the following is not considered a HIPAA EntityDesignatio
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n:
1. Affiliated covered entity K K



2. Entity that performs healthcare and non- K K K K K



healthcare component activities including both covered and no K K K K K K K



n-coveredfunctions K



3. A group health plan
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4. Contract arrangement with FEDEX carrier - K K K K K



ANSWER >> 4.Contract arrangement with FEDEX carrier
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What is Gramm-Leach-Bliley Act (GLBA)? - ANSWER >> Gramm-
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Leach-
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Bliley Act (GLBA), also known as the Financial Services Moderniza
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tion Act of 1999, includes The Financial Privacy Rule and The Safe
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guards Rule requires all financial institutions to protect customer
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's personal financial information.
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What is an OHCA? - K K K K



KANSWER >> OHCA (Organized Health Care Arrangement) it's a clin
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ically integrated care setting where individuals receive health care
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from more than one provider. These are joint arrangements/activi
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ties and have an IntegratedDelivery System for easy exchange of P
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HI data. See 45 CFR
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160.103. OHCAs can also utilize a joint NPP. See 45 CFR §164.520(d
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).

ACE (Affiliated Covered Entity) do not have an Integrated Deliver
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y System because these are legally separate covered entities that
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are associated in business, or affiliated as a resultof some comm
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on control or ownership.
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, Both the OHCA and the ACE would allow sharing of PHI acrossparti
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cipating entity lines for treatment, payment, operations purposes
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(TPO).

What's an ACE? - K K K



KANSWER >> ACE (Affiliated Covered Entity) Legally separate cover
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ed entities that share common control/ownership and designate t
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hemselves as a single CE forthe purpose of complying with the HIP
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AA Privacy standards.
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ACEs do not have an Integrated Delivery System, while OHCAdo
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, and can share a single NPP. See 45 CFR § 164.520(d)
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ACE example: a health system composed on several affiliatedhosp
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itals.

Both the OHCA and the ACE would allow sharing of PHI acrossparti
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cipating entity lines for treatment, payment, operations purposes
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(TPO).

What's a Hybrid Entity? -
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ANSWER >> Entity that conducts bothcovered functions (or health
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care-functions) and non-covered functions (other biz/non- K K K K K



healthcare functions) to elect to be a "hybrid entity."
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For instance, a University System that has a research laboratoryor
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academic medical center. K K



The post-secondary functions (non-
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healthcare components) doNOT need to comply with HIPAA.
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