CPB Certified Professional Biller Certification Practice Exam

What does case mix refer to?

1. The diversity of treatments offered in a healthcare facility

2. The types and categories of patients treated by a provider

3. The amount of time patients spend in a healthcare facility

4. The average cost of services provided to patients

The correct answer is: The types and categories of patients treated by a provider

Case mix refers specifically to the types and categories of patients treated by a provider. This encompasses various factors including the demographic characteristics, medical conditions, and treatment needs of patients. Understanding a provider's case mix is crucial for several reasons; it impacts resource allocation, reimbursement rates, and quality of care assessments. A diverse case mix can affect how a healthcare facility prepares for different clinical needs and the kind of services it offers. The other choices involve important aspects of healthcare but do not accurately define case mix. While the diversity of treatments and average costs are relevant to the overall functioning of a healthcare facility, they do not solely capture the essence of what case mix represents. Similarly, the time patients spend in a healthcare facility relates more to operational metrics rather than the patient population characteristics that case mix examines.