CNML FINAL PAPER 2026 COMPLETE
QUESTIONS AND CORRECT SOLUTIONS
◉ Prospective payments. Answer: Prospective payments are rates
agreed upon in advance by insurance companies and the hospital.
◉ DRG'S. Answer: diagnostic related groups of reimbursement rates
based on specific diagnoses.
◉ Capitation Answer: is a fee the insurance company pays per
patient for a set period of time whether they are admitted to the
hospital or use other medical services during that time.
◉ Per Diem Answer: Per diem are set rates of payment by the
insurance company per day of admission in the hospital.
◉ Case mix index (CMI) Answer: is a system that classifies pts
according to diagnosis, treatment, age, and other clinical/
financial/categories to develop a reimbursement rate.
◉ Productivity Answer: the amount of work performed by a set
number of employees.
QUESTIONS AND CORRECT SOLUTIONS
◉ Prospective payments. Answer: Prospective payments are rates
agreed upon in advance by insurance companies and the hospital.
◉ DRG'S. Answer: diagnostic related groups of reimbursement rates
based on specific diagnoses.
◉ Capitation Answer: is a fee the insurance company pays per
patient for a set period of time whether they are admitted to the
hospital or use other medical services during that time.
◉ Per Diem Answer: Per diem are set rates of payment by the
insurance company per day of admission in the hospital.
◉ Case mix index (CMI) Answer: is a system that classifies pts
according to diagnosis, treatment, age, and other clinical/
financial/categories to develop a reimbursement rate.
◉ Productivity Answer: the amount of work performed by a set
number of employees.
