The amount and causes insurance deductions of Shohada-e Sarvestan hospital and ways to reduce it by using the techniques of problem solving, ۲۰۱۲

Introduction:  Providing services to patients covered by different insurance companies, are among hospitals insurance sources, but insurance organizations deduct some of the claims after auditing hospital financial documents each month. We aimed to study deductions causes using “problem solving” technique. Methods:  In this cross sectional study, ۱۷۰۶ inpatients records and pharmacy and laboratory services of Shohada-e Sarvestan hospital were investigated. Checklist was used for data collection. Collected data were analyzed using Microsoft Excel version ۱۰. Results:  Deductions causes were patient history defect for inpatients records, prescriptions without pricing for paraclinic outpatients records and prescriptions without physician sign and stamp were for pharmacy outpatients’ records. Discussion and Conclusion:  Discussion and Conclusion:  According to the results, the need to hire a resident physician, taking less extra work, having shift works with proper intervals, informing and teaching the staff for solving the problems and reviewing insurance records on a regular basis to avoid accumulation of records, encouraging and educating the staff, labor division and the maximum cooperation of the staff is felt to decrease pharmacy and paraclinics deductibles.

کلیدواژه ها:

Deductions ، insurance ، hospital ، problem solving ، کسورات ، بیمه ، بیمارستان ، حل مساله