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1. A hospital uses a charge description master (CDM) to assign prices to the
services and items it provides to patients. Which of the following statements
is true about the CDM?
a) The CDM is updated annually by the Centers for Medicare and Medicaid
Services (CMS).
b) The CDM is based on the relative value units (RVUs) of each service or
item.
c) The CDM is a comprehensive list of all the charges that appear on a
patient's bill.
d) The CDM is a standardized tool that ensures consistent and accurate
billing across different payers. *
Rationale: The CDM is a standardized tool that ensures consistent and
accurate billing across different payers. It contains codes, descriptions, and
prices for each service or item that the hospital provides. The CDM is not
updated by CMS, but by the hospital itself. The CDM is not based on RVUs,
which are used to determine physician reimbursement. The CDM is not a
comprehensive list of all the charges that appear on a patient's bill, as some
charges may be added or adjusted by other departments or systems.
2. A patient visits an urgent care center for a minor injury and pays a
copayment at the time of service. The urgent care center submits a claim to
the patient's insurance company for reimbursement. Which of the following
terms best describes the amount that the insurance company pays to the
urgent care center?
a) Deductible
b) Coinsurance
c) Allowable amount *
d) Contr adjustment
Rationale: The allowable amount is the amount that the insurance companyÂÂ
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