American Academy of Professional Coders (AAPC) Practice Exam

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Prepare for the American Academy of Professional Coders exam with our comprehensive quiz, featuring multiple-choice questions designed to enhance your coding skills and knowledge. Ideal for aspiring medical coders looking to succeed in the certification process.

Each practice test/flash card set has 50 randomly selected questions from a bank of over 500. You'll get a new set of questions each time!

Practice this question and more.


Which entity falls under the "Health plan covered entity" category?

  1. Private Practices

  2. Health Maintenance Organizations (HMO)

  3. Urgent Care Facilities

  4. Independent Laboratories

The correct answer is: Health Maintenance Organizations (HMO)

The correct response identifies Health Maintenance Organizations (HMO) as a type of entity classified under "Health plan covered entity." HMOs are organizations that provide health insurance coverage to their members through a network of healthcare providers. They are responsible for managing the quality and cost of care while ensuring that their members have access to necessary health services. This classification as a health plan covered entity means that HMOs must comply with regulations established under HIPAA (Health Insurance Portability and Accountability Act) concerning the protection and confidentiality of patient information. Unlike private practices, urgent care facilities, and independent laboratories, which are primarily healthcare providers rather than payors, HMOs directly manage health care finances and deal with claims payments and reimbursement, fitting the definition of a health plan. Understanding the different roles of these entities helps clarify their relationship to health care coverage and the regulations they must follow.