THE STUDY DEDUCTIONS OF INSURANCE BILLS AND PRESENTING SUGGESTIONS APPROACHES IN SEYED ALSHOHADA HOSPITAL

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KARIMI SAEID; VESAL SAHAR; SAEEDFAR SAEEDEH; REZAYATMAND MOHAMMADREZA

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Journal: Journal of Health Information Management Year:2011 | Volume:7 | Issue:(SPECIAL ISSUE) Page(s): 594-600

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Title

THE STUDY DEDUCTIONS OF INSURANCE BILLS AND PRESENTING SUGGESTIONS APPROACHES IN SEYED ALSHOHADA HOSPITAL

Author(s)

KARIMI SAEID | VESAL SAHAR | SAEEDFAR SAEEDEH | REZAYATMAND MOHAMMADREZA | Issue Writer Certificate

Keywords

INSURANCEQ2

HOSPITALSQ3

FILESQ3

INPATIENTSQ3

HOSPITAL RECORDSQ3

Abstract

Introduction: INSURANCE considered as the main financial resource of HOSPITALS But HOSPITALS have disagreement with insuring organizations in some financial cases and usually they do not receive all their INSURANCE claims. The aim of current research was to review the causes of deductions in INSURANCE bills in Isfahan Seyed Alshahada hospital and suggest some suitable approaches.Methods: In this descriptive cross-sectional retrospective study, prescription information and records of patients referred to Seyed Alshahada Hospital (AS) in the second six months of 2007 were studied and information of patients with special diseases was extracted from. Sampling method was census records and during the study 4983 clinical prescriptions, 27238 paraclinical prescriptions and 3392 hospitalized case were investigated. Data was collected using a checklist which validity was confirmed by INSURANCE experts and management specialists and analyzed by statistical and descriptive scales.Results: The highest prevalence and causes of deductions in clinical prescriptions was related to INSURANCE organizations Komite Emdad (62%) due to confounding date. Next Rankings were Nirouhaye Mosalah, Tamin Ejtemaei and Khadamat Darmani INSURANCEs. The highest prevalence and causes of deductions in paraclinical prescriptions was related to INSURANCE organizations Komite Emdad (45.3%) due to lack of prescriptions. Next Rankings were Nirouhaye Mosalah, Tamin Ejtemaei and Khadamat Darmani INSURANCEs.The highest prevalence and causes of hospitalization records deductions was related to Tamin Ejtemaei (74.4%) due to lock exorbitant. Next rankings were Khadamat Darmani INSURANCE, Komite Emdad INSURANCE and Nirouhaye Mosalah INSURANCE.Conclusion: Most causes of outpatient deductions had direct correlation with organizational mistakes derived from hospital staff. In this field, educating physicians, nurses and other staff holding up in patients bill procedure seems to be necessary. On the other hand, the main cause for inpatient FILES as it was mentioned was due to extra demands, which did not count resources lose.Transparency of the deductions would reduce the disagreement between hospital and INSURANCE organizations.

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APA: Copy

KARIMI, SAEID, VESAL, SAHAR, SAEEDFAR, SAEEDEH, & REZAYATMAND, MOHAMMADREZA. (2011). THE STUDY DEDUCTIONS OF INSURANCE BILLS AND PRESENTING SUGGESTIONS APPROACHES IN SEYED ALSHOHADA HOSPITAL. HEALTH INFORMATION MANAGEMENT, 7((SPECIAL ISSUE)), 594-600. SID. https://sid.ir/paper/121888/en

Vancouver: Copy

KARIMI SAEID, VESAL SAHAR, SAEEDFAR SAEEDEH, REZAYATMAND MOHAMMADREZA. THE STUDY DEDUCTIONS OF INSURANCE BILLS AND PRESENTING SUGGESTIONS APPROACHES IN SEYED ALSHOHADA HOSPITAL. HEALTH INFORMATION MANAGEMENT[Internet]. 2011;7((SPECIAL ISSUE)):594-600. Available from: https://sid.ir/paper/121888/en

IEEE: Copy

SAEID KARIMI, SAHAR VESAL, SAEEDEH SAEEDFAR, and MOHAMMADREZA REZAYATMAND, “THE STUDY DEDUCTIONS OF INSURANCE BILLS AND PRESENTING SUGGESTIONS APPROACHES IN SEYED ALSHOHADA HOSPITAL,” HEALTH INFORMATION MANAGEMENT, vol. 7, no. (SPECIAL ISSUE), pp. 594–600, 2011, [Online]. Available: https://sid.ir/paper/121888/en

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