CPB Certified Professional Biller Certification Practice Exam

What does DSH refer to in healthcare billing?

1. Department of State Health

2. Disproportionate share hospital (adjustment)

3. Diagnostic Specialty Hospital

4. Direct Support Healthcare

The correct answer is: Disproportionate share hospital (adjustment)

The correct answer is that DSH refers to "disproportionate share hospital (adjustment)." This term is significant in healthcare billing as it pertains to the additional funds that hospitals, particularly those serving a large number of low-income patients, receive from Medicaid and Medicare. The purpose of these adjustments is to help cover the costs of uncompensated care resulting from treating uninsured or underinsured patients. Understanding DSH is essential for billing professionals, as it affects reimbursement rates and financial planning for hospitals that serve vulnerable populations. The adjustments are calculated based on the hospital's patient population and the specific Medicaid programs in their state, which influence the overall payment structure for these facilities. In contrast, the other options do not accurately define DSH in the healthcare billing context. For example, "Department of State Health" does not relate to the billing and revenue cycle aspects pertinent to disproportionate share hospitals. Similarly, "Diagnostic Specialty Hospital" and "Direct Support Healthcare" refer to specific types of healthcare facilities or supporting services, but they do not connect with the financial mechanisms involved in DSH adjustments.