Reestructuración del modelo de facturación en salud para una IPS de servicios domiciliarios en Colombia
Restructuring of the health billing model for an IPS of home services in Colombia
Abstract (en)
Taking into account that the social security system in health in Colombia defines that all health entities must be independent, autonomous and have growth and sustainability from the sale of their services, as described in Law 100 of 1993, It seeks to generate an optimization of the billing model supported by regulations that maintains the continuous flow of the portfolio. Based on the specifications of the current theoretical model, a behavior of the billing process for health services has been evidenced towards the development of the audit of accounts processes. We then want to review the problems of a particular entity of the health system and propose an alternative solution to build an efficient billing process. Therefore, it is intended to improve the billing process by establishing guidelines and steps necessary for the optimization of this area, in an IPS of home care services for patients with chronic diseases, which will generate a secondary impact that is carried out in an agile way, timely, clear and correct settlement of the accounts of each of the users of the health service provider entity, in order to collect and collect the value of the services provided and, in this way, guarantee the income that the survival, growth and development of the entity.
Abstract (es)
Teniendo en cuenta que el sistema de seguridad social en salud en Colombia define que todas las entidades de salud deben ser independientes, autónomas y tener un crecimiento y sostenimiento a partir de la venta de sus servicios, como está descrito en la Ley 100 de 1993, se busca entonces generar una optimización del modelo de facturación sustentado normativamente que mantenga el flujo continuo de cartera. Con base en las especificaciones del modelo teórico actual se ha mostrado un comportamiento del proceso de facturación de servicios de salud hacia el desarrollo de los procesos de la auditoría de cuentas. Se quiere entonces revisar la problemática de una entidad particular del sistema de salud y proponer una alternativa de solución para construir un proceso de facturación eficiente. Por lo anterior, se pretende mejorar el proceso de facturación estableciendo lineamientos y pasos necesarios para la optimización de esta área, en una IPS de servicios domiciliarios de atención de pacientes con patologías crónicas, lo cual generará un impacto secundario para realizar, de forma ágil, oportuna, clara y correcta, la liquidación de las cuentas de cada uno de los usuarios de la entidad prestadora de servicios de salud, con el fin de cobrar y recaudar el valor de los servicios prestados y, de esta manera, garantizar los ingresos que permitan la supervivencia, crecimiento y desarrollo de la entidad.
References
Accounter. (2009, 10 de junio). Facturación en servicios de salud. https://accounter.co/normatividad/conceptos/facturacion-en-servicios-de-salud.html
Bello, C. A. (2017). Sistema de gestión de calidad para el área de facturación del Hospital Regional de Sogamoso. Universidad Pedagógica y Tecnológica de Colombia. https://repositorio.uptc.edu.co/bitstream/handle/001/2520/TGT-1109.pdf;jsessionid=04AE17B9AED51F9FCE5BEC3A1B7FC8DB?sequence=1
Congreso de la República de Colombia. Ley 1122 del 9 de enero de 2007. El Abedul, Diario Oficial, 1-18. http://www.pos.gov.co/Documents/Archivos/Ley 1122 de 2007.pdf
Hopkins, J. (2010). Chronic Care: Making the Case for Ongoing Care. Health and Robert Wood Johnson Foundation http://www.fightchronicdisease.org/sites/default/files/docs/ChronicCareChartbook_FINAL_0.pdf
Ley 1231 del 17 de julio de 2008.
Ministerio de Salud y Protección Social (Minsalud). Ley 1438 de 2011 (Issue 4).
Minsalud. Decreto 4747 de 2007 (Vol. 2007, Issue Diciembre 7).
Minsalud. Resolución 3047 de 2008.
Oviedo Salcedo, I. T. y Leuro Martínez, M. (2010). Facturación y auditoría de cuentas en salud, 5.a ed. ECOE.
Ruth, Q. (2016). Gestión de glosas para prestadores de servicios de salud. Universidad Sergio Arboleda.
Tobar, F. N. (1998). Modelos de pago en servicios de salud. Cuadernos Médicos, 74.
How to Cite
License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
CIFE Journal is under license Creative Commons Atribución-NoComercial-CompartirIgual 4.0 Internacional (CC BY-NC-SA 4.0)
ASSIGNMENT OF AUTHOR'S PATRIMONIAL RIGHTS
_____________________,adult, identified with citizenship card No. _________ issued in the city of____________,henceforth the Assignor, in my capacity as author of the article __________________________________________________, to be published in thejournal _____________________________,volume____,number _____,year________in physical copies in the institutional portal, website or any known or future means, I express my willingness to give gratuitously the economic rights arising from the aforementioned article, in favor of the University of Santo Tomás, (hereinafter ASSIGNEE) specifically for the Journal_______________________in volume and year mentioned above.
THE ASSIGNOR declares that all contents of the aforementioned works are of his own, which are unpublished, that are not being evaluated by another institution, who has alienated them to third parties, which has no legal or contractual restriction that prohibits you authorize open publication and print media, digital access and make it visible in the databases and indexes where the magazine be indexed; The assignor is willing to go to sanitation by any action claim, plagiarism or other type of claim that might arise in this regard.
For all purposes to which it has place the applicable law in respect of this assignment will be legislation on the rights of prime author in the territory of Colombia as well as international treaties on this matter are accepted and incorporated into national legislation and additional legislation is issued on the matter.
Under this assignment, the assignee is authorized to copy, reproduce, distribute, publish, market the article under the transfer by any digital means, electronic or photocopying, known or unknown, retaining the obligation to respect in any case the author's moral rights contained in Article 30 of law 23 of 1982, law 1450 of 2011 and law 1520 of 2012.
It is signed in acceptance to the____day of ______
