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HIO-201 HIPAA Certified HIPAA Professional Free Practice Exam Questions (2025 Updated)

Prepare effectively for your HIPAA HIO-201 Certified HIPAA Professional certification with our extensive collection of free, high-quality practice questions. Each question is designed to mirror the actual exam format and objectives, complete with comprehensive answers and detailed explanations. Our materials are regularly updated for 2025, ensuring you have the most current resources to build confidence and succeed on your first attempt.

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Total 160 questions

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

Which transaction covers information specific to accidents?

A.

Accident Report.

B.

First Report of Injury.

C.

Health Care Claim.

D.

Health Care Claim Payment/Advice.

E.

Premium Payment.

The code set that must be used to describe or identify outpatient physician services and procedures is:

A.

ICD-9-CM, Volumes 1 and 2

B.

CPT-4

C.

CDT

D.

ICD-9-CM, Volume 3

E.

NDC

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.

Select the best statement regarding organized health care arrangements (OHCA).

A.

An organized health care arrangement is a clinically integrated setting in which patients receive care from multiple providers.

B.

Independent providers participating in an organized health care arrangement are business associates of each other.

C.

An example of an OHCA is a nurse employed in a physician's office.

D.

An example of an OHCA is a laboratory attached to a physician's office.

E.

An example of an OHCA is a health insurance company and its affiliated life insurancecompany.

Which HIPAA Title is fueling initiatives within organizations to address health care priorities in the areas of transactions, privacy, and security?

A.

Title I.

B.

Title II

C.

Title III

D.

Title IV.

E.

Title V.

Select the best statement regarding the definition of the term "use" as used by the HIPAA regulations.

A.

"Use" refers to the release, transfer, or divulging of IIHI between various covered entities

B.

"Use" refers to adding, modifying and deleting the PHI by other covered entities.

C.

"Use" refers to utilizing, examining, or analyzing IIHI within the covered entity

D.

"Use" refers to the movement of de-identified information within an organization.

E.

"Use" refers to the movement of information outside the entity holding the information

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

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

In terms of Security, the best definition of "Access Control" is:

A.

A list of authorized entities, together with their access rights.

B.

Corroborating your identity.

C.

The prevention of an unauthorized use of a resource.

D.

Proving that nothing regarding your identity has been altered

E.

Being unable to deny you took pan in a transaction.

A provider is in compliance with the Privacy Rule. She has a signed Notice of Privacy Practices from her patient. To provide treatment, the doctor needs to consult with an independent provider who has no relationship with the patient. To comply with the Privacy Rule the doctor MUST:

A.

Establish a business partner relationship with the other provider.

B.

Obtain a signed authorization from the patient to cover the disclosure.

C.

Make a copy of the signed Notice available to the other provider.

D.

Obtain the patients signature on the second provider's Notice of Privacy Practices.

E.

Do nothing more -the Notice of Privacy Practices covers treatment activities.

A grouping of functional groups, delimited by' a header/trailer pair, is called a:

A.

Data element

B.

Data segment

C.

Transaction set

D.

Functional envelope

E.

Interchange envelope

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

The Privacy Rule's penalties for unauthorized disclosure:

A.

Imposes fines and imprisonment as civil penalties for violations.

B.

Limits penalties to covered entities and their business associates.

C.

Imposes criminal penalties for noncompliance with standards.

D.

Limits imprisonment to a maximum often years.

E.

Is $1000 per event of disclosure.

ANSI X12 specifies the use of a (an):

A.

Simple flat file structure for transactions.

B.

Envelope structure for transactions.

C.

Employer identifier.

D.

Health plan identifier

E.

Provider identifier.

Within the context of a transaction set, the fields that comprise a hierarchical level are referred to as a(n):

A.

Loop.

B.

Enumerator.

C.

Identifier

D.

Data segment.

E.

Code set.

When PHI is sent or received over an electronic network there must be measures to guard against unauthorized access. This is covered under which security rule standard?

A.

Device and Media Controls

B.

Access Controls

C.

Transmission Security

D.

Integrity

E.

Audit Controls

Title 1 of the HIPAA legislation in the United States is about:

A.

PKI requirements for hospitals and health care providers.

B.

Encryption algorithms that must be supported by hospitals and health care providers.

C.

Fraud and abuse in the health care system and ways to eliminate the same.

D.

Guaranteed health insurance coverage to workers and their families when they change employers.

E.

The use of strong authentication technology that must be supported by hospitals and health care providers.

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

Some of the information that an authorization must include is:

A.

The date on which any automatic extension occurs.

B.

Covered entity's signature.

C.

A statement that federal privacy laws still protect the information after it is disclosed.

D.

A statement that the individual has no right to revoke the authorization.

E.

The date signed.

This transaction type may be used in three ways:

1) Reply to a Health Care Claim Status Request.

2) Unsolicited notification of a health care claim status.

3) Request for additional information about a health care claim.

A.

837.

B.

820.

C.

277.

D.

835.

E.

278.

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Total 160 questions
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