HCCA - CHPC Study Guide with Answers (300 Solved Questions)

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

• Prevent fraud, waste and abuse (via Administrative Simplification);

• Make health insurance portable under ERISA;

• Move health care onto a nationally standardized electronic billing platform

HIPAA resides in which CFR section? - ANSWER--45 CFR sections 164.102 through 164.534

What are the subparts of HIPAA part 164? - ANSWER--HIPAA - 45 CFR 164, subparts:

Subpart A - General rules

Subpart C - Security

Subpart D - Breach notification

Subpart E - Privacy

How do you determine if an organization is a "Covered Entity"? - ANSWER--1. compare if the
organization meets one of the 3 types of CE (provider, health plan, clearinghouse)

and

2. determine if the organization electronically transmits one of the 9 defined transactions:

• Health claims or equivalent encounter information

• Health claims attachments

• Enrollment and disenrollment in a health plan

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Subject
Health Care Compliance Association