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HIO-201 Certified HIPAA Professional Questions and Answers

Questions 4

Select the correct statement regarding the Notice of Privacy Practices.

Options:

A.

The Notice must be signed before a State authorized notary

B.

Direct Treatment Providers must make a good faith effort to obtain patient's written acknowledgement of Notice of Privacy Practices.

C.

Organizations may not have a "layered" Notice - a short, summary Notice preceding the more detailed Notice.

D.

Authorization forms are mandatory for the Notice to be valid

E.

An individual must sign an authorization before a state authorized notary.

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Questions 5

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:

Options:

A.

Access Control

B.

Security Incident Procedures

C.

Information Access Management

D.

Workforce Security

E.

Security Management Process

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Questions 6

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

Options:

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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Questions 7

Once a year, a team at ABC Hospital reviews environmental and operational changes that may have had an impact on the security of electronic PHI. This is an example of:

Options:

A.

Transmission Security

B.

Evaluation

C.

Audit Controls

D.

Integrity

E.

Security Management Process

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Questions 8

ABC Hospital implements policies and procedures to ensure that all members of its workforce have appropriate access to electronic protected health information. These policies and procedures satisfy which HIPAA security standard?

Options:

A.

Security Management Process

B.

Facility Access Control

C.

Security Awareness and Training

D.

Workforce Security

E.

Security Management Process

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Questions 9

Policies and procedures that address the final disposition of electronic PHI (including the media on which is stored) is address by this required implementation specification.

Options:

A.

Media Re-use

B.

Termination Procedures

C.

Risk Management

D.

Maintenance Records

E.

Disposal

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Questions 10

The implementation specifications for this HIPAA security standard (within Technical Safeguards) must support emergency access and unique user identification:

Options:

A.

Audit Control

B.

Integrity

C.

Access Control

D.

Person or Entity Authentication

E.

Transmission Security

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Questions 11

Health information is protected by the Privacy Rule as long as:

Options:

A.

The authorization has been revoked by the physician.

B.

The patient remains a citizen of the United States.

C.

The information is under the control of HHS.

D.

The information is in the possession of a covered entity.

E.

The information is not also available on paper forms.

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Questions 12

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

Options:

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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Questions 13

HPAA establishes a civil monetary penalty for violation of the Administrative Simplification provisions. The penalty may not be more than:

Options:

A.

$1,000,000 per person pet violation

B.

$10 per person pet violation

C.

$10,000 per person per violation

D.

$100 per person per violation

E.

$1000 per person per violation

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Questions 14

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

Options:

A.

270

B.

276

C.

278

D.

271

E.

834

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Questions 15

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

Options:

A.

Data group

B.

Segment

C.

Transaction set

D.

Functional group

E.

Interchange envelope

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Questions 16

The scope of the Privacy Rule includes:

Options:

A.

All Employers.

B.

The Washington Publishing Company

C.

Disclosure of non-identifiable demographics.

D.

Oral disclosure of PHI.

E.

The prevention of use of de-identified information.

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Questions 17

This HIPAA security area addresses the use of locks, keys and procedures used to control access to computer systems:

Options:

A.

Administrative Safeguards

B.

Physical Safeguards

C.

Technical Safeguards

D.

Audit Controls

E.

Information Access Management

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Questions 18

Which one of the following security standards is part of Technical Safeguards?

Options:

A.

Access Control

B.

Security Management Process

C.

Facility Access Controls

D.

Workstation Use

E.

Device and Media Controls

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Questions 19

Select the correct statement regarding the 834 - Benefit Enrollment and Maintenance transaction.

Options:

A.

It cannot be used to transfer enrollment information from a plan sponsor to a hearth care insurance company or other benefit provider.

B.

It can be used by a health insurance company to notify a plan sponsor that it has dropped one of its members.

C.

It cannot be used to enroll, update, or dis-enroll employees and dependents in a health plan.

D.

A sponsor can be an employer, insurance agency, association or government agency but unions are excluded from being plan sponsors.

E.

It can be used in either update or full replacement mode.

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Questions 20

A key date in the transaction rule timeline is:

Options:

A.

October 16, 2003 - small health plans to begin testing without ASCA extension

B.

October 16, 2004 - full compliance deadline for small health plans

C.

April 16, 2004 - small health plans to begin testing with ASCA extension

D.

April 16, 2003 - deadline to begin testing with ASCA extension

E.

April 14, 2003; deadline to begin testing with the ASCA extension.

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Questions 21

Select the correct statement regarding the definition of the term "disclosure" as used in the HIPAA regulations.

Options:

A.

"Disclosure" refers lo employing IIHI within a covered entity.

B.

"Disclosure" refers to utilizing, examining, or analyzing IIHI within a covered entity.

C.

"Disclosure" refers to the release, transfer, or divulging of IIHI to another covered entity.

D.

"Disclosure" refers to the movement of information within an organization.

E.

"Disclosure" refers to the sharing of information within the covered entity.

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Questions 22

One implementation specification of the Security Management Process is:

Options:

A.

Risk Analysis

B.

Authorization and/or Supervision

C.

Termination Procedures

D.

Contingency Operations

E.

Encryption and Decryption

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Questions 23

Select the correct statement regarding code sets and identifiers.

Options:

A.

The social security number has been selected as the National Health Identifier for individuals.

B.

The COT code set is maintained by the American Medical Association.

C.

Preferred Provider Organizations (PPO) are not covered by the definition of "health plan" for purposes of the National Health Plan Identifier

D.

HIPAA requires health plans to accept every valid code contained in the approved code sets

E.

An important objective of the Transaction Rule is to reduce the risk of security breaches through identifiers.

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Questions 24

When using the Health Care Eligibility Request/Response (270/271), if a provider submits certain minimum information and the patent/subscriber is in their database, the payer must generate a response. Which of the following is one of the minimum information fields?

Options:

A.

Patient's country of birth

B.

Patient's pet name

C.

Patient's weight

D.

Patient's address

E.

Patient's date of birth

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Questions 25

The Data Backup Plan is part of which Security Standard?

Options:

A.

Contingency Plan

B.

Evaluation

C.

Security Management Procedures

D.

Facility Access Control

E.

Security Incident Procedures

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Questions 26

Select the FALSE statement regarding health-related communications and marketing in the HIPAA regulations:

Options:

A.

A covered entity must obtain an authorization for any use or disclosure of protected health information for marketing, except if the communication is in the form allowed by the regulations.

B.

A face-to-face communication made by a covered entity to an individual is allowed by the regulations without an authorization

C.

A promotional gift of nominal value provided by the covered entity is NOT allowed by the regulations without an authorization.

D.

If the marketing is expected to result in direct or indirect remuneration to the covered entity from a third party, the authorization must state that such remuneration is expected

E.

Disclosure of PHI for marketing purposes is limited to disclosure to business associates (which could be a telemarketer) that undertakes marketing activities on behalf of the covered entity

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Questions 27

ANSI X12 specifies the use of a (an):

Options:

A.

Simple flat file structure for transactions.

B.

Envelope structure for transactions.

C.

Employer identifier.

D.

Health plan identifier

E.

Provider identifier.

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Questions 28

This transaction is the response to a Health Care Claim (837):

Options:

A.

Eligibility (270/271)

B.

Premium Payment (820)

C.

Claim Status Notification (277)

D.

Remittance Advice (835)

E.

Functional Acknowledgment (997)

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Questions 29

Dr Jones, a practicing dentist, has decided to directly implement an EDI solution to comply with the HIPAA transaction rule Dr. Jones employs a small staff of 4 persons for whom he has sponsored a health care plan. Dr. Jones has revenues of less than $1 million. Select the code set that Dr. Jones should consider supporting for his EDI system.

Options:

A.

837 - Professional

B.

834

C.

CPT-4

D.

837 - Institutional

E.

CDT

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Questions 30

Select the best example of a business associate (if they had access to PHI).

Options:

A.

Accountants

B.

Hospital employees

C.

A covered entity's internal IT department

D.

CEO of the covered entity

E.

The covered entity's billing service department

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Questions 31

One implementation specification of a contingency plan is:

Options:

A.

Risk analysis

B.

Applications and Data Criticality Analysis

C.

Risk Management

D.

Integrity Controls

E.

Encryption

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Questions 32

A covered entity must adopt policies and procedures governing disclosures of PHI that identify

Options:

A.

The types of financial information to be disclosed.

B.

The specific individuals or entities to which disclosure would be made.

C.

The types of persons who would receive PHI.

D.

The conditions that would not apply to disclosure of PHI

E.

The criteria for reviewing requests for routine disclosure of PHI.

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Questions 33

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

Options:

A.

Risk Analysis

B.

Access Control and Validation Procedures

C.

Integrity Controls

D.

Access Authorization

E.

Termination Procedures

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Questions 34

Which of the following is example of "Payment" as defined in the HIPAA regulations?

Options:

A.

Annual Audits

B.

Claims Management

C.

Salary disbursement to the workforce having direct treatment relationships.

D.

Life Insurance underwriting

E.

Cash given to the pharmacist for the purchase of an over-the-counter drug medicine

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Questions 35

Select the best statement regarding the definition of a business associate of a covered entity. A business associate is:

Options:

A.

A person who acts on behalf of a non-covered entity.

B.

A person who's function may involve claims processing, administration, data analysis or practice management with access to PHI.

C.

A person who is a member of the covered entity's workforce.

D.

A clearinghouse.

E.

A person that performs or assists in the performance of a function or activity that involves the use or disclosure of de-identified health information.

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Questions 36

Select the best statement regarding the definition of protected health information (PHI).

Options:

A.

PHI includes all individually identifiable health information (IIHI).

B.

PHI does not include physician's hand written notes about the patient's treatment.

C.

PHI does not include PHI stored on paper.

D.

PHI does not include PHI in transit.

E.

PHI includes de-identified health information

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Questions 37

Establishing policies and procedures for responding to an emergency or other occurrence that damages systems is an example of a(n):

Options:

A.

Security Awareness and Training

B.

Security Incident Procedure

C.

Information Access Management

D.

Security Management Process

E.

Contingency Plan

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Questions 38

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:

Options:

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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Questions 39

The key objective of a contingency plan is that the entity must establish and implement policies and procedures to ensure the:

Options:

A.

Creation and modification of health information during and after an emergency.

B.

Integrity of health information during and after an emergency.

C.

Accountability of health information during and after an emergency.

D.

Vulnerability of health information during and after an emergency.

E.

Non-repudiation of the entity.

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Questions 40

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

Options:

A.

A covered entity must apply disciplinary sanctions against members of its workforce who fail to comply with the privacy policies and procedures of the covered entity.

B.

A covered entity need not train all members of its workforce whose functions are materially affected by a change in policy or procedure.

C.

A covered entity must designate, and document, a contact person responsible for receiving acknowledgements of Notice of Privacy Practice.

D.

A covered entity may require individuals to waive their rights.

E.

A covered entity must provide maximum safeguards for PHI from any intentional or unintentional use or disclosure that is in violation of the regulations and to limit incidental uses and disclosures made pursuant to permitted or required use or disclosure.

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Questions 41

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

Options:

A.

Security Incident Procedures

B.

Assigned Security Responsibility

C.

Access Control

D.

Facility Access Controls

E.

Security Management Process

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Questions 42

Which of the following is NOT a HIPAA national health care identifier?

Options:

A.

National Provider Identifier (NPI)

B.

Social Security Number (SSN)

C.

National Health Plan Identifier (PlanID)

D.

National Employer Identifier for Health Care (EIN)

E.

National Health Identifier for Individuals (NHII)

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Questions 43

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

Options:

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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Questions 44

Select the correct statement regarding code sets and identifiers.

Options:

A.

A covered entity must use the applicable code set that is valid at the time the transaction is initiated.

B.

April 14, 2003 is the compliance date for implementation of the National Provider Identifier.

C.

CMS is responsible for updating the CPT-4 code set.

D.

An organization that assigns NPIs is referred to as National Provider for Identifiers.

E.

HHS assigns the Employer Identification Number (EIN), which has been selected as the National Provider Identifier for Health Care.

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Questions 45

This code set is used to describe or identify radiological procedures and clinical laboratory tests:

Options:

A.

ICD-9-CM, Volumes 1 and 2.

B.

CPT-4.

C.

CDT.

D.

ICD-9-CM, Volume 3.

E.

HCPCS.

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Questions 46

Select the FALSE statement regarding the X12N Implementation Guides.

Options:

A.

The Washington Publishing Company has the exclusive rights to publish the X12N Implementation Guides.

B.

HHS has adopted the Implementation Guides as standards for HIPAA transactions.

C.

The guides are intended to be instructive and need not be followed strictly.

D.

The guides may be downloaded free from WPC's Website.

E.

The guides explain the usage of the transaction set segments and data elements.

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Questions 47

The transaction number assigned to the Benefit Enrollment and Maintenance transaction is:

Options:

A.

270

B.

276

C.

278

D.

280

E.

834

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Questions 48

Assigning a name and/or number for identifying and tracking users is required by which security rule implementation specification?

Options:

A.

Access Authentication

B.

Integrity Controls

C.

Authorization and/or Supervision

D.

Data Authentication

E.

Unique User Identification

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Exam Code: HIO-201
Exam Name: Certified HIPAA Professional
Last Update: Apr 30, 2026
Questions: 160

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