Extended data
Medical refund
Outpatient refund management is an important part of hospital financial management and income internal control. Some hospitals only pay attention to cost management, but the internal control measures in the fee refund link are relatively weak, which makes it easy for criminals to illegally embezzle hospital funds by taking advantage of the loopholes in the fee refund link and increase the financial management risks of hospitals. How to strengthen the management of fee refund and formulate effective control schemes is of great practical significance for saving hospital human resources, improving work efficiency and increasing patient satisfaction. This paper makes a comprehensive analysis of the types of outpatient fee refund in Nantong Maternal and Child Health Hospital from March 2065438 to March 2005, points out the risk points in the process of outpatient fee refund, and puts forward the corresponding prevention and control measures.
First, the status quo of outpatient fee refund
The results showed that there were 3,506 outpatient refunds in March, amounting to 285,363.7 yuan, of which 2,480 were registered refunds, accounting for 70.74%, and the amount was 164 18 yuan, accounting for 5.75%. 273 drug refunds, accounting for 77.9%, amounting to 52,865.9 yuan, accounting for18.53%; 552 inspection fees were returned, accounting for 15.74%, and the amount was 7920 1.4 yuan, accounting for 27.75%; 334 people were refunded for treatment, accounting for 9.53%, and the amount was 28,348.8 yuan, accounting for 99.3%; 247 person-times, accounting for 7.05%, were refunded with the amount of 72 146 yuan, accounting for 25.28%; The material return fee is included in the relevant examination and treatment.
Second, the weakness of outpatient refund
2. 1 The refund system is not perfect.
At present, the design of outpatient fee refund management system is too simple, and the responsibilities and authority of each post involved in the fee refund process are not clearly defined, resulting in unclear responsibilities and vague authority, which can not contain and supervise each other.
2.2 the implementation system is not standardized
The system stipulates that the refund must indicate the reason for the refund, and all refunds must be signed by both parties. Some doctors directly sign the word "refund" on the refund form without understanding or explaining the reasons for the patient's refund, and have no comments on the refund. Only the signature of the pharmacy department has not been examined and signed by the outpatient department, and only the head of the laboratory department has not been signed by the clinician. The specific provisions have not been implemented, which leads to the system process being ineffective.
2.3 backward systems and processes
Nantong Maternal and Child Health Hospital has no outpatient triage system. Patients come to the hospital only by their own medical knowledge, and it is easy to hang the wrong number, resulting in a large number of registration fees being returned. However, on 20 14, the hospital changed the registered receipt from a fixed manual tear receipt to a machine print receipt. After the patient sees the doctor, the registration fee can still be refunded by the charging system. The system did not make corresponding provisions for the new situation, and the HIS system did not take measures to control it.
Third, outpatient refund risk control measures
3. 1 Improve the outpatient refund management system
According to the changes of external environment and the actual situation of the hospital, the risk points of outpatient fee refund are investigated, a strict fee refund management system is formulated, and relevant processes are improved. (1) The system of guiding nurses for fee refund was added to guide and accompany patients to refund fees and reduce patients' dissatisfaction with the hospital. (2) Clarify the responsibilities and signing authority of the relevant personnel of the refund, and the handlers in each link should strictly examine the authenticity and rationality of the refund and sign for approval after confirmation.