Establecimiento de procesos en auditoría médico financiera en el Hospital Militar Básico Loja para mejorar el relacionamiento con instituciones de la red pública integral de salud de la Zonal de Salud No 7 en cumplimiento a las modificaciones a la norma de relacionamiento para la atención de pacientes y reconocimiento económico por prestación de servicios de salud emitida por el Ministerio de Salud Pública del Ecuador
The Basic Military Hospital Loja, in forming the Integral Public Health Network as a service of a Basic Hospital, its operation and interrelation with the different subsystems is based on the compliance with the principles contained in the norm of relationship and its related norms, this guarantees...
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| Tipo de recurso: | tesis de maestría |
| Estado: | Versión publicada |
| Fecha de publicación: | 2017 |
| País: | Ecuador |
| Institución: | Universidad de las Américas |
| Repositorio: | Repositorio Universidad de las Américas |
| Idioma: | español |
| OAI Identifier: | oai:dspace.udla.edu.ec:33000/8162 |
| Acceso en línea: | http://dspace.udla.edu.ec/handle/33000/8162 |
| Access Level: | acceso abierto |
| Palabra clave: | AUDITORIA ADMINISTRATIVA CONTROL DE CALIDAD SERVICIO AL CLIENTE |
| Sumario: | The Basic Military Hospital Loja, in forming the Integral Public Health Network as a service of a Basic Hospital, its operation and interrelation with the different subsystems is based on the compliance with the principles contained in the norm of relationship and its related norms, this guarantees the economic recognition by the medical attentions to patients of the different subsystems. The main motivation of the present work are the errors found in the personnel responsible for generating information, gathering information, applying tariffs and sending medical documents for medical attention, as well as the inefficient handling of existing accounts information Receivable generated through documentary audit, medical relevance and financial concordance of the services rendered to the different subsystems in previous administrations. Added to this is the lack of communication with the subsystems regarding information on the payment status of accounts. The processes implemented follow a logical method and must be characterized as ordered, systematic and consistent; aimed at reducing all errors presented during previous procedures as well as establishing guidelines to be taken into account in the future by the personnel responsible for Medical Audit, in order to have processes approved by the Hospital Management, which are clear, easy to apply , adapted to current regulations, which are measurable in indicators and of measurable results, these processes will be constituted in guiding technologies for future administrations with the possibility that this information will be collected in a Process Manual and extrapolated to other Military Hospitals of Secondary level. In order to objectively understand the real institutional needs of the Medical Audit area and give it an adequate focus during the development of these processes, the identification of the main problems and the definition of clear objectives, as well as the description of the different factors in the deficient recovery of values, it is so that the ignorance of new legal, political and regulatory measures that govern the process of billing and economic recognition, economic factors (lack of monitoring of amounts receivable), factors (lack of value recovery that prevents reinvestment in new administrative technologies that help the collection process) and social factors (lack of collaboration of users to provide access to payment documents, lack of knowledge on the part of the responsible staff, Lack of team communication and between dependencies). It is proposed to survey and establish processes as a viable tool to efficiently formalize the logical order in which these activities are performed in the area of Medical Audit and related areas, based on the empirical training of the personnel responsible for these procedures ; This measure will represent an important point in the continuous and dynamic acquisition of knowledge of the work team responsible for the different activities in the Medical Audit area of the Loja Basic Military Hospital. |
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