Paper Title :A Study to Assess the Functioning of Billing Department in a Tertiary Care Hospital

Author :Asharani N A., Ramachandra Kamath U., H N Nagesha

Article Citation :Asharani N A. ,Ramachandra Kamath U. ,H N Nagesha , (2016 ) " A Study to Assess the Functioning of Billing Department in a Tertiary Care Hospital " , International Journal of Management and Applied Science (IJMAS) , pp. 25-30, Volume-2,Issue-10

Abstract : 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 care hospital. 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.

Type : Research paper

Published : Volume-2,Issue-10

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