Domin Cododikar Kula da Kula da Kuɗi da Lissafin Kuɗi, Darasi mai kyau ya zama Mahimmanci ga Success
Cibiyoyin kula da kiwon lafiya sune masana'antun da aka tsara, da kyakkyawan dalili, yayin da miliyoyin rayuka suke tasiri akan ingancin kiwon lafiya da aka ba marasa lafiya a fadin kasar. Duk da haka, yana yiwuwa a iya sarrafa tsarin masana'antu sosai ? Ta yaya kara yawan matsalolin sababbin ka'idodin, sababbin hanyoyin, da kuma ka'idoji masu tsabta sun shafi miliyoyin likitocin kiwon lafiya waɗanda suka hada da ma'aikatan kiwon lafiya?
Wasu nazarin suna nuna cewa za a iya sarrafa tsarin kula da lafiyar jiki, ko a kalla ma an tsara shi don ma'aikatan kiwon lafiya da yawa su ci gaba ba tare da matakan damuwa da kurakurai ba. Ci gaba da ci gaba da sauye-sauye a ka'idojin kiwon lafiya ya ci gaba da ƙara lalata kayan aiki, ya haifar da damuwa ga ma'aikatan kiwon lafiya, har ma suna jin cewa an lalata su kuma a cire su daga ma'aikata, abin da ya sa basu ji daɗin tallafawa da kayan aikin da za su yi aiki sosai . A gaskiya ma, asibitoci a Amurka na iya faruwa a wani rikici, tare da kashi 56 cikin dari na ma'aikata suna jin wannan hanya, bisa ga binciken da CultureIQ ya yi a 2017, mai suna "Haɗin kai da kuma riƙewa a ma'aikatan kiwon lafiya."
Coding Canje-canje
Ɗaya daga cikin kwanan nan, kuma babbar canji a tsarin kiwon lafiyar shi ne sabon tsarin coding ICD-10, wanda ya maye gurbin ICD-9 a watan Oktobar 2015.
Sabuwar tsarin haɓaka kusan quadrupled ƙara yawan lambobin bincike daga 14,000 zuwa 68,000, yayin da ka'idodin ka'idoji suka tashi fiye da kashi 2,000, daga 4,000 zuwa 87,000 lambobin. Wannan ya haifar da karuwar 69 cikin adadin lokacin da ake aiwatar da takardun magani na likita (minti 17 a kan ICD-10, vs. minti 5 na coding akan ICD-9).
Ƙayyadaddun lambobin ICD-10 ya haifar da rashin fahimta kalmomin a wurin aiki, haifar da kuskure, aiki, da kuma iyakance lokaci don kammala tsarin lissafin kuɗi . Wannan ya haifar da raguwa a cikin reimbursements, da karuwa a halin kaka, likitocin kudi, dukkansu yayin da rage yawan ingancin kulawa da haƙuri, in ji David Womack, shugaban da Shugaba na Cibiyar Gudanarwa na Kasuwancin (PMI), wanda ke bayar da ilimi da horo ga ma'aikatan kiwon lafiya a asibitocin, jihohin kiwon lafiya, da kuma cibiyoyin ilimi a duk fadin duniya.
Kodayake aiwatar da yarjejeniyar ICD-10 da aka kaddamar da shi, ƙaddamar da ƙaddamar da sababbin bayanai zai iya samun kishiyar hakan , in ji Womack.
Bisa ga kwarewarsa a cikin aikin horo na ma'aikatan kiwon lafiya, Womack ya ce rahotannin ma'aikatan da aka ba da izini sun kasance sakamakon wannan tsari, tare da rashin horo. Per Womack, irin wannan ƙwarewar bayanai ba tare da horarwa ba zai iya zama babban haɗari ga masana'antun kiwon lafiya - haɗarin haɗari ga masana'antun da ke fama da kurakurai .
Rashin kuskure yana da tsada ga masana'antun lafiya
Kuskuren ba kawai kudin masana'antu ba ne, da masu daukan ma'aikata, yawancin kudaden kuɗi a cikin reimbursements.
Kuskuren yana darajar lokaci mai mahimmanci, da inganci-kai tsaye na lafiyar lafiya.
Lokacin da aka buga ma'aikata da abubuwa da yawa da zarar ba su fahimta ba, sun shiga cikin rashin tausayi kuma suna tunatarwa - sakamakon rashin kuskure, kurakurai, da rashin fahimta.
Har zuwa kashi 80 cikin dukkan takardun kudi na likita sun hada da kuskuren, suna kashe dala biliyan 68 a asibiti . Cikin haɗakar da sababbin bayanai, Womack ya ce hadarin kurakurai yana ƙaruwa sau goma.
Me ya sa ake samun irin wadannan kuskuren lissafin kuɗi? "An lura da wa] anda ke biyan ku] a] e," in ji Womack. "Masu ba da lamuni na gwamnati da masu kula da gwamnati suna bincikar da'awar da suka dace game da daidaito.
Lokacin da aka samo matsalolin, an hana ikirarin, kuma kudaden sun ɓace. "
Menene Magani? Yadda za a Shirya, Haɗawa ma'aikatan Gyara Sabon Dokokin
Ƙungiyar kiwon lafiya za ta iya zama daɗaɗɗa a cikin gaba. Sabili da haka, a cewar Womack, kyakkyawan halayen, horo na ma'aikata yana da mahimmanci ga ci gaba da haɗin kai, tsunduma cikin ƙungiya kuma ya rage girman kurakurai.
"Kamfanin dillancin labarai na Womack ya ce" ma'aikata masu aiki ne ma'aikata masu horo. " "Coding da ma'aikatan da aka ba da kyauta tare da horo na dacewa suna taimakawa wajen magance matsalar ta hanyar tsabta, mai inganci [asibiti na kiwon lafiya] ya ce."
Nazarin ya nuna cewa kungiyoyin kiwon lafiya da ma'aikata masu tsauraran ra'ayi sunyi nasara a kan kare lafiyar, ingancin, da kuma matakan da suka shafi haƙuri, suna tasiri sosai ga sakamakon kudi.
Womack ya kara da cewa kamfanonin suna ba da takardun sana'a a tsarin likitanci, ƙididdigar wasu, gudanar da ofis, da kuma biyan kuɗi, suna taimakawa wajen kafa ƙwararren aiki ta hanyar samar da ilimi da gwadawa na yau da kullum don tabbatar da cikakkiyar fahimtar kowa. Sakamakon haka shine likitoci na iya mayar da hankalinsu kawai ga kulawa da haƙuri, fassarawa zuwa mafi kwarewa ga mai haƙuri, duk yayin tabbatar da cewa aikin ya ci gaba da ci nasara.
Bugu da ƙari kuma, Womack ya gargadi kan karɓar masu ba da izini na likitoci da 'yan kasuwa. "Daya daga cikin manyan matsalolin yin amfani da coders ba a samo ba ne idan masu kula da kiwon lafiya sun sami matsalolin da suka haifar da dawo da kudaden kuɗi don abubuwa kamar cajin kudi don ayyukan da ba a sanya su ba, ba tare da dalili ba, haɓakawa, da dai sauransu. A ƙarshe, likita na da alhakin sanya hannu akan duk da'awar, amma ma'aikatan zasu iya ba da alhakin aikata ayyukan biyan kuɗi, idan sun san da'awar ƙarya. "
Shin lissafin kuɗi daidai ne da kuma ƙidayar tarihin kalubale ga ayyukan likita? Haka ne, in ji Womack. "Mahimmancin tsari na tsabar kudi shine ainihin abin damuwa, Womack ya ce. "Yin gwagwarmaya don daloli [wa] don yin aiki na iya zama mahimmanci a wasu lokuta a kan magance yanayin likita don tabbatar da ci gaba da aikin likita. Coders da basu dace horo ba da makamashi ga wuta, "in ji shi.
Ba wai kawai iya samun horarwa ga likitoci da likitocin likitoci na tasiri na asibiti na likita ba, kuma yana iya tasiri da yawancin aikin da ake yi. "Kwararru masu horarwa da 'yan kasuwa nagari suna iya inganta yawancin aikin ta hanyar samun damar shiga kuɗi da aka rasa kuma suna biyan kuɗi don kowace dollar da aka yi daidai. Ma'aikatan da aka horar da su sun inganta aiki, ƙananan kurakurai da [mafi girma].
> Sources:
> "Haɗin kai da kuma riƙewa a ma'aikatan kiwon lafiya." CultureIQ. Menene Al'adu? CultureIQ., Nd
> "ICD-10 Aikace-aikace da Fursunoni." MedLink. Np, 20 Janairu 2016
> "Hanyoyin Cutar Ba daidai ba Cutar da Core Data Used by Health Care Facilities, yana da sakamako masu ma'ana a cikin dukan kiwon lafiya Industry." Ƙungiyar kula da lafiya ta haɗin gwiwa. Np, n
> Jensen D, Ward E da Starbuck L. "Shekaru Daga baya: Hanyoyin Imel na ICD-10 kan Gudanar da Harkokin Kasuwanci." Gudanar da Sashin Lafiya. Np, 21 Dec. 2016.
> "Mahimmanci zuwa Ƙaƙidar Ƙaƙwalwar Kasuwanci, Ayyukan Gudanar da Harkokin Kasuwanci a Kamfanin Gudanar da Ayyuka, Cibiyar Ganey Research ta nuna." Asusun lafiya na Lafiya. Np, n