手术收费管理常见问题及对策

Problems and Countermeasures of Surgery Charge Management

目的通过优化收费流程及智能辅助工具的建立,更好地规范医疗收费行为,提高医疗服务的满意度。方法运用闭环管理的理念,实行手术收费三方核查(保存者、记账者、核查者)的方法,并借助“手术收费提醒框”智能工具,对手术收费流程进行优化。结果收费流程优化后,每月医保主管部门审核反馈的医保违规扣罚金额平均下降了27.2%;手术室收费相关投诉实现零投诉。结论精准多样化培训、强化工作职责、优化收费流程、收费问题实时监控及行之有效的沟通协作是手术收费管理的必要手段。

Objective To regulate medical charging and improve the satisfaction with medical services by optimizing the charging process and establishing intelligent auxiliary tools.Methods The concept of closed-loop management was used to implement tripartite verification(depositor,bookkeeper and verifier)of surgical fees,and the"urgery fee reminder box"was used to optimize the procedure of surgery charging.Results After the optimization of the charging process,the average amount of penalty for medical insurance violations reported by the administrative department of medical insurance decreased by 27.2%.Complaints related to operating room charges reduced to zero.Conclusion Precise and diversified training,strengthened work responsibilities,optimized charging process,real-time monitoring of charging problems and effective communication and cooperation are the necessary means of surgery fee management.