Determining the Amount of Deductions for Inpatient Bills Covered by Social Security Insurances in Amir al Momenin Hospital in Zabol at the First Quarter of 2018

Authors

  • Madahian, Behruz Department of Health Services Management, Isfahan University of Medical Sciences, Esfahan, Iran
  • Alimoradnori, Mohammad Department of Health Services Management, Isfahan University of Medical Sciences, Esfahan, Iran
  • Noura, Neda Department of Health Services Management, Zabol University of Medical Sciences, Zahedan, Iran
  • Zargar Balaye Jame, Sanaz Department of Health Management and Economics, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
Abstract:

Introduction: Most of the hospital’s special revenues are created by contracting with insurance companies and providing services to insured persons. Large amounts of revenues from hospitals and medical education centers are deducted annually. Reducing hospital deductions is not only important due to manage of hospitals, but also it is necessary. Therefore, the current study aimed to determine the amount of deductions for inpatient bills covered by Social Security Insurances in Amir al Momenin hospital in Zabol in the first quarter of 2018. Methods and Materials: This descriptive and cross-sectional study has been performed in 2018. The sample of study was selected through census method. They included all inpatient medical records covered by Social Security Insurances in Amir al Momenin hospital in Zabol in first quarter of 2018. Data were collected through a checklist and they were analyzed by SPSS software version 23. Results: The highest amount of deductions were for consumer goods and second cause of deductions were surgeon’s fees and anesthesiologist’s fees.The lowest amount of deductions were for cost of ultrasound and CT Scan. Discussion and Conclusion: It is possible to reduce the amount of deductions in cases such as requiring physicians to comply with surgical and anesthetic codes, preparing and approving specific tariffs for medicines and medical supplies, monitoring individuals, training individuals to correctly enter patient records And insurance companies to reduce the amount of deductions by specifying insurance coverage.

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Journal title

volume 13  issue 4

pages  35- 42

publication date 2019-03

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