Akademik Veri Yönetim Sistemi
Daşdemir E. (Yürütücü)
TÜBİTAK Projesi, 2012 - 2013
Hospital billing process is a crucial
component for hospital management. Due to the complexity of the hospital
billing processes, billing errors may result in costly financial losses. In Turkish
social security system, Social Security Institution (SGK) provides individuals
health insurance and thus it is the most important financer of costs for hospitals.
Furthermore, a billing procedure for hospitals is established by SGK to finance
the healthcare costs of individuals. Hospitals have to obey these rules to
avoid SGK stoppages and fines. In the following, Hacettepe University Hospitals’,
where 95 % of the payments are obtained from the SGK, are studied. Nevertheless, there is a huge amount of
financial losses from SGK because of the errors occurring during billing
process. Here, the aim is to minimize Hacettepe University Hospitals’ financial
losses caused by the billing errors. To realize this aim, Lean Six Sigma framework
and problem solving methods of statistical quality control are used. The
billing process of the hospital is studied first and critical points are
determined. After meetings with the hospital IT personnel and hospital
administration, some important data, including the past billing errors are
retrieved. The main billing errors, their reasons and the financial costs of
the errors are aanlyzed with statistical and graphical tools. To solve the
problems and remove the errors, work flow and standard operating procedures of
the hospital billing process is prepared.