{"id":115462,"date":"2023-08-24T11:15:28","date_gmt":"2023-08-24T11:15:28","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=115462"},"modified":"2023-08-24T11:15:32","modified_gmt":"2023-08-24T11:15:32","slug":"hcca-chpc-study-questions-master-flashcards-updated-2023-2024-actual-exam","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/08\/24\/hcca-chpc-study-questions-master-flashcards-updated-2023-2024-actual-exam\/","title":{"rendered":"HCCA &#8211; CHPC Study Questions (MASTER FLASHCARDS) Updated 2023\/ 2024 Actual Exam"},"content":{"rendered":"\n<p>HCCA &#8211; CHPC Study Questions (MASTER<br>FLASHCARDS) Updated 2023\/ 2024 Actual<br>Exam<br>What is the purpose of HIPAA? &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; \u2022 Protect PHI from<br>unauthorized disclosure\/use;<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Prevent fraud, waste and abuse (via Administrative Simplification);<\/li>\n\n\n\n<li>Make health insurance portable under ERISA;<\/li>\n\n\n\n<li>Move health care onto a nationally standardized electronic billing platform<br>Ref. https:\/\/quizlet.com\/6202453\/hcca-chpc-overview-flash-cards\/<br>More on HIPAA: https:\/\/www.hhs.gov\/hipaa\/index.html<br>HIPAA resides in which CFR section? &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; 45 CFR sections<br>164.102 through 164.534<br>https:\/\/www.ecfr.gov\/current\/title-45\/subtitle-A\/subchapter-C\/part-164<br>What are the subparts of HIPAA part 164? &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; HIPAA &#8211; 45<br>CFR 164, subparts:<br>Subpart A &#8211; General rules<br>Subpart C &#8211; Security<br>Subpart D &#8211; Breach notification<br>Subpart E &#8211; Privacy<br>https:\/\/www.ecfr.gov\/current\/title-45\/subtitle-A\/subchapter-C\/part-164<br>How do you determine if an organization is a &#8220;Covered Entity&#8221;? &#8212;&#8212;&#8212; Correct Answer &#8211;<br>&#8212;&#8212;- 1. compare if the organization meets one of the 3 types of CE (provider, health<br>plan, clearinghouse)<br>and<\/li>\n<\/ul>\n\n\n\n<ol class=\"wp-block-list\">\n<li>determine if the organization electronically transmits one of the 9 defined<br>transactions:<\/li>\n<\/ol>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Health claims or equivalent encounter information<\/li>\n\n\n\n<li>Health claims attachments<\/li>\n\n\n\n<li>Enrollment and disenrollment in a health plan<\/li>\n\n\n\n<li>Eligibility for a health plan<\/li>\n\n\n\n<li>Health care payment and remittance advice<\/li>\n\n\n\n<li>Health plan premium payments<\/li>\n\n\n\n<li>First report of injury<\/li>\n\n\n\n<li>Health claim status<\/li>\n\n\n\n<li>Referral certification and authorization<\/li>\n<\/ul>\n\n\n\n<p>In addition, business associates of covered entities must follow parts of the HIPAA<br>regulations.<br>https:\/\/www.hhs.gov\/hipaa\/for-individuals\/guidance-materials-for-consumers\/index.html<br>This Act established in 1974 was created for government agencies placing restrictions<br>on how the government can share the information maintained in Federal systems of<br>records that might infringe on an individual&#8217;s privacy rights with other individuals and<br>agencies. &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; The Privacy Act of 1974<br>Which of the following is not considered a HIPAA Entity Designation:<\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Affiliated covered entity<\/li>\n\n\n\n<li>Entity that performs healthcare and non-healthcare component activities including<br>both covered and non-covered functions<\/li>\n\n\n\n<li>A group health plan<\/li>\n\n\n\n<li>Contract arrangement with FEDEX carrier &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; 4. Contract<br>arrangement with FEDEX carrier<br>What is Gramm-Leach-Bliley Act (GLBA)? &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; GrammLeach-Bliley Act (GLBA), also known as the Financial Services Modernization Act of<br>1999, includes The Financial Privacy Rule and The Safeguards Rule requires all<br>financial institutions to protect customer&#8217;s personal financial information.<br>What is an OHCA? &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; OHCA (Organized Health Care<br>Arrangement) it&#8217;s a clinically integrated care setting where individuals receive health<br>care from more than one provider.<br>These are joint arrangements\/activities and have an Integrated Delivery System for<br>easy exchange of PHI data. See 45 CFR 160.103. OHCAs can also utilize a joint NPP.<br>See 45 CFR \u00a7 164.520(d).<br>ACE (Affiliated Covered Entity) do not have an Integrated Delivery System because<br>these are legally separate covered entities that are associated in business, or affiliated<br>as a result of some common control or ownership.<br>Both the OHCA and the ACE would allow sharing of PHI across participating entity lines<br>for treatment, payment, operations purposes (TPO).<br>What&#8217;s an ACE? &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; ACE (Affiliated Covered Entity)<br>Legally separate covered entities that share common control\/ownership and designate<br>themselves as a single CE for the purpose of complying with the HIPAA Privacy<br>standards.<br>ACEs do not have an Integrated Delivery System, while OHCA do, and can share a<br>single NPP. See 45 CFR \u00a7 164.520(d)<br>ACE example: a health system composed on several affiliated hospitals.<\/li>\n<\/ol>\n\n\n\n<p>Both the OHCA and the ACE would allow sharing of PHI across participating entity lines<br>for treatment, payment, operations purposes (TPO).<br>What&#8217;s a Hybrid Entity? &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; Entity that conducts both covered<br>functions (or healthcare-functions) and non-covered functions (other biz\/non-healthcare<br>functions) to elect to be a &#8220;hybrid entity.&#8221;<br>For instance, a University System that has a research laboratory or academic medical<br>center.<br>The post-secondary functions (non-healthcare components) do NOT need to comply<br>with HIPAA.<br>The research lab\/med center functions (healthcare component) needs to comply with<br>HIPAA provisions to protect the use\/disclosure of PHI involved.<br>https:\/\/www.hhs.gov\/hipaa\/for-professionals\/faq\/315\/when-does-a-covered-entity-havediscretion-to-determine-coveredfunctions\/index.html#:~:text=For%20example%2C%20a%20hybrid%20entity,hybrid%20<br>entity&#8217;s%20health%20care%20component.<br>https:\/\/privacyruleandresearch.nih.gov\/pr_06.asp<br>The transmission of information between two parties to carry out financial or<br>administrative activities related to health care is called: &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211;<br>Transaction (healthcare transaction).<br>Few examples of healthcare transactions:<br>healthcare claims;<br>coordination of benefits;<br>health plan premium payments;<br>remittance advice (or ETF, electronic fund transfer);<br>referral certification and authorization<br>What are examples of a BA? &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; BA (Business Associate) &#8211;<br>performs functions or activities on behalf of a covered entity that involve access by the<br>business associate to protected health information.<br>Examples:<br>claims processing<br>data analysis<br>billing<br>benefit management<br>quality assurance<br>quality improvement<br>practice management<br>legal<br>actuarial<br>accounting<\/p>\n\n\n\n<p>accreditation<br>other administrative services<br>https:\/\/www.hhs.gov\/hipaa\/for-professionals\/privacy\/guidance\/businessassociates\/index.html<br>True or False:<br>A hospital is not required to have a business associate contract with the specialist to<br>whom it refers a patient and transmits the patient&#8217;s medical chart for treatment<br>purposes. &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; TRUE<br>Remember, use and disclosure of PHI for purposes of TPO requires no specific<br>authorization<br>Except for TPO, list two examples where a CE requires an authorization to use\/disclose<br>PHI &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; 1. Sales and marketing<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"2\">\n<li>Psychotherapy notes<br>How do you determine if an entity is subject to HIPAA? &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211;<br>By understanding the applicability (healthcare component), entities that transmit health<br>information and fall under the 3 types of CE (health plans, clearinghouses, and<br>providers)<br>HIPAA provide standards for the access, disclosure, transmission, and retention of PHI,<br>and created a national baseline for health information Privacy and Security. At the state<br>level, they can also develop health information statutes but only adding higher or more<br>restrictive standards than the Federal HIPAA rules. This is referred as:<br>a. HIPAA status<br>b. HIPAA assurance<br>c. HIPAA preemption<br>d. HIPAA state law &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; c. HIPAA preemption<br>What is the intent of HIPAA?<br>a. standardize healthcare billing and coding to comply with national accounting<br>principles<br>b. increase payment from providers given the rising cost of healthcare and fraud<br>violations<br>c. allow group health plans collect premiums after individual has left a job\/employer<br>d. improve healthcare programs and data flow between providers to data mine for<br>fraudulent behavior &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; d. improve healthcare programs and<br>data flow between providers to data mine for fraudulent behavior<br>The intent of HIPAA is to improve healthcare programs and the delivery of services<br>through the two largest health plans in the U.S., This is accomplished by improved data<br>flows that leads to better outcomes using national standards formats and specific<br>transactions to increase accuracy and rapid way to data mine ad detect fraudulent<br>behavior.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>HCCA &#8211; CHPC Study Questions (MASTERFLASHCARDS) Updated 2023\/ 2024 ActualExamWhat is the purpose of HIPAA? &#8212;&#8212;&#8212; Correct Answer &#8212;&#8212;&#8211; \u2022 Protect PHI fromunauthorized disclosure\/use; In addition, business associates of covered entities must follow parts of the HIPAAregulations.https:\/\/www.hhs.gov\/hipaa\/for-individuals\/guidance-materials-for-consumers\/index.htmlThis Act established in 1974 was created for government agencies placing restrictionson how the government can share the information [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-115462","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/115462","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=115462"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/115462\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=115462"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=115462"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=115462"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}