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HIO-201 Practice Exam Questions with Answers Certified HIPAA Professional Certification

Question # 6

When limiting protected health information (PHI) to the minimum necessary for a use or disclosure, a covered entity can use:

A.

Their professional judgment and standards.

B.

The policies set by the security rule for the protection of the information.

C.

Specific guidelines set by WEDI.

D.

Measures that are expedient and reduce costs.

E.

The information for research and marketing purposes only.

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Question # 7

This transaction, which is not a HIPAA standard, may be used as the first response when receiving a Health Care Claim (837):

A.

Eligibility (270/271).

B.

Premium Payment (820).

C.

Unsolicited Claim Status (277).

D.

Remittance Advice (835).

E.

Functional Acknowledgment (997).

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Question # 8

Select the FALSE statement regarding the administrative requirements of the HIPAA privacy rule.

A.

A coveted entity must mitigate, to the extent practicable, any harmful effect that it becomes aware of from the use or disclosure of PHI in violation of its policies and procedures or HIPAA regulations.

B.

A covered must not in any way intimidate, retaliate, or discriminate against any individual or other entity, which files a compliant.

C.

A covered entity may not require individuals to waive their rights as a condition for treatment, payment, enrollment in a health plan, or eligibility for benefits

D.

A covered entity must retain the documents required by the regulations for a period of six years.

E.

A covered entity must change its policies andprocedures to comply with HIPAAregulations no later than three years after the change in law.

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Question # 9

The transaction pair used for requesting and responding to a health claim status inquiry is:

A.

270/271

B.

276/277

C.

278/278

D.

834/834

E.

837/835

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Question # 10

Which of the following is NOT a correct statement regarding HIPAA requirements?

A.

A coveted entity must change its policies and procedures to complywith HIPPPregulations, standards, and implementation specifications.

B.

A covered entity must reasonably safeguard PHI from any intentional or unintentional use or disclosure that is in violation of the regulations.

C.

A covered entity must provide a process for individuals to make complaints concerning privacy issues.

D.

A covered entity must document all complaints received regarding privacy issues.

E.

The Privacy Rule requires that the covered entity has a documented security policy.

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Question # 11

This transaction type is a "response" transaction that may include information such as accepted/rejected claim, approved claim(s) pre-payment, or approved claim(s) post-payment:

A.

270.

B.

820

C.

837.

D.

277.

E.

278.

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Question # 12

One characteristic of the Notice of Privacy Practices is:

A.

H must be written in plain, simple language

B.

It must explicitly describe all uses of PHI

C.

A description about the usage of hidden security cameras for tracking patient movements for implementing privacy.

D.

A description of the duties of the individual

E.

A statement that the individual must abide by the terms of the Notice.

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Question # 13

A State insurance commissioner is requesting specific, individually identifiable information from an insurer as a part of a routine review of the insurer's practices. What must the insurer do to deidentify the information?

A.

The protected health information must be removed from the information. A substitute "key" may be supplied to allow re-identification, if needed.

B.

Limit the information to coverage, dates of treatment, and payment amounts to avoid collecting any protected data.

C.

Nothing. An oversight agency has the right to access this information without prior authorization.

D.

Request that the insurance commissioner ask for an exception from HIPAA from the Department of Health and Human Services.

E.

A written authorization is required from the patient.

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Question # 14

Implementing policies and procedures to prevent, detect, contain, and correct security violations is required by which security standard1?

A.

Security Incident Procedures

B.

Assigned Security Responsibility

C.

Access Control

D.

Facility Access Controls

E.

Security Management Process

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Question # 15

When submitting a Health Care Claim Status Request, it is important to provide the proper tracking information to exactly identify the previously submitted claim. Select the information that would be most important to the claim inquiry process.

A.

Authorization Number

B.

Provider's National Provider Identifier (NPI)

C.

Claim Submitter home phone number

D.

Patient's lab report

E.

Provider's security PIN code

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Question # 16

The transaction number assigned to the Health Care Eligibility Request transaction is:

A.

270

B.

276

C.

278

D.

271

E.

834

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Question # 17

Which of the following was not established under the Administrative Simplification title?

A.

National PKI Identifier.

B.

National Standard Health Care Provider Identifier.

C.

National Standard Employer Identifier.

D.

Standards for Electronic Transactions and Code Sets.

E.

Security Rule.

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Question # 18

The Security Incident Procedures standard requires just one implementation specification. That implementation specification is:

A.

Termination Procedures

B.

Automatic Logoff

C.

Emergency Access Procedure

D.

Contingency Operations

E.

Response and Reporting

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Question # 19

HIPAA defines transaction standards for:

A.

Encrypted communication between patient and provider.

B.

All patient events.

C.

Security.

D.

Benefits inquiry.

E.

Emergency treatment.

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Question # 20

Ensuring that physical access to electronic information systems and the facilities in which they are housed is limited, is addressed under which security rule standard?

A.

Security Management Process

B.

Transmission Security

C.

Person or Entity Authentication

D.

Facility Access Controls

E.

Information Access Management

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Question # 21

Which one of the following implementation specifications is associated with the Facility Access Control standard?

A.

Integrity Controls

B.

Emergency Access Procedure

C.

Access Control and Validation Procedures

D.

Security Reminders

E.

Security Policy

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Question # 22

One implementation specification of the Security Management Process is:

A.

Risk Analysis

B.

Authorization and/or Supervision

C.

Termination Procedures

D.

Contingency Operations

E.

Encryption and Decryption

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Question # 23

The Health Care Claim Status Response (277) can be used in a number of ways. Select the correct usage.

A.

As a response to a health care claim status request

B.

As a health care claim payment advice

C.

Electronic funds transfer

D.

As a request for health care claims status

E.

Request for the psychotherapy notes of a patient

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Question # 24

Select the correct statement about the 820-Payment Order/Remittance advice transaction.

A.

It can be used for the payment of provider claims.

B.

It can be used to pay for insurance products (either individual or group premiums).

C.

It can function solely as a remittance advice.

D.

Electronic Funds Transfer is fully supported.

E.

This transaction can carry either summary or detailed remittance information.

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Question # 25

Which one of the following is a required implementation specification of the Security Management Process?

A.

Risk Analysis

B.

Access Control and Validation Procedures

C.

Integrity Controls

D.

Access Authorization

E.

Termination Procedures

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Question # 26

In an emergency treatment situation, a health care provider:

A.

Must obtain the signature of the patient before disclosing PHI to another provider.

B.

Must contact a relative of the patient before disclosing PHI to another provider.

C.

May use their best judgment in order to provide appropriate treatment.

D.

May use PHI but may not disclose it to another provider.

E.

Must inform the patient about the Notice of Privacy Practices before delivering treatment.

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Question # 27

A covered entity that fails to implement the HIPAA Privacy Rule would risk:

A.

$5,000 in fines.

B.

55000 in fines and six months in prison.

C.

An annual cap of $50,000 in fines.

D.

A fine of up to $50,000 if they wrongfully disclose PHI.

E.

Six months in prison.

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Question # 28

As defined in the HIPAA regulations, a group of logically related data in units is called a:

A.

Data group

B.

Segment

C.

Transaction set

D.

Functional group

E.

Interchange envelope

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Question # 29

A pharmacist is approached by an individual and asked a question about an over-the-counter medication. The pharmacist needs some protected health information (PHI) from the individual to answer the question. The pharmacist will not be creating a record of this interaction. The Privacy Rule requires the pharmacist to:

A.

Verbally request 3 consent and offer a copy of the Notice of Privacy Practices.

B.

Verbally request specific authorization for the PHI.

C.

Do nothing more.

D.

Obtain the signature of the patient on their Notice of Privacy Practices.

E.

Not respond to the request without an authorization from the primary physician.

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Question # 30

The Integrity security standard has one addressable implementation standard which is:

A.

Encryption

B.

Authorization and/or Supervision

C.

Mechanism to Authenticate Electronic PHI

D.

Applications and Data Critically Analysis

E.

Isolating Health care Clearing House Functions

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Question # 31

Which of the following is not one of the HIPAA Titles?:

A.

Title IX: Employer sponsored group health plans.

B.

Title III: Tax-related Health Provisions.

C.

Title II: Administrative Simplification.

D.

Title I: Health Care Insurance Access, Portability, and Renewability.

E.

Title V: Revenue Offsets.

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Question # 32

The purpose of this security rule standard is to implement technical policies and procedures for electronic information systems that maintain electronic PHI, and to allow access only to those persons or software programs that have been granted access rights:

A.

Person or Entity Authentication

B.

Audit Controls

C.

Facility Access Controls

D.

Transmission Security

E.

Access Controls

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Question # 33

Select the best statement regarding de-identified information (DII).

A.

De-identified information is IIHI that has had all individually (patient) identifiable information removed.

B.

Oil may be used only with the authorization of the individual.

C.

Oil remains PHI.

D.

The only approved method of de-id entitle at ion is to have a person with “appropriate knowledge and experience” de-identify the IIHI.

E.

All PHI use and disclosure requirements do not apply to re-identified DII.

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Question # 34

This Administrative Safeguard standard implements policies and procedures to ensure that all members of its workforce have appropriate access to electronic information.

A.

Security Awareness Training

B.

Workforce Security

C.

Facility Access Controls

D.

Workstation Use

E.

Workstation Security

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Question # 35

Signed authorization forms must be retained:

A.

Indefinitely, because the life of a signed authorization isindefinite.

B.

Six (6) years from the time it expires.

C.

For as long as the patient's records are kept.

D.

Until it is specifically revoked by the individual.

E.

Ten (10) years from the date it was signed.

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Question # 36

The code set that must be used to describe or identify inpatient hospital services and surgical procedures is:

A.

ICD-9-CM, Volumes land 2

B.

CPT-4

C.

CDT

D.

ICD-9-CM, Volume 3

E.

HCPCS

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Question # 37

The Final Privacy Rule requires a covered entity to obtain an individual's prior written authorization to use his or her PHI for marketing purposes except for:

A.

Situations where the marketing is for a drug or treatment could improve the health of that individual.

B.

Situations where the patient has already signed the covered entity's Notice of Privacy Practices.

C.

A face-to-face encounter with the sales person of a company that provides drug samples

D.

A communication involving a promotional gift of nominal value.

E.

The situation where the patient has signed the Notice of Privacy Practices of the marketer.

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Question # 38

A hospital is preparing a file of treatment information for the state of California. This file is to be sent to external medical researchers. The hospital has removed SSN, name, phone and other information that specifically identifies an individual. However, there may still be data in the file that potentially could identify the individual. Can the hospital claim "safe harbor" and release the file to the researchers?

A.

Yes - the hospital's actions satisfy the "safe harbor" method of de-identification.

B.

No - a person with appropriate knowledge and experience must determine that the information that remains can’t identify an individual.

C.

No - authorization to release the information is still required by HIPAA

D.

No - to satisfy "safe harbor" the hospital must also have no knowledge of a way to use the remaining data to identify an individual.

E.

Yes - medical researchers are covered entities and "research" is considered a part of "treatment" by HIPAA.

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Question # 39

Conducting an accurate and thorough assessment of the potential risks and vulnerabilities to the confidentiality, integrity, and availability of electronic PHI is:

A.

Risk Analysis

B.

Risk Management

C.

Access Establishment and Modification

D.

Isolating Health care Clearinghouse Function

E.

Information System Activity Review

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Question # 40

Select the phrase that makes the following statement FALSE. The 270 Health Care Eligibility Request can be used to inquire about:

A.

Eligibility status

B.

Benefit maximums

C.

Participating providers

D.

Deductibles & exclusions

E.

Co-pay amounts

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Question # 41

Which of the following is primarily concerned with implementing security measures that are sufficient to reduce risks and vulnerabilities to a reasonable and appropriate level.

A.

Access Establishment and Modification

B.

Isolating Health care Clearinghouse Functions

C.

Information System Activity Review

D.

Risk Management

E.

Risk Analysis

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Question # 42

This rule covers the policies and procedures that must be in place to ensure that the patients' health information is respected and their rights upheld:

A.

Security rule.

B.

Privacy rule.

C.

Covered entity rule.

D.

Electronic Transactions and Code Sets rule.

E.

Electronic Signature Rule.

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Question # 43

Performing a periodic review in response to environmental or operational changes affecting the security of electronic protected health information is called:

A.

Transmission Security

B.

Evaluation

C.

Audit Control

D.

Integrity

E.

Security Management Process

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Question # 44

Select the FALSE statement regarding the transaction rule.

A.

The Secretary is required by statue to Impose penalties of at least $100 per violation on any person or entity that fails to comply with a standard except that the total amount imposed on any one person in each calendar year may not exceed $1,000.000 for violations of one requirement

B.

Health plans are required to accept all standard transactions.

C.

Health plans may not require providers to make changes or additions to standard transactions

D.

Health plans may not refuse or delay payment of standard transactions.

E.

If additional information is added to a standard transaction it must not modify the definition, condition, intent, or use of a data element

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Question # 45

A business associate must agree to:

A.

Report to the covered entity any security incident of which it becomes aware

B.

Ensure the complete safety of all electronic protected health information

C.

Compensate the covered entity for penalties incurred because of the business associate's security incidents.

D.

Register as a business associate with HHS

E.

Submit to periodic audits by HHS of critical systems containing electronic protected health information

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Question # 46

The National Provider File (NPF) includes information such as:

A.

Effective date.

B.

CPT-4.

C.

CDT.

D.

ICD-9-CM.

E.

Enrollment date.

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Question # 47

One implementation specification of a contingency plan is:

A.

Risk analysis

B.

Applications and Data Criticality Analysis

C.

Risk Management

D.

Integrity Controls

E.

Encryption

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Question # 48

This security rule standard requires policies and procedures for authorizing access to electronic protected health information that are consistent with its required implementation specifications- which are Isolating Health Care Clearinghouse Function, Access Authorization, and Access Establishment and Modification:

A.

Access Control

B.

Security Incident Procedures

C.

Information Access Management

D.

Workforce Security

E.

Security Management Process

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