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HCCA-CHPC EXAM LATEST ACTUAL EXAM 400
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |AGRADE
What date did HIPAA became law .....ANSWER.....1996
What is the purpose of HIPAA? .....ANSWER.....1. Protect
individuals' PHI
2. Promote high quality healthcare
3. Protect the public's health and well being
HIPAA resides in what CFR section .....ANSWER.....45 CFR sections
164.102 through 164.534
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
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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
.....ANSWER.....compare the functions of the entity to the three
principal types of "covered entities" (CE)
What are the different types of CEs .....ANSWER.....- Provider
- Health Plan
- Clearing House
- Other Types
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How is a Provider defined .....ANSWER.....Supports medical or
health services such as SNFs, home health, hospitals, physician
clinics, etc that transmit in electronic form
Does a provider need a standing facility to be considered a CE
.....ANSWER.....No, a provider does not need a standing facility
to be considered a CE
What is a Health Plan .....ANSWER.....(1) A healthcare
organization that provides or pays the cost of medical care
(2) Includes Medicaid, Medicare, and self funded plans
What is a Clearinghouse .....ANSWER.....(1) processes health
information from a nonstandard data elements of health
information into standard data
elements
(2) includes billing services, health information systems, etc
(3) does NOT include Third Party Administrations ( TPAs)
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What are the three Organizational Arrangements
.....ANSWER.....Organized Health Care Arrangement (OHCA)
Affiliated Covered Entities (ACE)
Hybrid Covered Entity (HCE)
What is a Hybrid Covered Entity (HCE) .....ANSWER.....single
covered entity with non-health care components
What is an Organized Health Care Arrangement (OHCA)?
.....ANSWER.....clinically integrated care setting where individuals
receive health care from more than one covered entity
What is an Affiliated Covered Entity (ACE)? .....ANSWER.....(1)
legally separate covered entities that share common control or
common ownership
(2) choose to designate themselves as one affiliated CE for the
purposes of complying with the HIPAA Privacy standard
HCCA-CHPC EXAM LATEST ACTUAL EXAM 400
QUESTIONS AND CORRECT DETAILED ANSWERS WITH
RATIONALES (VERIFIED ANSWERS) |AGRADE
What date did HIPAA became law .....ANSWER.....1996
What is the purpose of HIPAA? .....ANSWER.....1. Protect
individuals' PHI
2. Promote high quality healthcare
3. Protect the public's health and well being
HIPAA resides in what CFR section .....ANSWER.....45 CFR sections
164.102 through 164.534
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
,Page 2 of 53
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
.....ANSWER.....compare the functions of the entity to the three
principal types of "covered entities" (CE)
What are the different types of CEs .....ANSWER.....- Provider
- Health Plan
- Clearing House
- Other Types
,Page 3 of 53
How is a Provider defined .....ANSWER.....Supports medical or
health services such as SNFs, home health, hospitals, physician
clinics, etc that transmit in electronic form
Does a provider need a standing facility to be considered a CE
.....ANSWER.....No, a provider does not need a standing facility
to be considered a CE
What is a Health Plan .....ANSWER.....(1) A healthcare
organization that provides or pays the cost of medical care
(2) Includes Medicaid, Medicare, and self funded plans
What is a Clearinghouse .....ANSWER.....(1) processes health
information from a nonstandard data elements of health
information into standard data
elements
(2) includes billing services, health information systems, etc
(3) does NOT include Third Party Administrations ( TPAs)
, Page 4 of 53
What are the three Organizational Arrangements
.....ANSWER.....Organized Health Care Arrangement (OHCA)
Affiliated Covered Entities (ACE)
Hybrid Covered Entity (HCE)
What is a Hybrid Covered Entity (HCE) .....ANSWER.....single
covered entity with non-health care components
What is an Organized Health Care Arrangement (OHCA)?
.....ANSWER.....clinically integrated care setting where individuals
receive health care from more than one covered entity
What is an Affiliated Covered Entity (ACE)? .....ANSWER.....(1)
legally separate covered entities that share common control or
common ownership
(2) choose to designate themselves as one affiliated CE for the
purposes of complying with the HIPAA Privacy standard
