CPB (Certified Professional Biller) Certification Practice Exam

Which term refers to the process of developing patient care plans in a cost-effective manner?

1. Case Law

2. Case Manager

3. Case Mix

4. Case Management Services

The correct answer is: Case Management Services

The correct choice is the term that specifically refers to the organized approach focused on developing patient care plans while ensuring that the services provided are cost-effective. Case management services encompass the coordination of care for patients, which involves identifying needs, developing individualized care plans, and managing resources effectively to optimize care and minimize costs. This holistic approach is essential in healthcare settings, where balancing quality care and financial constraints is critical. In contrast, the other options relate to different aspects of healthcare and law. Case law pertains to judicial decisions and precedents rather than patient care. A case manager is a professional role involved in the provision of case management services but does not encapsulate the entire process. Case mix refers to a classification of patients based on their diagnoses and treatment requirements, which is important for understanding the services needed but does not directly convey the proactive planning process that case management services represent. Thus, case management services adequately capture the notion of developing patient care plans in a cost-effective manner.