Reestructuración del modelo de facturación en salud para una IPS de servicios domiciliarios en Colombia Thesis

short description

  • Master's thesis

Thesis author

  • González Jiménez, Sandra Milena
  • Novoa Vargas, Ricardo Alberto

external tutor

  • Gonzalez-Rodriguez, Javier-Leonardo
  • Pardo Martínez, Clara Inés

abstract

  • Taking into account that the health social security system in Colombia defines that all health entities must be independent, autonomous and have growth and sustainability from the sale of their services, as described in Law 100 of 1993, the aim is then to generate a billing model for the sale of services supported by regulations that maintains the continuous flow of the portfolio. Based on the specifications of this theoretical model, a behavior of the billing process for health services towards the development of the accounts audit processes has been evidenced. It is then wanted to review the problems of a particular entity of the health system and propose an alternative solution. To do this, we started with the review of some invoices generated in the last quarter of 2019, the results of which showed 43% of billing errors, of which 24% can subsequently be corrected; but there is an 18% that is caused by errors in billing secondary to the policy established in the institution to settle the account on medical orders and there is another 1% generated by unclear fees. Therefore, the aim is to improve the billing process by establishing guidelines and steps necessary to optimize this area in a home service IPS, which will generate a secondary impact that is to perform in an agile, timely, complete, clear and correct way the settlement of the accounts of each of the users of the entity providing health services, in order to collect the value of the services provided and, in this way, guarantee the income that allows the survival, growth and development of the entity.

publication date

  • December 2, 2020 5:13 AM

keywords

  • Billing model
  • Health portfolio
  • Home health services
  • IPS (Health Provider Institute)
  • Process optimization

Document Id

  • acaed751-f88b-413a-9cbb-0b2f6f0fcef1