CHPSE Final Test New Latest Version with

CHPSE Final Test New Latest Version with All Questions from Actual Past Exam and 100% Correct Answers

Which transaction is appropriate for replying to X12 syntax errors that affect the entire transaction set?

• 835
• 277
• 997
• 999 --------- Correct Answer --------- d. 999

Which two transactions form the Electronic Remittance Advice (ERA)?

• 997 and 277
• 837 and 835
• 997 and 835
• 835 and 277 --------- Correct Answer --------- d. 835 and 277

The taxonomy is a required data element on which transaction?

• 837 institutional claim
• 837 professional claim
• 278 prior authorization
• All of the above --------- Correct Answer --------- d. All of the above

How many taxonomy codes does a provider have?

• It depends on the provider's specialty
• One only
• A maximum of 3
• None of the above --------- Correct Answer --------- c. A maximum of 3

What is the X12834 format used to establish?

• Claims Attachment
• Referral certification or authorization
• Communication between the sponsor of a health benefit and the health plan
• Health plan enrollment or disenrollment --------- Correct Answer --------- d. Health plan

enrollment or disenrollment

What does Transaction Set 997 do?

• It is used to make a premium payment for insurance products.
• It is used to inquire about the health care benefits and eligibility associated with a

subscriber or dependent

• It is used to enroll members to a payer
• It is used to define the control structures for a set of acknowledgments to indicate the

results of the syntactical analysis of the electronically encoded documents --------- 1 / 4

Correct Answer --------- d. It is used to define the control structures for a set of acknowledgments to indicate the results of the syntactical analysis of the electronically encoded documents

An Explanation of Payments (EOP) can only be used by a health plan to send remittance advice to a provider

• True
• False --------- Correct Answer --------- a. True

Is there a limit to the allowable transmission size of an X12 transaction?

• Yes
• No --------- Correct Answer --------- b. No

Is a payer required to send a response to an 837 transaction using EDI?

• Yes
• No --------- Correct Answer --------- b. No

If a provider requests a health plan to conduct a transaction as a HIPAA compliant standard transaction, does the health plan have to do so?

• Yes, but the plan can require the provider to submit a minimum number of

transactions usually 200 per month

• Yes, and also send the 835 RA in the electronic version
• No, if the provider's billing system is not on the plan's approved listing
• None of the above --------- Correct Answer --------- b. Yes, and also send the 835 RA

in the electronic version

• The following health plans are required to adhere to the HIPAA Privacy Rule: ---------

Correct Answer ---------- a) Workers compensation

b) Medicare

c) Life insurance

d) Malpractice

• Why did Congress pass HIPAA in 1996?

a) To make sure patient information was not shared with anyone for any reasons

b) To penalize physicians who are guilty of malpractice

c) To simplify health information exchange

d) To prevent pharmaceutical companies from accessing any identifiable patient

information --------- Correct Answer ---------- c) To simplify health information exchange

What do HIPAA security standards require attention to?

a) Confidentiality

b) Integrity

c) Availability

d) All of the above --------- Correct Answer ---------- d) All of the above 2 / 4

• All health care providers are required to comply with the HIPAA Administrative

Simplification Provisions.

a) True

b) False --------- Correct Answer ---------- a) True

5. The Center for Medicare and Medicaid Services (CMS) is responsible for:

a) Enforcing the HIPAA Transaction and Code Sets Rule and the National Identifier

Rules

b) Enforcing the HIPAA Privacy Rule

c) Enforcing the HIPAA Transactions and Code Sets Rule

d) Maintaining the HCPCS code sets --------- Correct Answer ---------- a) Enforcing the

HIPAA Transaction and Code Sets Rule and the National Identifier Rules

• Diagnosing and treating an elderly patient in a skilled nursing facility (long term care)

for diabetes is considered health care.

a) True

b) False --------- Correct Answer ---------- a) True

• What are the objectives are covered in this chapter?

a) To understand the purpose of HIPAA legislation

b) Review the HIPAA administrative simplification title

c) Review non-compliance penalties (civil and criminal)

d) All of the above --------- Correct Answer ---------- d) All of the above

• The HIPAA act of 1996 resulted in substantial investment in e-health initiatives and

deployment of security technology in the healthcare industry

a) True

b) False --------- Correct Answer ---------- a) True

• What was not addressed in the HIPAA act of 1996?

a) Insurance portability

b) Fraud

c) Administrative simplification

d) Worker's Compensation case information --------- Correct Answer ---------- d) Worker's

Compensation case information

• Simplification of clinical data exchange was one of the goals of the HIPAA law

a) True

b) False --------- Correct Answer ---------- b) False

• The following health plans are required to adhere to the HIPAA Privacy Rule

a) Workers compensation

b) Medicare

c) Life insurance

d) Malpractice --------- Correct Answer --------- b) Medicare 3 / 4

Chapter 1: HIPAA Basics

• Why did Congress pass HIPAA in 1996?

a) To make sure patient information was not shared with anyone for any reasons

b) To penalize physicians who are guilty of malpractice

c) To simplify health information exchange

d) To prevent pharmaceutical companies from accessing any identifiable patient

information --------- Correct Answer --------- c) To simplify health information exchange

Chapter 1: HIPAA Basics

What do HIPAA security standards require attention to?

a) Confidentiality

b) Integrity

c) Availability

d) All of the above --------- Correct Answer --------- d) All of the above

Chapter 1: HIPAA Basics

• All health care providers are required to comply with the HIPAA Administrative

Simplification Provisions.

a) True

b) False --------- Correct Answer --------- a) True

Chapter 1: HIPAA Basics

5. The Center for Medicare and Medicaid Services (CMS) is responsible for:

a) Enforcing the HIPAA Transaction and Code Sets Rule and the National Identifier

Rules

b) Enforcing the HIPAA Privacy Rule

c) Enforcing the HIPAA Transactions and Code Sets Rule

d) Maintaining the HCPCS code sets --------- Correct Answer --------- a) Enforcing the

HIPAA Transaction and Code Sets Rule and the National Identifier Rules

Chapter 1: HIPAA Basics

• Diagnosing and treating an elderly patient in a skilled nursing facility (long term care)

for diabetes is considered health care.

a) True

b) False --------- Correct Answer --------- a) True

Chapter 1: HIPAA Basics

• What are the objectives are covered in this chapter?

a) To understand the purpose of HIPAA legislation

• / 4