HOSPITAL REIMBURSEMENT 2

Hospital Reimbursement

Reimbursement is the main source of revenue for healthcare facilities. This is the money
that the facilities receive from third parties such as insurance companies for services offered to
patients. The speed and level of reimbursement is affected by activities in hospital departments.
During check-in, the patient goes through the first procedure which involves recording of
their details by front office who are under the administration department. The staff record not
just demographic information of the patient but also their insurance provider and insurance
policy number (Cleverley & Cleverley, 2017). This activity is important because any error done
at this stage is carried forward to other stages which may lead to the hospital not receiving
reimbursement (Cleverley & Cleverley, 2017). Additionally, it is at this stage that the hospital is
able to establish whether the insurer will pay for the care that the hospital is likely to provide to
the patient.
The next procedure is medical care in the clinical department. Here the patient receives
actual care that brought them to the hospital in the first place. Staff at this department record the
procedures performed on the patient using medical codes. The codes are translations of the
diagnoses and medical procedures that patients receive at this department (Cleverley &Cleverley,
2017). It is important that all information entered at this department is accurate because any
errors or omissions may lead to the healthcare facility not receiving the required reimbursement.
After receiving medical services, the patient checks out. The finance departments starts
billing process which involves checking accuracy of codes, ensuring that the codes are billable,
and making sure that the bill is prepared to specified requirements (Cleverley & Cleverley,
2017). The bill is then sent to the insurer for payment. If there are no issues, the hospital collects
the payment.

HOSPITAL REIMBURSEMENT 3
In conclusion, the three departments discussed here all play an important role in making
sure that the hospital receives the requested reimbursement for services that it provides to
patient. Failure of any one department negatively affects the speed and accuracy of
reimbursement. It is, therefore, to have the departments work together to make sure that the bill
sent to the provider has no error.

HOSPITAL REIMBURSEMENT 4

References

Cleverley, W. O., & Cleverley, J. O. (2017). Essentials of health care finance. Jones & Bartlett
Learning.