EVALUATION OF REGION 1 MEDICAL CENTER'S BILLING SECTION PERFORMANCE FOR DISCHARGED IN-PATIENTS FOR THE YEAR 2007-2008
BY: ZALDY P. GUICO, M.D. (MAY 2009)
ABSTRACT:
THIS IS AN EXPLORATORY DESCRIPTIVE STUDY WHICH EVALUATED THE REGION 1 MEDICAL CENTER BILLING SECTION PERFORMANCE FOR DISCHARGED IN-PATIENTS FOR THE YEARS 200-2008. A REVIEW OF RECORDS OF THE BILLING SECTION WAS DONE AND QUESTIONNAIRES FOR BOTH THE BILLING PERSONNEL AND PATIENTS/RELATIVES/COMPANIONS WERE ADMINISTERED. THE OBJECTIVES WERE: TO DETERMINE THE DEGREE AND EXTENT OF IMPLEMENTATION OF THE BILLING SECTION'S POLICIES AND PROCEDURES; TO IDENTIFY THE PROBLEMS AND DIFFICULTIES IN THE IMPLEMENTATION OF THE BILLING SECTION'S POLICIES AND PROCEDURES; AND TO DISCUSS THE POLICY AND MANAGEMENT IMPLICATIONS OF THE FINDINGS.
RESULTS SHOWED THAT THERE WAS A HUGE PORTION OF UNSETTLED PN'S AND ACCOUNTS RECEIVABLE. THE EMPLOYEES ASSESSED THE OVER-ALL DEGREE OF THE IMPLEMENTATION OF THE PARAMETERS OF TIMELINESS, FOLLOW-UP, PROCESS AND TECHNOLOGY AS "AVERAGE", WHILE THE PARAMETERS OF COMPETENCE, CULTURE AND CUSTOMER SERVICE HAD A "GOOD" ASSESSMENT. EMPLOYEES IDENTIFIED TIMELINESS, COMPUTERIZATION AND NEED FOR MORE PHYSICAL SPACE AS AREAS OF IMPROVEMENT. EIGHTY SIX PERCENT (86%) TO 96% OF PATIENT RESPONDENTS STATED THAT FLOWCHARTS RELATED TO BILLING AND PAYMENT WERE PRESENT AND PLACED IN STRATEGIC LOCATIONS, CLEAR AND UNDERSTANDABLE, BILLS WERE PROPERLY COMPUTED AND ADEQUATE EXPLANATIONS WERE GIVEN WHEN DOCUMENTS WERE NOT COMPLETE. THEY IDENTIFIED THE FOLLOWING PROBLEMS: FLOWCHARTS NOT SEEN AND UNDERSTOOD (10.3%), IMPATIENT EMPLOYEES (5.3%), AND SLOW PROCESSING OF BILLS (4.3%). RECOMMENDATIONS ARE: TO REVIEW, ORIENT, ENFORCE AND IMPLEMENT THE POLICIES AND PROCEDURES, TO APPOINT A REGULAR SECTION HEAD OF BILLING, TO CONDUCT REORIENTATION, RETAINING AND MOTIVATIONAL PROGRAM OF THE PERSONNEL
ABSTRACT:
THIS IS AN EXPLORATORY DESCRIPTIVE STUDY WHICH EVALUATED THE REGION 1 MEDICAL CENTER BILLING SECTION PERFORMANCE FOR DISCHARGED IN-PATIENTS FOR THE YEARS 200-2008. A REVIEW OF RECORDS OF THE BILLING SECTION WAS DONE AND QUESTIONNAIRES FOR BOTH THE BILLING PERSONNEL AND PATIENTS/RELATIVES/COMPANIONS WERE ADMINISTERED. THE OBJECTIVES WERE: TO DETERMINE THE DEGREE AND EXTENT OF IMPLEMENTATION OF THE BILLING SECTION'S POLICIES AND PROCEDURES; TO IDENTIFY THE PROBLEMS AND DIFFICULTIES IN THE IMPLEMENTATION OF THE BILLING SECTION'S POLICIES AND PROCEDURES; AND TO DISCUSS THE POLICY AND MANAGEMENT IMPLICATIONS OF THE FINDINGS.
RESULTS SHOWED THAT THERE WAS A HUGE PORTION OF UNSETTLED PN'S AND ACCOUNTS RECEIVABLE. THE EMPLOYEES ASSESSED THE OVER-ALL DEGREE OF THE IMPLEMENTATION OF THE PARAMETERS OF TIMELINESS, FOLLOW-UP, PROCESS AND TECHNOLOGY AS "AVERAGE", WHILE THE PARAMETERS OF COMPETENCE, CULTURE AND CUSTOMER SERVICE HAD A "GOOD" ASSESSMENT. EMPLOYEES IDENTIFIED TIMELINESS, COMPUTERIZATION AND NEED FOR MORE PHYSICAL SPACE AS AREAS OF IMPROVEMENT. EIGHTY SIX PERCENT (86%) TO 96% OF PATIENT RESPONDENTS STATED THAT FLOWCHARTS RELATED TO BILLING AND PAYMENT WERE PRESENT AND PLACED IN STRATEGIC LOCATIONS, CLEAR AND UNDERSTANDABLE, BILLS WERE PROPERLY COMPUTED AND ADEQUATE EXPLANATIONS WERE GIVEN WHEN DOCUMENTS WERE NOT COMPLETE. THEY IDENTIFIED THE FOLLOWING PROBLEMS: FLOWCHARTS NOT SEEN AND UNDERSTOOD (10.3%), IMPATIENT EMPLOYEES (5.3%), AND SLOW PROCESSING OF BILLS (4.3%). RECOMMENDATIONS ARE: TO REVIEW, ORIENT, ENFORCE AND IMPLEMENT THE POLICIES AND PROCEDURES, TO APPOINT A REGULAR SECTION HEAD OF BILLING, TO CONDUCT REORIENTATION, RETAINING AND MOTIVATIONAL PROGRAM OF THE PERSONNEL