Academic literature on the topic 'Hospital Billing'
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Journal articles on the topic "Hospital Billing"
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SoRelle, Ruth. "Hospital ED Billing." Emergency Medicine News 29, no. 3 (March 2007): 38. http://dx.doi.org/10.1097/01.eem.0000264690.65513.fa.
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Welton, John M., and Kathy Harris. "Hospital Billing and Reimbursement." JONA: The Journal of Nursing Administration 37, no. 4 (April 2007): 164–66. http://dx.doi.org/10.1097/01.nna.0000266846.77178.23.
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Mitchell, Colby L., Ernest R. Anderson, and Leeann Braun. "Billing for inpatient hospital care." American Journal of Health-System Pharmacy 60, suppl_6 (November 1, 2003): S8—S11. http://dx.doi.org/10.1093/ajhp/60.suppl_6.s8.
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Merritt-Myrick, Samirah, and David Harris III. "Successful Billing Strategies in the Hospital Industry." International Journal of Human Resource Studies 11, no. 1 (January 15, 2020): 85. http://dx.doi.org/10.5296/ijhrs.v11i1.18212.
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This paper explores the negative impact of changing Medicare regulations have on hospital profitability. Findings indicate that the successful strategies billing managers could use to ensure Medicare reimbursement and profitability include remaining up to date with Medicare changing compliance regulations, enhancing communication with staff, multiple departments, and Medicare, and adopting a robust billing system and other systems that compliment billing. Since the implementation of changes, hospitals continued to foster criterion to ensure successful Medicare reimbursement, thereby remaining in operation to continue to support the healthcare needs of families in the local communities. The biggest obstacle for hospitals is the ever-revolving Medicare reform and the effects it has on lowering reimbursement for the hospital industry. Hospitals that are affected by reform report issues that relate to the Medicare Prospective Payment System (PPS), payment for performance, and value-based payments.
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Labrèche, France, Tom Kosatsky, and Raymond Przybysz. "Childhood Asthma Surveillance using Administrative Data: Consistency between Medical Billing and Hospital Discharge Diagnoses." Canadian Respiratory Journal 15, no. 4 (2008): 188–92. http://dx.doi.org/10.1155/2008/412809.
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BACKGROUND: The absence of ongoing surveillance for childhood asthma in Montreal, Quebec, prompted the present investigation to assess the validity and practicality of administrative databases as a foundation for surveillance.OBJECTIVE: To explore the consistency between cases of asthma identified through physician billings compared with hospital discharge summaries.METHODS: Rates of service use for asthma in 1998 among Montreal children aged one, four and eight years were estimated. Correspondence between the two databases (physician billing claims versus medical billing claims) were explored during three different time periods: the first day of hospitalization, during the entire hospital stay, and during the hospital stay plus a one-day margin before admission and after discharge (‘hospital stay ± 1 day’).RESULTS: During 1998, 7.6% of Montreal children consulted a physician for asthma at least once and 0.6% were hospitalized with a principal diagnosis of asthma. There were no contemporaneous physician billings for asthma ‘in hospital’ during hospital stay ± 1 day for 22% of hospitalizations in which asthma was the primary diagnosis recorded at discharge. Conversely, among children with a physician billing for asthma ‘in hospital’, 66% were found to have a contemporaneous in-hospital record of a stay for ‘asthma’.CONCLUSIONS: Both databases of hospital and medical billing claims are useful for estimating rates of hospitalization for asthma in children. The potential for diagnostic imprecision is of concern, especially if capturing the exact number of uses is more important than establishing patterns of use.
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Murray, Marilyn K., and John J. Matchulat. "Hospital Charity Care and Billing Practices." JONA: The Journal of Nursing Administration 35, no. 6 (June 2005): 286???292. http://dx.doi.org/10.1097/00005110-200506000-00004.
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Buppert, Carolyn. "8 Things About Billing Hospital NP Services." Journal for Nurse Practitioners 10, no. 3 (March 2014): 207–8. http://dx.doi.org/10.1016/j.nurpra.2013.12.006.
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Cobaito, Francisco. "Faturamento Hospitalar Sob a Lente da Qualidade Total Hospital Billing Under the Lens of Total Quality." Revista de Gestão em Sistemas de Saúde 5, no. 1 (June 1, 2016): 52–61. http://dx.doi.org/10.5585/rgss.v5i1.167.
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Teufack, Sonia G., Peter Campbell, Pascal Jabbour, Mitchell Maltenfort, James Evans, and John K. Ratliff. "Potential financial impact of restriction in “never event” and periprocedural hospital-acquired condition reimbursement at a tertiary neurosurgical center: a single-institution prospective study." Journal of Neurosurgery 112, no. 2 (February 2010): 249–56. http://dx.doi.org/10.3171/2009.7.jns09753.
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Object The Centers for Medicare and Medicaid Services (CMS) have moved to limit hospital augmentation of diagnosis-related group billing for “never events” (adverse events that are serious, largely preventable, and of concern to the public and health care providers for the purpose of public accountability) and certain hospital-acquired conditions (HACs). Similar restrictions may be applied to physician billing. The financial impact of these restrictions may fall on academic medical centers, which commonly have populations of complex patients with a higher risk of HACs. The authors sought to quantify the potential financial impact of restrictions in never events and periprocedural HAC billing on a tertiary neurosurgery facility. Methods Operative cases treated between January 2008 and June 2008 were reviewed after searching a prospectively maintained database of perioperative complications. The authors assessed cases in which there was a 6-month lag time to allow for completion of hospital and physician billing. They speculated that other payers would soon adopt the present CMS restrictions and that procedure-related HACs would be expanded to cover common neurosurgery procedures. To evaluate the impact on physician billing and to directly contrast physician and hospital billing impact, the authors focused on periprocedural HACs, as opposed to entire admission HACs. Billing records were compiled and a comparison was made between individual event data and simultaneous cumulative net revenue and net receipts. The authors assessed the impact of the present regulations, expansion of CMS restrictions to other payers, and expansion to rehospitalization and entire hospitalization case billing due to HACs and never events. Results A total of 1289 procedures were completed during the examined period. Twenty-five procedures (2%) involved patients in whom HACs developed; all were wound infections. Twenty-nine secondary procedures were required for this cohort. Length of stay was significantly higher in patients with HACs than in those without (11.6 ± 11.5 vs 5.9 ± 7.0 days, respectively). Fifteen patients required readmission due to HACs. Following present never event and HAC restrictions, hospital and physician billing was minimally affected (never event billing as percent total receipts was 0.007% for hospitals and 0% for physicians). Nonpayment for rehospitalization and reoperation for HACs by CMS and private payers yielded greater financial impact (CMS only, percentage of total receipts: 0.14% hospital, 0.2% physician; all payers: 1.56% hospital, 3.0% physician). Eliminating reimbursement for index procedures yielded profound reductions (CMS only as percentage of total receipts: 0.62% hospital, 0.8% physician; all payers: 5.73% hospital, 8.9% physician). Conclusions The authors found potentially significant reductions in physician and facility billing. The expansion of never event and HACs reimbursement nonpayment may have a substantial financial impact on tertiary care facilities. The elimination of never events and reduction in HACs in current medical practices are worthy goals. However, overzealous application of HACs restrictions may remove from tertiary centers the incentive to treat high-risk patients.
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Erna Permanasari, Adhistya, Silmi Fauziati, and Argi Kartika Candri. "Development of a Web-Based Convergent Hospital Billing System." MATEC Web of Conferences 248 (2018): 02001. http://dx.doi.org/10.1051/matecconf/201824802001.
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Given the large volume of data generated in hospitals, the usage of hospital information system (HIS) that may ease the hospital’s workload on managing patient bills is critical. Thus, this paper presents the development of a web based hospital billing system which allows the staffs to manage and store patient bills in such a way that it can integrate bills from various departments. In addition to that, the system has additional features to allow down payments, automatically generate accounting reports, as well as integrate some features of the registration and the pharmacy system. The system design followed the Waterfall approach and was done using the use case diagram, activity diagram, sequence diagram, and entity relationship diagram. The data processed was actual data from the hospital and dummy data for the pharmacy system. The system’s functionality was tested using the black-box method and then evaluated by the hospital staffs using the SUS (System Usability Scale) method. From there, we obtained a score of 77.5 out of 100 from the SUS evaluation and 100% success rate from 102 features tested with the black-box testing method. Therefore, we can conclude that the new system works well and has good usability.
Dissertations / Theses on the topic "Hospital Billing"
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Merritt, Samirah. "Successful Billing Strategies in the Hospital Industry." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6621.
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Failure to collect reimbursement because of changing regulations negatively impacts hospital profitability. A multiple case study approach was used to explore the successful strategies billing managers employed to collect reimbursement for all legitimate Medicare claims. The target population for this study included 5 hospital billing managers from 3 organizations in the Northern New Jersey region. The complexity theory was used as a framework for assessing changing Medicare regulations and how the managers adapted to them. The data collection process for this study involved gathering data from participant interviews, documentation from the organizations of the participants, and government documented regulations and manuals. The logical and sequential order of data analysis for this study embraced Yin's 5-steps data analysis that includes compiling data, disassembling data, reassembling data, interpreting the data, and concluding. The successful strategies billing managers used that emerged as themes were remaining up to date with Medicare changing compliance regulations; enhancing communication with staff, multiple departments, and Medicare; and adopting a robust billing system and other systems that compliment billing. The implications of this study for social change include the potential to ensure access to patient care for benefiting families and communities through the sharing of successful strategies for Medicare claims.
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Zunta, Raquel Silva Bicalho. "O gerenciamento de custos relativos às glosas técnicas de um centro cirúrgico: um estudo de caso." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-17052017-110901/.
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Introdução: A ocorrência de glosas nas contas hospitalares impacta no adequado faturamento assistencial, especialmente em unidades de maior faturamento como o Centro Cirúrgico (CC), requerendo estratégias para sua minimização. Objetivos: mapear, descrever e validar o processo de auditoria e faturamento de contas em um hospital geral, de grande porte, privado; calcular a percentagem das glosas técnicas geradas por profissionais de enfermagem e médicos anestesistas no CC; verificar qual(is) item(ns) foi(ou foram) mais glosado(s) por grupo contábil; identificar as facilidades e dificuldades relativas ao registro de materiais, medicamentos, equipamentos, gases, taxas e ao lançamento de débitos e propor uma ação educativa, com foco no faturamento assistencial, direcionada aos profissionais da equipe cirúrgica do CC. Método: Trata-se de pesquisa quantitativa, exploratória, descritiva, retrospectiva, documental, na modalidade de estudo de caso único. Foram realizadas visitas aos Setores de Auditoria Interna e de Recurso de Glosas visando o mapeamento dos processos desenvolvidos, os dados obtidos foram documentados descritivamente e ilustrados na forma de fluxogramas. Concomitantemente foram coletados dados de 383 prontuários de pacientes atendidos no CC, relativos a três meses típicos, para o cálculo e a análise das glosas técnicas. Na sequência, realizou-se o recrutamento de integrantes da equipe de colaboradores do CC, por amostragem não probabilística, que responderam a um questionário para identificação das facilidades e dificuldades quanto ao registro da assistência prestada e obtenção de subsídios para proposição de ação educativa. Resultados: Os processos de auditoria e faturamento e de recurso de glosas, vigentes na instituição, foram mapeados e validados por especialistas da área de auditoria de contas hospitalares internos e externos ao hospital. O faturamento relativo ao atendimento dos 383 pacientes totalizou R$5.623.968,17 (100%), sendo R$164.892,29 (2,93%) referentes às glosas técnicas, 2,01% relacionado à categoria profissionais de enfermagem e 0,92% a categoria médico anestesista. O valor médio glosado correspondeu a R$ 430,53 (DP= R$ 573,07) e a porcentagem média de valor glosado a 3,56% (DP=4,55). Os itens do grupo contábil materiais foram os mais glosados (67,7%) seguidos pelos grupos contábeis medicamentos (13,2%), equipamentos (8,1%), gases (4,2%) e taxas (6,8%). Quanto aos itens glosados com maior impacto no grupo contábil materiais destacou-se o avental descartável (12,7%); no grupo medicamentos o item solução (38,7%); no grupo equipamentos o item capnógrafo (31,3%); no grupo gases o item oxigênio (75,9%) e no grupo taxas o item antissepsia (44,1%). A maior porcentagem de itens glosados no grupo contábil materiais, 74,0%, foi gerada pela categoria profissionais de enfermagem sendo superior a porcentagem da categoria médico anestesista (38,4%). Nos grupos contábeis medicamentos, equipamentos e gases a categoria médico anestesista apresentou mais itens glosados em comparação a categoria profissionais de enfermagem: 35,9% e 8,2%, 18% e 6,0% e 7,8% e 3,5%, respectivamente. A categoria profissionais de enfermagem foi responsável por 82,15% dos itens glosados e a categoria médicos anestesistas por 17,85% que, por sua vez, apresentou a maior porcentagem de itens glosados por paciente (1,83%) comparada à categoria profissionais de enfermagem (0,81%). A maioria dos enfermeiros e dos auxiliares/técnicos respondeu saber o que era faturamento assistencial e conhecer sua atuação neste processo; a totalidade dos médicos anestesistas respondeu desconhecer o que era faturamento assistencial. Para melhorar o processo de faturamento da assistência as propostas dos médicos anestesistas centraram-se na realização da conferência da Ficha de Anestesia ao final do ato cirúrgico e aprimoramento deste impresso. Entre as propostas dos enfermeiros destacaram-se a informatização da documentação e o registro dos materiais, usados durante o procedimento cirúrgico, por meio de leitura ótica. Além dessas sugestões auxiliares/técnicos de enfermagem indicaram o uso de um impresso gerado pela farmácia do hospital contendo os materiais disponíveis na sala cirúrgica, sendo registradas apenas as quantidades utilizadas. O conhecimento das dificuldades e facilidades no processo de documentação da assistência prestada, evidenciadas por componentes da equipe cirúrgica, subsidiou a proposição de uma ação educativa, com ênfase no processo de faturamento assistencial, a fim de diminuir a ocorrência de glosas técnicas nas contas hospitalares do CC. Conclusão: Os resultados obtidos favorecerão a busca de alternativas que permitam a diminuição da ocorrência de glosas técnicas e, consequentemente, melhoria do processo de faturamento assistencial no CC. Entretanto, os profissionais precisam estar sensibilizados e comprometidos com a adequação da documentação da assistência prestada, compreendendo que a inadequação dos seus registros incorrerá em perdas financeiras para a organização de saúde que podem atingi-los direta ou indiretamente.Introduction: The occurrence of glosses in hospital bills is a problem to obtain a satisfactory healthcare income, especially in higher revenue units as the Surgical Center (SC) requiring strategies to minimize it. Objectives: to map, describe and validate the audit process and billing accounts in a large, general, and private hospital; calculate the percentage of technical glosses generated by nurses and anesthesiologists in the SC; verify which was (were) the more glossed item (s)generated by the accounting group; identify the positive aspects and difficulties related to the registration of materials, drugs, equipment, gas, taxes, debit posting and also to propose an educational activity focusing on healthcare income for the SC team of professionals. Method: This is a quantitative, exploratory and descriptive, retrospective, documentary study, single case study mode. Visits to the Internal Audit Sector and Glosses Resources were performed to map the processes and data were described, documented and illustrated in flowcharts. Concomitantly, data collected from medical records of 383 patients treated at SC, were related to three typical months to calculate and analyze technical glosses. Further, members of the SC team were enrolled at a nonprobability sampling .They answered a questionnaire to identify the positive aspects and difficulties regarding the register of healthcare service and grants obtained for the proposed educational activities. Results: The audit and healthcare income processes, the gloss resource existing in the institution have been mapped and validated by audit specialists in the area of internal and external hospital bills. The profits related to care of 383 patients amounted to R $ 5,623,968.17 (100%), of which R $ 164,892.29 (2.93%) for technical glosses, 2.01% related to the category \"nursing professionals\" and 0.92% for the category \"anesthesiologist.\" The mean glossed value corresponded to R $ 430.53 (SD = R $ 573.07) and the mean percentage of glossed value to 3.56% (SD = 4.55). The items of the accounting group \"materials\" were the most glossed(67.7%) followed by accounting group \"drugs\" (13.2%), \"equipment\" (8.1%), \"gas\" (4.2%) and \"fees\" (6.8%). As for glossed items with a great impact on the accounting group \"material\", the \"disposable apron\" (12.7%) was pointed out; in the group \"drugs\" the item \"solution\" (38.7%); the group \"equipment\" item \"capnography\" (31.3%); in the group \"gas\" the item \"oxygen\" (75.9%) and in the group \"fees\" item \"antisepsis\" (44.1%). The highest percentage of glossed items in the accounting group \"material\", 74.0% was generated by the category \"nursing professionals\" being higher than the percentage of the category \"anesthesiologist\" (38.4%). In the accounting groups \"drugs\", \"equipment\" and \"gas\" the category \"anesthesiologist\" presented more glossed items when compared to the category \"nursing professionals\": 35.9% and 8.2%, 18% and 6.0 % and 7.8% and 3.5%, respectively. The category \"nursing professionals\" accounted for 82.15% of glossed items and the category \"anesthesiologists\" by 17.85% which, in turn, had the highest percentage of glossed items per patient (1.83%) when compared to the category \"nursing professionals\" (0.81%). Most of nurses and assistants / technicians comprehended what healthcare income was and they understand their role in this process; all the anesthesiologists said they had no knowledge of the healthcare income. To improve this process the anesthesiologists´ proposals focused on to implement an Anesthesia Record Form at the end of each surgery procedure \"and\" to develop this form.\" Among the proposals of the nurses it was highlighted the \"computerized clinical documentation system\" and registration of the materials used during the surgical procedure through \"optical scanning\". In addition to these suggestions, nursing assistants / technicians indicated the use of a printed material, created by the hospital pharmacy containing the materials available in the operating room in which only the number of materials used must be reported. The knowledge of the difficulties and positive aspects in the healthcare documentation process mentioned by the components of the surgical team, subsidized the proposition of an educational activity, with emphasis on healthcare income process to reduce the occurrence of technical glosses in hospital bills in the SC. Conclusion: The results will favor the search for alternatives to reduce the occurrence of technical glosses and consequently, improving the healthcare income process on the SC. However, professionals need to be aware and committed to the adequacy of the healthcare documentation considering that inadequacy of its records will bring financial losses to the health organization and affect them direct or indirectly.
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Guerrer, Gabriela Favaro Faria. "Auditoria de contas em um hospital de ensino especializado em cardiologia e pneumologia: um estudo de caso." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-08032013-140459/.
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As instituições hospitalares que prestam serviços às operadoras de planos de saúde investem na auditoria de contas visando à adequada remuneração do atendimento prestado. No momento da pré-análise das contas a equipe de auditoria realiza correções para fundamentar a cobrança dos procedimentos, evitar glosas e perdas de faturamento. Nesta perspectiva esta pesquisa objetivou verificar os itens componentes das contas dos pacientes internados, conferidos por enfermeiras, que mais receberam ajustes no momento da pré-análise; identificar o impacto dos ajustes no faturamento das contas analisadas pela equipe de auditoria (médicos e enfermeiras) do hospital após a pré-analise; calcular o faturamento que esta equipe consegue ajustar nas contas e identificar as glosas relacionadas aos itens por ela conferidos. Tratou-se de uma pesquisa exploratória, descritiva, retrospectiva, de abordagem quantitativa na modalidade de estudo de caso, desenvolvida no Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Foram estudadas 2.613 contas pré-analisadas pela equipe de auditoria do InCor no período de janeiro a dezembro de 2011. O faturamento concentrou-se em 04 (62,9%) das 34 operadoras de planos de saúde credenciadas. Houve predominância da operadora A (27,6%), porém o maior valor médio obtido por conta referiu-se a operadora D com R$ 19.187,50. Os itens mais incluídos nas contas pelas enfermeiras foram gases (90,5%); materiais de internação (85%) e serviço de enfermagem (83,2%). Materiais de Hemodinâmica com média de R$ 1.055,90 (DP± 3.953,45); gases com média de R$ 707, 91 (DP± 843,95) e equipamentos com média de R$ 689, 42 (DP± 1145,20) constituíram os itens de maior impacto financeiro nesses ajustes. Os itens mais excluídos das contas referiram-se a medicamentos de internação (41,2%); equipamentos (28%) e serviços de enfermagem (17%). Em relação aos ajustes negativos os itens que tiveram maior impacto financeiro foram os materiais de Hemodinâmica com média de R$ 3.860,15 (DP± 15.220,80); medicamentos utilizados na Hemodinâmica com média de R$ 1.983,04 (DP± 8.324,42) e gases com média de R$ 1.048,51 (DP± 3.025,53). As enfermeiras incluíram R$ 1.877.168,64 e excluíram R$ 1.155.351,36 e os médicos incluíram R$ 563.927,46 e excluíram R$ 657.190,19. Caso não fosse realizada a pré-análise, haveria a perda de R$ 628.554,55 no faturamento. Dentre as contas analisadas 91,42% receberam ajustes, sendo 57,59% positivos, com média de R$ 1.340,75 (DP±2.502,93) e 33,83% negativos, com média de R$ 1.571,58 (DP± 5.990,51). O total de glosas dos itens analisados por enfermeiras ou por médicos, bem como em itens examinados por ambos, correspondeu em média a R$ 380,51 (DP±1.533,05). As glosas referentes aos itens conferidos por médicos perfizeram um total médio de R$ 311,94 (DP±646,86) e as glosas referentes aos itens conferidos por enfermeiras de R$ 255,84 (DP± 1.636,76). O excesso de ajustes evidenciou a deficiência e a falta de uniformidade dos registros da equipe de saúde. Considera-se que esta pesquisa representa a possibilidade de avanço no conhecimento acerca da auditoria de contas hospitalares à medida que investigou o processo de pré-análise realizado por enfermeiras e médicos auditoresHospitals that provide services to health plan companies invest in the audit of accounts aiming to provide adequate remuneration of their service. The pre-analysis of accounts is when the audit team makes corrections to determine the foundations for billing the procedures, and to avoid disallowances and revenue losses. From that perspective, the objective of the present study was to identify the patient bill items that were most corrected after being submitted to pre-analysis; identify the impact of those corrections on the revenue of accounts that were analyzed by the hospitals audit team (physicians and nurses) after the pre-analysis; calculate the revenue that the referred team is able to correct, and identify the disallowances related to the items they checked. This exploratory, descriptive, retrospective case study was performed at the Heart Institute (InCor) of the University of São Paulo School of Medicine Clinics Hospital (HCFMUSP) using a quantitative approach. The study included a total of 2,613 accounts that had been pre-analyzed by the InCor audit team in the period spanning January to December of 2011. The revenue was concentrated in four (62.9%) of the 34 credited health plan companies. There was predominance by company A (27.6%), but the highest mean value per account was obtained by company D, with R$ 19,187.50. The items most often included in the accounts by the nurses were gauzes (90.5%); hospitalization materials (85%) and nursing care (83.2%). Hemodynamics materials, with a mean R$ 1,055.90 (SD± 3,953.45); gauzes, with a mean R$ 707.91 (SD± 843.95), and equipment, with a mean R$ 689.42 (SD± 1145.20) were the items with the strongest financial impact on the corrections. The items most often excluded from the accounts referred to hospitalization medications (41.2%); equipment (28%) and nursing care (17%). Regarding the negative changes, the items with the strongest financial impact were Hemodynamics materials, with a mean R$ 3,860.15 (SD± 15,220.80); medications used in Hemodynamics, with a mean R$ 1,983.04 (SD± 8,324.42), and gauzes, with a mean R$ 1,048.51 (SD± 3,025.53). Nurses included a total of R$ 1,877,168.64, and excluded R$ 1,155,351.36, while physicians included R$ 563,927.46 and excluded R$ 657,190.19. If the pre-analysis had not been performed, there would have been a revenue loss of R$ 628,554.55. Of all the accounts submitted to analysis, 91.42% were corrected, of which 57.59% were positive, with a mean R$ 1,340.75 (SD±2,502.93) and 33.83% were negative, with a mean R$ 1,571.58 (SD± 5,990.51). Regarding disallowances, the final sum considering the items analyzed by nurses, physicians or both corresponded to a mean R$ 380.51 (SD±1,533.05). The disallowances referring to the items analyzed by physicians added up to a mean total of R$ 311.94 (SD±646.86), and those referring to the items analyzed by nurses to R$ 255.84 (SD± 1,636.76). The excessive number of corrections showed the lack of uniformity in the records made by the health team. This study represents a possibility of knowledge advancement regarding the audit of hospital accounts as it investigated the pre-analysis process performed by nurses and physicians
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Handlon, Lauree E. "The Relationship of the Financial Condition of a Healthcare Organization and the Error Rate of Potentially Missed Coding/Billing of Select Outpatient Services." The Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=osu1204650548.
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Lemos, Lucimeire Fermino. "Análise dos registros de curativos em prontuários de um hospital de ensino do Estado de Goiás." Universidade Federal de Goiás, 2016. http://repositorio.bc.ufg.br/tede/handle/tede/6268.
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Health records are important for keeping effective communication among all professionals involved in the process of taking care as well as for legitimating the team actions in the face of patients and families. The records must be clear and objective because they are sources of information for judicial, research, teaching, billing and auditing issues. This study has an objective to analyze the records of procedures of Level II Curative in medical records of hospitalized patients, from the nurses’ perspective, before and after the pedagogical intervention, in a Brazilian teaching hospital in the Midwest region. It was a descriptive study with both qualitative and quantitative research and was developed in many stages. The first stage included the nurses’ profiles and the identification of the main reasons why the nursing actions were not recorded. The second stage was the analysis of the records before and after the pedagogical action, which was the third stage. At last, the nurses were interviewed about their perception of the importance of the records for billing. It was observed among the sample of nurses the predominance of women (87,2%), post-graduated (82,1%) and statuary civil servants (80,4%). Even though 53,6% of the nurses said that they do not have double employment relationships, 46,4% said they do. The nurses said that it was not possible to record the procedures due to lack of time (50%), work overload (20%), lack of human resources and access to the records (12,5%), interruptions and lack of guidance (2,5%). The objective of the intervention was to discuss the importance of health records, and specially, in relation to the level II curative. 45,2% of the nurses of this institution took part in this event. In the analysis of the records, before and after the intervention, it was possible to observe the increase of the records of the curatives (82,3%), the detailing of the quantity of curatives per patient (69,9%), the classification of the wounds (63,5%), the description of the materials used in the procedures (67,3%), and also the scheduling (74%) and the checking (71,4%). The data shows that the quantity of material used maintained still. However, there was a rise of curative prescription by the nurses (79,4%) and a fall of curative prescription by the doctors (18,3%). It was also possible to observe that the performed and not prescribed procedures or prescribed and not verified procedures, in both cases, were not billed. Nevertheless, the hospital overturn related to this procedure has an increase, from July 2015. The interviews with the nurses showed that they take the responsibility in the treatment of wounds for themselves. However, it is necessary to standardize the prescriptions and the evolutions of the procedure. The complete record of this intervention is important to safeguard the institution in case of auditing. In conclusion, nurses have an important role in recording the wound treatment. The obligation of recording should be reinforced due to the quality of the service and the profession´s visibility as well as for a better material and input control and billing.
Os registros em saúde são importantes tanto para garantir comunicação efetiva entre todos os profissionais envolvidos no processo de cuidar, quanto para legitimar as ações da equipe junto ao usuário e família. Devem ser claros, e objetivos, pois servem de fonte de informações para questões jurídicas, de pesquisa, ensino, faturamento e auditoria. Este estudo teve por objetivo analisar os registros do procedimento curativo (curativo grau II) nos prontuários de pacientes internados, em um hospital universitário de Goiás, na perspectiva dos enfermeiros, antes e após um treinamento, em hospital de ensino da região Centro-Oeste do Brasil. Tratouse de estudo descritivo, de natureza mista, quanti-qualitativa, desenvolvido em várias etapas. A primeira etapa compreendeu a caracterização do grupo de enfermeiros e a identificação dos principais motivos para a falta de registro das ações de enfermagem. Na segunda etapa, a análise do prontuário procurou em dois momentos, antes e após ação educativa (terceira etapa), identificar o registro. Por último, em entrevista com enfermeiros, verificou-se sua percepção quanto à importância dos registros para o faturamento. Na amostra dos enfermeiros, observou-se predominância feminina (87,2%), de pós-graduados, (82,1%), com vínculo estatutário (80,4%). Embora 53,6% tenham alegado não ter duplo vínculo empregatício, chama a atenção 46,4% alegarem esta condição. Os enfermeiros referem ainda que nem sempre é possível a efetuação dos registros, relatando como motivos: falta de tempo (50%), sobrecarga de trabalho (20%), falta de recursos humanos e acesso à papeleta (12,5%), e interrupções e falta de orientação (2,5%). Realizou-se atividade interventiva, que teve por objetivo tratar de assunto referente à importância do registro em saúde, e especificamente em relação ao curativo grau II, e contou com a participação de 45,2% dos enfermeiros desta instituição. A análise dos prontuários antes a após a intervenção, verificou o aumento dos registros de prescrição de curativos (82,3%), discriminação da quantidade de curativos por paciente (69,9%), classificação das feridas (63,5%), descrição dos materiais utilizados (67,3%), além do aprazamento (74%) e checagem (71,4%). Não se verificou alteração relacionada ao registro da quantidade de materiais. Evidenciou-se aumento das prescrições do procedimento por enfermeiros (79,4%) e diminuição pelos médicos (18,3%). O estudo permitiu ainda identificar procedimentos executados e não prescritos ou prescritos e não checados, em ambos os casos não faturados. Apesar disto, o faturamento do hospital, no que se refere a este procedimento, apresentou aumento a partir de julho de 2015. A entrevista com enfermeiros evidenciou que este profissional assume para si a responsabilidade do tratamento de feridas, mas ainda é necessária a padronização das prescrições e evoluções referentes a este cuidado. O registro completo da intervenção é importante para que a instituição se resguarde em caso de auditoria. O enfermeiro tem papel importante no registro do tratamento de feridas. Deve ser reforçada a obrigatoriedade do registro, tanto para a qualidade do atendimento prestado e visibilidade da profissão, quanto para o melhor controle de materiais e insumos e do faturamento relacionado a este procedimento.
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SOUZA, Ana Maria de Freitas Moura. "Melhoria da qualidade do processo de faturamento: o caso do Hospital Federal dos Servidores do Estado do Rio de Janeiro." Universidade Federal Rural do Rio de Janeiro, 2016. https://tede.ufrrj.br/jspui/handle/jspui/2296.
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The aim of this work is to implement improvements in the quality of the billing process of the Federal Hospital of the State Servers, under invoicing and not billing procedures performed on an outpatient basis, making it vulnerable hospital to prove its production, justify spending on materials and equipment and the need to increase the budget. It is classified as a study applied descriptive and that used as research methodology the case study of one type with complementary instruments to collect data as bibliographic and documentary research, process mapping, semi-structured questionnaire and participant observation. Qualitative results demonstrated the need to implement improvements in different activities of the registration processes of care productivity and outpatient billing. The quantitative research was conducted with a stratified sample of top-level professional categories working in the hospital's outpatient clinic. Quantitative results showed that most professionals do not use the instrument for the codification of the services provided under the National Health System and who do not realize institutional initiatives to improve the record of care productivity and outpatient billing. The implemented improvements are being monitored and has contributed to the greater professionalization of the activities developed by the Medical Documentation and Statistical Office of the Federal Hospital of the State Servers
O objetivo desta disserta??o ? implementar melhorias na qualidade do processo de faturamento do Hospital Federal dos Servidores do Estado, em virtude do subfaturamento e n?o faturamento de procedimentos realizados a n?vel ambulatorial, tornar o hospital vulner?vel para comprovar sua produ??o, justificar os gastos com materiais e equipamentos e a necessidade de aumento no or?amento. ? um estudo classificado como aplicado e descritivo que utilizou como metodologia de pesquisa o estudo de caso do tipo ?nico, com instrumentos complementares de coleta de dados como pesquisas bibliogr?ficas e documentais, mapeamento de processos, question?rio semi-estruturado e observa??o participante. Os resultados qualitativos demonstraram a necessidade de implementa??o de melhorias em diferentes atividades dos processos de registro da produ??o assistencial e faturamento ambulatorial. A pesquisa quantitativa foi realizada com uma amostra estratificada das categorias profissionais de n?vel superior que atuam no ambulat?rio do hospital. Os resultados quantitativos evidenciaram que a maioria dos profissionais n?o utiliza o instrumento para a codifica??o dos servi?os prestados ?mbito do Sistema ?nico de Sa?de e que n?o percebem iniciativas institucionais para a melhoria do registro da produ??o assistencial e do faturamento ambulatorial. As melhorias implementadas est?o sendo monitoradas e vem contribuindo para a maior profissionaliza??o das atividades desenvolvidas pelo Servi?o de Documenta??o e Estat?stica M?dica do Hospital Federal dos Servidores do Estado.
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Teixeira, Renata Valéria Longo. "O retorno financeiro das atividades realizadas pela enfermagem em uma Unidade de Terapia Intensiva." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-22082012-160114/.
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O enfermeiro tem sido cada vez mais requisitado para envolver-se nas decisões financeiras nas organizações de saúde. Sua participação no gerenciamento dos custos associado à assistência de enfermagem é importante para conhecer o quanto a enfermagem contribui para o faturamento de uma Unidade de Terapia Intensiva (UTI) e ao faturamento de um hospital e evidenciar, financeiramente, a relevância do trabalho desse profissional. No entanto, a literatura brasileira carece de estudos nesse aspecto. O objetivo deste estudo foi levantar o valor do faturamento gerado pelos procedimentos de enfermagem, mediante as prescrições médica e de enfermagem, identificar as atividades de enfermagem que são realizadas, mas não recebem pagamento pelas operadoras de saúde e estimar a perda monetária do hospital pela não taxação das atividades de enfermagem, em uma. Tratou-se de um estudo de caso exploratório, descritivo, com abordagem quantitativa. O estudo foi desenvolvido na UTI Cardiológica de um hospital geral filantrópico, com 319 leitos, na cidade de São Paulo. A amostra total calculada para 3 meses foi de 168 pacientes. O faturamento médio gerado pelas prescrições de enfermagem e médica foi de R$ 773,98, e R$ 333,06 corresponderam à prescrição de enfermagem e R$ 440,92, à prescrição médica. Em relação ao valor gerado pela prescrição de enfermagem (R$333,06), R$ 261,67 corresponderam ao pagamento de materiais de consumo e R$ 71,39, ao pagamento de taxas. Em relação ao valor gerado pela prescrição médica (R$ 440,92), R$ 322,51 corresponderam ao pagamento de materiais de consumo e R$ 118,41, ao pagamento de taxas. Os procedimentos da prescrição de enfermagem que mais contribuíram para o faturamento foram a troca de filtro bacteriano (R$ 10.342,80), a realização de punção venosa (R$ 8.062,99), o curativo de ferida operatória (R$ 5.315,26) e o curativo de traqueostomia (R$ 4.762,42). Os procedimentos provenientes da prescrição médica que mais geraram faturamento foram a realização de glicemia capilar (R$ 21.602,06), passagem de pressão arterial invasiva (R$ 14.220,56) e a passagem de sonda gástrica/enteral (R$ 20.239,00). A perda média estimada foi de R$ 480,65 por paciente da amostra. A estimativa média de perda para a amostra estudada foi de R$ 81.263,65. A projeção de perda média de faturamento, para o período dos 3 meses do estudo, para a amostra selecionada, foi de R$ 153.391,15. A extrapolação da estimativa de perda média para o período de um ano, para a amostra selecionada, foi de R$ 613.564,60. Do faturamento total da amostra selecionada, as atividades de enfermagem contribuíram com 1,7% do faturamento, e 0,65% corresponderam aos procedimentos executados mediante a prescrição de enfermagem e 1,05%, aos procedimentos provenientes da prescrição médicaNurses have increasingly been asked to participate in financial decisions in healthcare organizations. Their participation in managing the costs of nursing care is important to know how nursing contributes to the turnover of an ICU and hospital billing, and, it shows, financially, the relevance of the work of these professionals. However, Brazilian literature lacks studies in this regard. The objective of this study was to raise the value of the revenue generated by nursing procedures by the medical and nursing requirements, to identify nursing activities that are performed but not paid by health insurance companies and to estimate the monetary loss of the hospital for not taxing nursing activities in an intensive care unit (ICU). It was an occurrence study, exploratory, descriptive in a quantitative approach. The study was conducted in the Cardiology ICU of a philantropic general hospital, with 319 beds in the city of Sao Paulo. The total sample calculated for three months was 168 patients. The sources of information were the medical and accounting records of selected patients. The average revenue generated by medical and nursing prescriptions was R$ 773,98 which R$ 333,06 corresponded to the nursing prescription and R$ 440,92, the medical one. In relation to the value generated by the nursing prescription (R$ 333,06), R$ 261,67 corresponded to the payment of consumables and R$ 71,39 to fees. For the value generated by the prescription (R$ 440,92), R $ 322,51 corresponded to the payment of consumables and R$ 118,41, the payment of fees. The procedures of nursing prescription which most contributed to revenue were the exchange of bacteria filter (R$ 10.342,80), performing venipuncture (R$ 8.062,99), the surgical wound dressing (R$ 5,315.26) and tracheostomy dressing (R$ 4.762,42). The procedures from prescription which most generated revenues were performing capillary blood glucose (R$ 21.602,06), passage of invasive blood pressure (R$ 14.220,56) and passage of nasogastric tube / enteral (R$ 20.239,00). The average loss was estimated at R$ 480,65 per patient sample. The average estimate of loss for the sample studied was R$ 81.263,65. The projected average loss of revenue for the period of three months of the study, for the sample selected, was R$ 153.391,15. The extrapolation of the estimated average loss for the period of one year, for the selected sample, was R$ 613.564,60. From the total revenue of the selected sample, nursing activities accounted for 1.7% of revenues, and 0.65% corresponded to the procedures performed by nursing prescription and 1.05% corresponded to the procedures from the doctors prescription
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Li, Jia-Yu, and 李佳俞. "Patient’s Acceptability on Balance Billing of Drug-Eluting Stent—A Pilot Study on Regional Hospital in Taichung." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/13692065451191819444.
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碩士亞洲大學
健康管理研究所
97
Since March 1995 when National Health Insurance was enacted, the way people receive medical treatment has changed. After the balance billing system initiated in August 1999, people had to pay for expensive medical devices and medications at their cost. Under the coverage of current National Health Insurance Law, hospitals cannot charge patients the full cost or the price differentials. The National Health Insurance provides the basic coverage beyond which the patients will have to pay the price differentials for better services. In December 2006, the drug eluting stents was included in one of the balance billing items. General population cannot afford the expensive price differentials. Public acceptance can serve as a reference for policy promotion. The study was conducted utilizing questionnaire survey with the primary objective to study whether the predisposition factor, capacity factor and demand factor in the Andersen model would affect people’s acceptance of high balance billing of drug eluting stents. It also investigates whether balance billing policy is associated with the willingness and acceptance of the population. Research results show that people with occupation from the other category, family income over 70,000 dollars and covered by private health and medical insurance are more open to balance billing of drug eluting stents. People with medium health beliefs (43-54 points) are less willing to accept the balance billing of drug eluting stents than those with low health beliefs (31-42 points). The result was statistically significant, indicating that these factors do affect the balance billing of drug eluting stents. The National Health Insurance falls under social insurance, and is compulsory. Due to the insufficient insurance fund, the enormous medical costs shadow the medical behaviour of the general public. Private insurance has also launched “supplementary health insurance” which stresses on the medical costs with limited coverage or not covered by National Health Insurance and reduces the enormous financial burden for medical treatment. This will also make medical services more accessible for the public.
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Han, Tsung-Chih, and 韓宗志. "Balance Billing For Inpatient Under National Health Insurance－An Example of Regional Hospitals in Kaohsiung-Pingtung Area." Thesis, 2003. http://ndltd.ncl.edu.tw/handle/35874921451715614463.
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碩士國立中山大學
人力資源管理研究所
91
Abstract After the National Health Insurance was implemented ,it provides our citizens not only the basic medical treatment but also reduce the financial burden. However, the financial difficulties is becoming worse for National Health Insurance of Taiwan. In order to reduce the medical expenses. The Health Insurance authorities implemented many different policies.Balance billing was one of these interventions. The purposes of this research included to understand the relationships between the balance billing and the characteristics of physicians and patients .Particularly, this research focused on the perceptions of balance billing form the Physicians and hospitalized patients’points of view. The Andersen’s health behavior model was the conceptual framework for this study. The questionnaire was sent out to 200 doctors and 1000 patients in Kaohsiung , Pingtung regional hospitals ,with 101 (response rate 50.6%) and 638 (63.8%)returned , respectively. The characteristic and the attitude towards balance billing system such as medical quality, medical care and medical expenses from both physicians and patients were collected. Descriptive analysis and logistic regression were used to analyze this study. The Results from physicians survey are summarized as follows: 1.There were no statistical significance between the physicians’ characteristics (such as age, gender, and tenure) and the agreement of balance billing .Ninety-four out of 101 physicians agreed on the new policy. 2.There would be no influence of balance billingon the medical care from the perspective of physicians. 3.Physicians who agreed on the viewpoints of paying extra payments would lead to the better treatment were 12 times more likely to accept the balance billing. 4.There were no difference among medical expenditures, the level of understanding, and the policy of balance billing. The results from inpatient survey are summarized as follows: 1. Inpatients demographic characteristics, (such as education、occupation and disease), were significant related to the agreement of the policy of balance billing system. However, there were no statistical difference in age, gender, language, and private insurance. 2.Most inpatients who agreed on the balance billing policy were 1.8 times more to believe that if they paid out-of-pocket, they would gain more medical attention form physicians. 3.Regarding the quality of care, inpatients whoever agreed upon the policy of balance billing would perceive that they would receive 3 to 3.8 times higher quality of care in medical materials and medicine, respectively. 4.The more the agreement of the balance billing policy, the higher the satisfactory. 5.Inpatients who understood the new policy were more likely to pay extra payment. Based on the results from this study, it is certain to conclude that both the doctors and inpatient of the region hospital are supporting the balance billing policy .The average score of the inpatient questionnaire is 3.305.And 93.1% of the surveyed. Doctors accepted the policy of balance billing. We encouraged the bureau of National Health Insurance to continuing communication with the public and the providers to assure the success of new policy.
Books on the topic "Hospital Billing"
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Magovern, Susan. Hospital billing: Completing UB-04 claims. 2nd ed. Boston: McGraw Hill Higher Education, 2009.
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Magovern, Susan. Hospital billing: Completing UB-04 claims. Boston: McGraw Hill, 2009.
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Understanding hospital billing and coding: A worksheet. Australia: Thompson Delmar Learning, 2007.
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General, Connecticut Office of the Attorney. Findings and recommendations regarding hospital billing practices. [Hartford]: Office of the Attorney General, State of Connecticut, 1995.
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Abbey, Duane C. Charge master: Review strategies for improved billing and reimbursement. New York: McGraw-Hill, 1997.
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CodeBusters' quick guide to coding and billing compliance for medical practices. Gaithersburg, Md: Aspen Publishers, 1999.
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Handbook for hospital billing with answer key: A reference and training tool for the UB-04 manual. Chicago, Ill: AHA Press, 2009.
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Birkenshaw, Claudia. Handbook for hospital billing without answer key: A reference and training tool for the UB-04 manual. Chicago, Ill: AHA Press, 2009.
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Birkenshaw, Claudia. UB-04 handbook for hospital billing, with answer key: A reference and training tool for efficient operations in health care facilities. Chicago: Health Forum, Inc, 2007.
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Investigations, United States Congress House Committee on Energy and Commerce Subcommittee on Oversight and. A review of hospital billing and collections practices: Hearing before the Subcommittee on Oversight and Investigations of the Committee on Energy and Commerce, House of Representatives, One Hundred Eighth Congress, second session, June 24, 2004. Washington: U.S. G.P.O., 2004.
Find full textBook chapters on the topic "Hospital Billing"
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Patel, Himati P., and Negin J. Ahadi. "Basics of Billing and Coding: A Primer for the New Hospitalist Attending." In Hospital Medicine, 75–83. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-49092-2_8.
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Littmann, Jasper, A. M. Viens, and Diego S. Silva. "The Super-Wicked Problem of Antimicrobial Resistance." In Ethics and Drug Resistance: Collective Responsibility for Global Public Health, 421–43. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-27874-8_26.
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Abstract Antimicrobial resistance (AMR) – the progressive process by which microbes, such as bacteria, through evolutionary, environmental and social factors develop the ability to become resistant to drugs that were once effective at treating them – is a threat from which no one can escape. It is one of the largest threats to clinical and global health in the twenty-first century – inflicting monumental health, economic and social consequences. All persons locally and globally, and even all future persons yet to come into existence, all suffer the shared, interdependent vulnerability to this threat that will have a substantial impact on all aspects of our lives. For example, while reliable data are hard to find, the European Centre for Disease Prevention and Control (ECDC) has conservatively estimated that, in Europe alone, AMR causes additional annual cost to health care systems of at least €1.5 billion, and is responsible for around 25,000 deaths per year. Furthermore, AMR significantly increases the cost of treating bacterial infections with an increase in length of hospital stays and average number of re-consultations, as well as the resultant lost productivity from increased morbidity. With a combined cost of up to $100 trillion to the global economy – pushing a further 28 million people into extreme poverty – this is one of the most pressing challenges facing the world. Most troublingly, if we do not succeed in diminishing the progression of AMR, there is the very real potential for it to threaten common procedures and treatments of modern medicine, including the safety and efficacy of surgical procedures and immunosuppressing chemotherapy. Some experts are warning that we may soon be ushering in a post-antibiotic area.
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Rambabu, D. "Diagnostic Departments: Central Billing." In Reality of Hospital Administration, 49. Jaypee Brothers Medical Publishers (P) Ltd., 2014. http://dx.doi.org/10.5005/jp/books/12302_7.
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Kontos, Nicholas, Robert M. Stern, and Theodore A. Stern. "Billing, Documentation, and Cost-Effectiveness of Consultation." In Massachusetts General Hospital Handbook of General Hospital Psychiatry, 667–79. Elsevier, 2010. http://dx.doi.org/10.1016/b978-1-4377-1927-7.00051-0.
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STERN, R. "Billing Documentation and Cost-Effectiveness of Consultation." In Massachusetts General Hospital Handbook of General Hospital Psychiatry, 773–86. Elsevier, 2004. http://dx.doi.org/10.1016/b978-0-323-02767-0.50049-8.
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Banks, David, and David Werner. "Hospital and Professional Reimbursement." In The Pediatric Procedural Sedation Handbook, edited by Cheryl K. Gooden, Lia H. Lowrie, and Benjamin F. Jackson, 399–406. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190659110.003.0058.
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The sustainability of a sedation service depends on its ability to generate revenue, both for the providers and for the facility/institution. A complete understanding of the process of coding and billing to achieve maximum reimbursement is necessary for planning a new sedation service, as well as maintaining and expanding an existing one. This section discusses CPT coding and billing for deep sedation, moderate sedation, provider consulting, and facility fees. Coding and billing for deep sedation involves using CPT codes for anesthesia services. Coding and billing for moderate sedation involves the use of the moderate sedation CPT codes that were updated for 2017. Coding and billing for hospital services associated with providing deep sedation involves the use of facility revenue codes.
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Reich, Adam D. "Good Business." In Selling Our Souls. Princeton University Press, 2014. http://dx.doi.org/10.23943/princeton/9780691160405.003.0005.
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This chapter examines the link between Emergency Medical Incorporated's financial success and the quality of hospital care it ultimately was able to provide. Emergency Medical Incorporated, one of the nation's largest contract management groups, held the contract for the emergency department at HolyCare Hospital. The company managed the scheduling, billing, and workflow of the emergency medicine physicians, who were technically “independent contractors” with the company. It also provided them with medical malpractice insurance and helped them minimize legal risk. The chapter considers the billing practices of HolyCare doctors and the effects of physicians' individualism on the quality of care at HolyCare. It shows that entrepreneurship was structured within larger organizations (from the physicians' group to the hospital itself) that also profited from doctors' profiteering.
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Rajkumar, Rajasekaran. "Wireless Heartrate Monitoring Along Prioritized Alert Notification Using Mobile Techniques." In Hospital Management and Emergency Medicine, 230–43. IGI Global, 2020. http://dx.doi.org/10.4018/978-1-7998-2451-0.ch013.
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The increasing number of problems that need to be addressed in the hospital sector calls for innovation in this field. It brings us the need to find cost-effective and memory-efficient solutions to handle the vast data and sector it into essential information to operate on the patient. There used to be many systems to manage clinical records which are fixed at a place. It is quite complicated to get the information and make this data available at a patient's bedside. This leads to a considerable amount of wasted time in moving to those storage PCs and also the cost afforded is comparatively high. A computer system that controls and accomplishes all the data in the hospital database to provide effective healthcare is called hospital information system (HIS). The introduction of HIS made billing and inventor easier for the staff. This paper discusses diverse methods that improve the cost, demands of HIS, and provide techniques to function efficiently using wireless networks. Also, the paper gives a comparative study on different aspects such as cost, quality of service, transportation, and security. A new system is proposed by combining the wireless healthcare system along prioritized alert notification.
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"Table 1: Comparison of CMS Payment for 2013 and 2014 for Facility Fee Billing." In G-Code 2014: Hospital-Based Outpatient Clinic Facility Fee Payment eReport, 6. American Society of Health-System Pharmacists, 2014. http://dx.doi.org/10.37573/9781585284634.004.
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Leite, Larissa de Oliveira Matia, Alexandre Minoru Sasaki, Rosimeire Sedrez Bitencourt, Maria Lucia Miyake Okumura, and Osiris Canciglieri Junior. "Humanization and Macroergonomics: An Analysis in the Billing Sector of a University Hospital in Paraná." In Advances in Transdisciplinary Engineering. IOS Press, 2020. http://dx.doi.org/10.3233/atde200078.
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The humanization of organizations is a trend in companies that have a vision of the future aligned with the needs of the market. In the health area, this humanization should not be limited to its users, but include the employees involved in the work system. The human aspect and its relations with the work system is a focus of studying ergonomics, which in its macroergomic approach aims at integrating organization-man-machine systems into a sociotechnical and participatory context. This study aims to apply the macroergonomic approach with health workers in order to propose and implement improvements; evidencing the importance of their involvement in better acceptance of the proposed improvements generating greater satisfaction. To this end, a study was conducted in the Billing sector of a Brazilian Hospital. Ergonomic demands were identified in a participatory way through the Macroergonomic Analysis of Work (MAW) method, proposed in [1]. The results were tabulated and divided into constructs: Environment, Biomechanical, Cognitive, Work Organization, Risk, Company and Discomfort/Pain. After one year, a new macroergonomic evaluation was carried out and the improvements implemented included the concept of the sociotechnical system, which were: i) acquisition of new computers; ii) implementation of a new computational system and; iii) implementation of changes in the form of sector management. The results showed an increase of up to 40% in satisfaction with the improvements implemented in the Biomechanical and Organizational constructs, indicating that the application of participatory ergonomics and macroergonomics was fundamental for the changes made to increase satisfaction in aspects of the work performed by them. Finally, this research highlights the importance of employee involvement in sociotechnical analysis for the humanization of organizations and it is suggested for future studies the proposition of improvements related to the Environment and Cognitive constructs and pain/discomforts.
Conference papers on the topic "Hospital Billing"
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Vedomske, Michael A., Matthew S. Gerber, Donald E. Brown, and James H. Harrison. "Scalable and Locally Applicable Measures of Treatment Variation That Use Hospital Billing Data." In 2013 12th International Conference on Machine Learning and Applications (ICMLA). IEEE, 2013. http://dx.doi.org/10.1109/icmla.2013.159.
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Gontina S, Willia, and Atik Nurwahyuni. "Determinants of Inpatient Cost for Patients with ST-Elevation Myocardial Infarct at Mayapada Hospital, Tangerang." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.04.27.
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ABSTRACT Background: Inpatient health services for heart attack patients is a complex problem and the highest billing rate in hospitals. Due to the high cost of hospitalization, delay treatment cases may cause fatal health consequences. This study aimed to determine factors affecting the inpatient cost for patients with ST-elevation myocardial infarction at Mayapada hospital, Tangerang, West Java. Subjects and Method: A cross-sectional study was conducted at Mayapada hospital, Tangerang, West Java, from July to December 2019. A sample of 31 patients diagnosed with ST-elevation myocardial infarction (STEMI) was selected by total sampling. The dependent variable was total inpatient service costs counted according to the clinical pathway. The independent variables were doctor in charge presented the direct cost, age, gender, patient’s distance to hospital, payment method, and length of stay. The data were collected using medical records. The data were analyzed by multiple linear regression. Results: Inpatient service cost in STEMI patients was positively associated with the doctor direct cost (b= 0.51; p= 0.003), distance to hospital (b= 0.13; p= 0.501), and length of stay (b= 0.39; p= 0.330). Inpatient service cost in STEMI patients was negatively associated with age (b= -0.30; p= 0.107), gender (b= -0.13; p= 0.550), and payment method (b= -0.26; p= 0.214). Conclusion: Inpatient service cost in STEMI patients have a positive association with the doctor direct cost, distance to hospital, length of stay, and negative association with age, gender, and payment method. Keywords: inpatient service cost, length of stay, STEMI patients Correspondence: Willia Gontina S. Masters Program in Health Policy and Administration, Faculty of Public Health, Universitas Indonesia, Depok, West Java. Email: amyamandacp@gmail.com. Mobile: +6281280778000. DOI: https://doi.org/10.26911/the7thicph.04.27
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Sommer, C., S. Kätzlmeier, T. Do, and G. Richter. "Clinic of Radiology with own patient ward and coding/billing responsibility: Economic Performance Indicators on the example of a German Hospital offering the full spectrum of IR." In 101. Deutscher Röntgenkongress und 9. Gemeinsamer Kongress der DRG und ÖRG. © Georg Thieme Verlag KG, 2020. http://dx.doi.org/10.1055/s-0040-1703395.
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Baca, Justin T., David N. Finegold, and Sanford A. Asher. "Photonic Crystal Sensors for the Rapid Detection of Myocardial Ischemia." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176582.
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Coronary Heart Disease is the leading cause of death in the United States and was responsible for approximately one of every five deaths in 2003 [1]. Unnecessary admissions to US Hospitals of patients with suspected Acute Coronary Syndrome (ACS) is estimated to cost about 12 billion dollars a year [2]. The earliest biochemical markers currently assayed do not appear in the blood for hours after the onset of chest pain; a rapid test for myocardial ischemia would help to expedite treatment and avoid unnecessary hospital admissions [3].
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Pedamallu, Lakshman Ravi Teja, Vivek Kumar Singh, and Alvaro Peixoto Filipe Gomes. "Quantitative Assessment of Advanced Energy Efficiency Retrofitting for Hospitals in India." In ASME 2016 10th International Conference on Energy Sustainability collocated with the ASME 2016 Power Conference and the ASME 2016 14th International Conference on Fuel Cell Science, Engineering and Technology. American Society of Mechanical Engineers, 2016. http://dx.doi.org/10.1115/es2016-59307.
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Achieving energy efficiency in buildings is an important factor in developed and as well in developing countries in order to meet its energy demand. Over the past few years, a number of reports have been emerged stating that the buildings sectors are responsible for approximately 31% of global final energy demand. Buildings account for 35% of total final energy consumption in India and building energy consumption is growing about 8% per years. Final energy demand in Indian building sector will grow up-to five times by the end of this century, driven by rapid income and population growth. Hospitals are institutions for the care of people with health problems and are usually functional 24hrs a day, all year around, which demands a lot of energy. Health sector is one of the largest and fastest growing sectors in India. By 2020, it is expected to become a $ 280 billion industry. In India hospitals contribute 23% of total energy consumption and the hospital building growth rate 12–15% in last decade. The World Health Organization estimated that India need 80,000 additional hospital beds every year to meet the demands of India’s population. The aim of this study is to assess the energy demand, energy savings & reduced greenhouse gas emissions by increasing the energy efficiency using advanced retrofitting. Bottom-Up Energy Analysis System (BUENAS) is an end use energy demand projection model for Hospital buildings in India, to normalize the assessment of energy-saving models also going to fill the gap in energy demand reduction by energy system modeling and decomposition analysis. Energy efficiency retrofitting of existing buildings plays a major role in developing country like India in order improve its energy security and minimizing the greenhouse gases. The positive effects of retrofitting of energy efficiency and need the policies and target base proposal for government intention to achieve the potential for energy efficiency are discussed.
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Park, Pan Gi, and Leszek J. Sudak. "Interaction Between Bone Cement Cracking and Non-Slip Implant Interfaces." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-175920.
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According to National Hospital Discharge Survey 2003, approximately 217,000 and 402,000 patients in the U.S. underwent Total Hip Replacement (THR) and Total Knee Replacement (TKR) operations, respectively and $24.7 billion dollars were spent in hospitalization related to these replacement surgeries. In addition, there were 36,000 revision hip replacements and 33,000 revision knee replacements. To decrease the revision surgeries and increase the performance of the implants, many researchers have provided new techniques for better implant fixation and mechanisms of debonding around implants. With respect to fixation, performance of cemented prosthesis is reported to be better than those of cementless ones. Moreover, surgery with cemented implants has been among the most popular and widely performed.
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Goldie, Stephan E. "Two Thousand New, Million-Person Cities by 2050 – We Can Do It!" In 55th ISOCARP World Planning Congress, Beyond Metropolis, Jakarta-Bogor, Indonesia. ISOCARP, 2019. http://dx.doi.org/10.47472/ysfj6819.
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In 1950 three quarters of a billion people lived in large towns and cities, or 30% of the total world population of over 2.5 billion. By 2009 this had grown to 3.42 billion, just over half of a total population of over 6.8 billion. The United Nations Secretariat currently forecasts that in 2050 6.4 billion, 67% of a total of almost 9.6 billion people will live in urban areas. Just over a third of that growth, around one billion people, is expected to be in China, India and Nigeria, but the remaining two billion will be in the countries around those countries: a massive arc stretching across the world from West Africa through the Middle East, across Asia and into the Pacific. In these other countries, an additional two billion urban residents over thirty years translates into a need to build a new city for a population of one million people, complete with hospitals, schools, workplaces, recreation and all the rest, at a rate of more than four a month: 2000 cities, in countries with little urban planning capability! In addition, the United Nations’ sustainable development goals (SDGs) include goal 11: Sustainable Cities & Communities "Make cities and human settlements inclusive, safe, resilient and sustainable”, so these new cities should demonstrate a level of planning competence and city management ability that many towns and cities in the world are struggling to achieve. Notwithstanding the scale of the problem, the size and cost of the planning effort is demonstrated to be feasible, provided that action is swift and new technologies are developed and applied to the planning and approvals processes. Of course, taking these plans to construction is a much bigger effort, but the economy of cities is strongly circular, meaning that the initial cash injection generates jobs that pay wages that are spent on rent and goods within the city, which then generate profits that fund developments that generate jobs, etc. However, this requires good governance, a planning consideration that must also be addressed if the full benefits of planning, designing and building 2000 cities in the Third World are to be enjoyed by the citizens of those cities. Finally, failure is not an option, because “If we don't solve this equation, it is not that people will stop coming to cities. They will come anyhow, but they will live in slums, favelas and informal settlements” (Arevena, 2014), and we know that slums the world over produce crime, refugees and revolution, and then export these problems internationally, one way or another. The world most certainly does not want more refugees or another Syria, so planners must rescue us from that future, before it happens!
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Viker, Tom, and Jim Stice. "Modular Redundancy for Cerebrospinal Fluid Shunts: Reducing Incidence of Failure due to Catheter Obstruction." In 2019 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2019. http://dx.doi.org/10.1115/dmd2019-3291.
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Cerebrospinal fluid shunts for the treatment of hydrocephalus fail at a rate of 40% within the first year. The importance of this problem is supported by one institution’s analysis of neurosurgical 30-day readmissions with CSF shunt failure only second to brain tumor readmissions. Hospital shunt related costs have been estimated at $1.4 to $2 billion annually. The majority of these costs are attributable to shunt failures based on the number of revisions out of the total numbers of annual shunt procedures. The technical innovation of this project is a low cost, low risk and easy to implement CSF shunt design change compatible with current protocols. The proposed product is an innovative distal catheter to minimize the need for revision surgery due to obstruction (also referred to as occlusion). This is accomplished with a dual lumen catheter (current distal catheters are single lumen) consisting of a primary lumen and a secondary lumen providing redundant functionality in the event ofprimary lumen occlusion thereby eliminating the need for surgical shunt revision. 40% of shunts fail within the year after implant and distal catheter obstruction accounts for up to 24% of failures. Though less prevalent than proximal catheter occlusion, incidence of distal catheter occlusion is significant and improved reliability would reduce costs and improve patient outcomes by lowering the number of revisions.
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Vishwa Mohan, Vangari, and Vahideh Zarea Gavgani. "Informing Clients through Information Communication Technology in Health Care Systems." In InSITE 2009: Informing Science + IT Education Conference. Informing Science Institute, 2009. http://dx.doi.org/10.28945/3367.
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Information Communication Technology (ICT) has revolutionized the world communication order. People can be informed in more effective, efficient and convenient ways. Access to media has percolated to the grassroots. In spite of all such remarkable developments, whether ICT facilitates Science communication is a billion dollar question. Though information is freely and widely available by virtue of ICT, yet, there are areas where Science communication through ICT still needs to be developed to deliver critical information to the needy. Objectives: The objectives of the study are to find out: whether patients and care givers have perception of their information needs? What sources of information they usually consult? What type of channels/media they possess to access the information? What sources the patients and care givers prefer to consult? Whether in the opinion of the patients and their care givers, the ICTs are effective in delivering the critical information. Methodology: An exploratory survey was conducted. A semi-structured interview was employed to collect data from a group of 188 patients and care givers in the hospitals and clinics in Hyderabad (India). Results and conclusion: The study determined the patients’ and care givers’ preferences for technologies in keeping informed. It also brought to light the limitations and usefulness of ICTs in Science communication in general and medical information in particular.
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Noko, Ofentse, Ariel Lashansky, Giancarlo Beukes, and Sudesh Sivarasu. "An Open Source Biometric Patient Identification System for Low Resource Setting." In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3477.
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It is estimated that as many as 1.5 billion people globally do not possess any form of identification [1]. Most of these people currently live in Africa and Asia. The lack of identification prevents them from accessing the basic rights and services afforded to them. In healthcare, proof of identity is required to access basic health services, and accurately monitor one’s diagnosis and treatment. This enables health care facilities to provide quality services. Without any identification, governments and development organisations cannot cater to the basic needs of these individuals. This is a key factor in the increased adoption of digital information systems in healthcare. These systems assist with validating patients’ identities. Additionally, these systems store information about patients’ medical history to allow for more effective treatment practices [2]. Digital information systems have proven to be more reliable than paper-based systems currently used in many health facilities in developing countries. Health service providers are now seeking ways to integrate these systems into their daily operations. Electronic health record systems could potentially solve many problems these facilities face. This includes issues related to data management and patient identification. These systems, when paired with biometric technologies, can remove the need for patients to carry physical identification to gain access to medical services. This would be a great benefit to rural communities. It could also assist with reducing the prevalence of fraud in these communities. Cases where individuals make use of stolen identification cards and multiple identities to access health benefits are known to occur in these areas. Existing biometric identification solutions are not designed specifically for the rural environment. Therefore, an open source biometric patient identification system was developed. The system was developed specifically for a hospital located in a rural setting. The aim was to leverage off existing technologies, and adapt it accordingly to suit the conditions faced by health service providers in these areas.