HCCA - CHPC OVERVIEW EXAM
WITH CORRECT QUESTIONS AND
ANSWERS 2025
1. HIPAA became law - CORRECT-ANSWERS1996
2. What is the purpose of HIPAA? - CORRECT-ANSWERS• 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
3. Intent - CORRECT-ANSWERSpurpose 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.
4. HIPAA resides in what CFR section - CORRECT-ANSWERS45 CFR sections 164.102
through 164.534
5. Identify the four sections in the CFR by location and topic - CORRECT-
ANSWERSSection One: 164.102 - 164.318 and 164.530 - 164-534 Organizational
Requirements
6. Section Two: 164.500 - 164.514 Use and Disclosure of Information
,7. Section Three: 164.520 - 164.528 Individual's Rights and Penalties
8. Section Four: Interaction with the HIPAA Security Rule
9. How do you determine if organization is a CE - CORRECT-ANSWERS- 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"
10. What are the different types of CEs - CORRECT-ANSWERS- Provider
- Health Plan
- Clearing House
- Other Types
11. How is a Provider defined - CORRECT-ANSWERS- "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.
12. Does a provider need a standing facility to be considered a CE - CORRECT-
ANSWERSNO
13. What does "Health Plan" mean? - CORRECT-ANSWERSAn 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
14. 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
15. .
16. What is a Clearinghouse - CORRECT-ANSWERSmay be a public or private entity that
processes
17. or facilitates the processing of nonstandard data elements of health information into
standard data
18. elements.
19. What are other HIPAA Entities - CORRECT-ANSWERSHybrid, Business Associate
20. Organized Health Care Arrangement
WITH CORRECT QUESTIONS AND
ANSWERS 2025
1. HIPAA became law - CORRECT-ANSWERS1996
2. What is the purpose of HIPAA? - CORRECT-ANSWERS• 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
3. Intent - CORRECT-ANSWERSpurpose 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.
4. HIPAA resides in what CFR section - CORRECT-ANSWERS45 CFR sections 164.102
through 164.534
5. Identify the four sections in the CFR by location and topic - CORRECT-
ANSWERSSection One: 164.102 - 164.318 and 164.530 - 164-534 Organizational
Requirements
6. Section Two: 164.500 - 164.514 Use and Disclosure of Information
,7. Section Three: 164.520 - 164.528 Individual's Rights and Penalties
8. Section Four: Interaction with the HIPAA Security Rule
9. How do you determine if organization is a CE - CORRECT-ANSWERS- 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"
10. What are the different types of CEs - CORRECT-ANSWERS- Provider
- Health Plan
- Clearing House
- Other Types
11. How is a Provider defined - CORRECT-ANSWERS- "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.
12. Does a provider need a standing facility to be considered a CE - CORRECT-
ANSWERSNO
13. What does "Health Plan" mean? - CORRECT-ANSWERSAn 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
14. 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
15. .
16. What is a Clearinghouse - CORRECT-ANSWERSmay be a public or private entity that
processes
17. or facilitates the processing of nonstandard data elements of health information into
standard data
18. elements.
19. What are other HIPAA Entities - CORRECT-ANSWERSHybrid, Business Associate
20. Organized Health Care Arrangement
