Propuesta de mejoramiento del proceso de facturación de servicios de salud en la Clínica de Ortopedia y Fracturas TRAUMEDICAL S.A.S.

Abstract

This manuscript analyses the structuring of the health services billing process provided by the Orthopedics and Fractures Clinic TRAUMEDICAL S.A.S, considering that the company’s financial support, is dependent on its liquidity, and profitability, as well as the decision-making for the implementation of projects for their growth, provision of new health services, and advancement to another level of complexity within the Health System in Colombia. Initially, there is a diagnosis of the billing process, with its development and results. Then, applying the Business Process Management (BPM) analysis tool, as the methodology that allows the optimization of business processes, and through the contextualization of the main problems that influence the obtaining of a final product, that in this case is called a sales invoice, a redesign of the current billing process is proposed. This redesign contemplates changes in the execution of critical procedures that contribute to minimizing, especially, the financial risks that arise when the invoice has errors in its elaboration, generating objections represented in glosses or returns detected in the audit processes carried out by the ones responsible for the payment, be it the Health Services Provider Company (EPS) or insurance company, in cases of traffic accidents, occupational accidents in among others.