Javad Zarei; Amir Abbas Azizi; Khosro Keshavarz; Elham Seyavashi
Abstract
Introduction: Every year, the considerable amounts of hospital income are deducted by the insurance organizations as deductions. The aim of this study was to survey the deductions applied by medical services and social security insurances organizations on bills of teaching hospitals affiliated to Ahvaz ...
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Introduction: Every year, the considerable amounts of hospital income are deducted by the insurance organizations as deductions. The aim of this study was to survey the deductions applied by medical services and social security insurances organizations on bills of teaching hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences. Methods: This is cross-sectional study which was conducted in 2009-2010. All of the bills sent by five teaching hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences, to medical services and social security insurance organizations in years 2008-2009 were studied. Instrument for data gathering was checklists designed according to the bills sent to insurance organization. The Checklist validity was confirmed by expert's opinions. Data analyzed by using descriptive statistics in SPSS software. Results: The total deduction for outpatient and inpatient bills applied by Medical Services Insurance organization was 6.62 %. The total deduction for outpatient and inpatient bills applied by Social Security Insurance was 4.9%. In comparison, the deductions of inpatient hospital bills were more than outpatient hospital bills (6.99% to 3.36%). Conclusion: Results showed that although small percentage of accounts involves deductions but the low amount of this deduction had significant financial imposes to hospitals. Thus, planning to reduce deductions is recommended by the Universities of Medical Sciences. Keywords: Insurance; Social Security; Health Services; Hospitals
