A Study to Assess the Functioning of Billing Department in a Tertiary Care Hospital
The hospital billing process is mainly to obtain remuneration for the services and materials provided by hospital
to patients. On the basis of literature review it was found that there is a gap to study the hospital inpatient billing process in
detail as a separate entity and to identify the factors influencing delay in billing process of insurance patients in a tertiary
The aim of this study was to evaluate the functioning of billing department in a tertiary care hospital as it plays an important
role, as liaison office between the management and the patients. Billing process is the final step in hospital, which is directly
proportional to patient satisfaction. Billing plays a vital role in the discharge process and billing documents are even legally
important. An observational and descriptive study was conducted by using flow chart and root-cause analysis as a statistical
tool for analyzing & understanding the billing process in detail and to identify the factors influencing delay in submission of
insurance patients’ bill for my research.
The study results that there is a delay in the submission of insurance patients’ bill and for the same 23% of cases are imposed
for deduction. The reasons for delay in submission are as reporting of investigations, files kept in ward without dispatching,
incomplete file, absence of process monitoring, lack of training, resubmission of documents or bills, shortage of manpower
and so on. Some of the ways for optimizing the billing process was suggested and they are increasing the manpower,
responsibility and authority matrix, control chart, training and key performance measures for analyzing the overall
department. The study concludes that it is important for billing personnel’s to understand the billing process in detail so as to
have an effective billing process in healthcare organization.
Keywords— Billing Process, Insurance Patients.