Evaluación del proceso de facturación de los servicios de salud de Clínica Santamaría CLISANTA S.A. para la creación del departamento de auditoría médica.

Abstract

The purpose of this project is to improve the processes of preparing medical records of Hospital Clinic Santamaría for the creation of the Department of Medical Audit that allows reducing the percentage of glosses presented in the institution. Due to the characteristics of the study, the deductive methodology was determined with a qualitative approach, where data analysis was used as a tool, whose data collection allowed to know that Clinical Santamaría Clisanta S.A has come strong economic sanctions ranging between $ 528,198.50 and $ 1,388,194.27, which represents a severe punishment for non-compliance with internal procedures in accordance with current regulations. Finally, and based on the results of the study, the proposal of "Creation of the Medical Audit Department" is presented, where the technical, administrative, and financial study was detailed in depth. Where the incremental cash flows were built which evidenced the viability of the project having an average saving of $34000 to $41000 and a Positive NPV of $2,835,229.40 and an IRR of 62% and a profitability greater than that required given that having the review of the audits would reduce the errors of the medical records and that they are not observed by the regulatory entities thus achieving that it is not possible to not be financial sanction to the hospital entity