The COVID-19 pandemic puts all professional sectors on alert. However, the health sector is certainly one of the most affected, as it is one of the most important sectors in combating the global health crisis.

Nowadays, auditing medical bills is something that must be taken even more into consideration, as financial resources have become even more scarce.

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Auditing medical bills during a pandemic becomes even more important!

Audit procedures aim to check, in detail, all processes related to a given sector. For example, doctors can check documents completed by other healthcare professionals to check for errors or errors in filling out.

In the case of auditing medical bills, all procedures related to the health organization's finances are checked by trained professionals, whether company employees or an outsourced company specialized in the subject.

Health operators, for example, must carry out the disallowance processes correctly and transparently, otherwise they could be turned against due to ANS monitoring. These must be closely analyzed by hospital auditors, since, without correct control and open resources for disallowances, it is possible to lose a lot of money over time.

Every company needs an audit to function properly. Combating fraud, economic waste and reviewing processes are the most effective ways to keep all professional procedures properly aligned, in addition to facilitating the growth of the clinic or hospital.

Auditing medical bills must be carried out in both the public and private healthcare spheres, even though the procedures are quite different. After all, the taxpayer's hard-earned money needs to be well spent, and not the victim of embezzlement. Especially in times as delicate as the pandemic.

All efforts related to correct financial verification within healthcare institutions are due to the accelerated growth of medical technologies, which allow a better quality of life for patients and professionals. It would be impossible to imagine the rapid development of such an important sector without establishing financial precautions.

After all, behind all the cutting-edge technology present in clinics and hospitals, whether public or private, there is a heavy financial investment that must be closely monitored by professionals who understand the subject.

However, you should not think about auditing medical bills only in order to reduce costs, it is about much more than that.

Through the correct audit process, it is possible to optimize all processes within a healthcare unit, making it more efficient and, as a result, patients will have an even better quality of life throughout their treatments.

This is especially important for private units, which compete directly with other renowned institutions around Brazil.

Therefore, once problems or points that can be improved have been notified, it will be possible to suggest strategies for resolution, whether short, medium or long term. The time target may vary, of course, depending on the severity of the problem.

"Read too: Patient or client? Increase profitability by improving service”

What is the appropriate professional profile to take on the role?

The position for auditing medical bills, as well as any other role related to the audit and compliance area, requires a very analytical professional profile, with eyes prepared to discover flaws and non-conformities in the smallest details.

Good audit professionals are ethical people, who have in-depth knowledge of all the company's procedures and, as a result, are able to analyze the entire scenario and suggest cost reductions and improvements so that some sectors operate with greater accuracy and efficiency.

A strong systemic vision, therefore, is one of the most important points for this important professional to perform his role with excellence. It does not give up using technology to its advantage, seeking solutions that facilitate the most critical processes and which are linked to a drop in the operator's accident rate.

Due to this versatile and complete profile, it is necessary to know in depth important details about the legislation and, therefore, suggest improvements and corrections that are based on the country's laws.

All procedures must be based on regulations from the Federal Council of Medicine, the Federal Nursing Council, among other regulatory bodies responsible for other sectors.

Medical bill audit professionals can be called upon to carry out refresher checks with teams to ensure that all procedures are carried out with maximum efficiency. Furthermore, such initiatives reinforce the idea that things will only flow correctly if all procedures are strictly followed.

Therefore, the professional necessary for the correct execution of medical bill auditing goes far beyond simple financial checking and the use of spreadsheets to present economic indicators.

This is work that functions as a kind of compliance department, where transparency is fundamental.

Main problem addressed by the audit

As with any business, there are certain problems that are more common than others. According to Fiocruz, many doctors neglect to correctly fill out their patients' medical records, which can cause several mistakes and headaches during the treatment of illnesses.

Incorrectly filling out medical records reduces trust between healthcare professionals and patients, in addition to potentially compromising treatment. It is worth mentioning that any damage caused to the health professional's morale could be passed on to the institution that hired them, becoming negatively associated with poor service in the past.

It is much more complicated to recover a destroyed reputation than to build one from scratch. Therefore, management and audit work must strive for excellence to avoid situations like this.

Another study, also carried out by Fiocruz, showed that the completion of medical records often leaves something to be desired, both in the public and private spheres (including NGOs). It is worth mentioning that the Federal Council of Medicine requires the correct completion of medical records.

Don't leave your operator out!

It is true to say that, without the correct audit of medical bills, healthcare work is compromised and the quality of patient treatment will be greatly reduced. Therefore, you should not be too careful when selecting trustworthy professionals or companies to deal with this delicate matter.

The management of healthcare providers, if done correctly, can greatly assist the work of hospitals and clinics, avoiding mistakes and headaches. They also need to make use of accurate auditing mechanisms to avoid communication problems with clinics and hospitals.

Your healthcare institution needs the best to survive the crisis. To this end, Saudi has developed a complete medical bill audit system especially for you. Click here and discover the most awarded medical bill audit system in Brazil.