Modelagem do processo de faturamento de convênio em uma clínica terapêutica com foco na diminuição de glosa
Developing a process strategy that enables therapeutic clinics to thrive in an unstable and highly competitive context requires the utilization of innovative management methodologies to address specific challenges, such as the billing process. Amidst a complex landscape of agreements and regulati...
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| Formato: | bachelorThesis |
| Idioma: | pt_BR |
| Publicado em: |
Universidade Federal do Rio Grande do Norte
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| Assuntos: | |
| Endereço do item: | https://repositorio.ufrn.br/handle/123456789/53660 |
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| Resumo: | Developing a process strategy that enables therapeutic clinics to thrive in an unstable
and highly competitive context requires the utilization of innovative management
methodologies to address specific challenges, such as the billing process. Amidst a
complex landscape of agreements and regulations, it is essential to adopt agile
approaches that allow for rapid implementation, evaluation, and improvement of
solutions. The research was conducted in six stages: work planning, data collection,
data analysis, execution, monitoring, and results evaluation. In the work planning
stage, specific objectives and goals were established for the billing process
improvement project. Afterwards, the data collection phase was conducted to obtain
information about the existing billing process, identifying the main causes of
disallowance and process bottlenecks. Data analysis provided a deep understanding
of the identified problems, highlighting critical areas and improvement opportunities.
Based on this analysis, specific actions were planned to eliminate disallowance,
including procedure review, team training, and implementation of suitable
technologies. After implementing the planned actions, the insurance billing process
was closely monitored to assess the effectiveness of the improvements. Regular
measurements and analysis of the obtained results were conducted, with a focus on
reducing disallowance. The results obtained were highly satisfactory. Through the
implementation of billing process improvements, the clinic successfully achieved the
set target for disallowance reduction. This resulted in a significant increase in
operational efficiency as previously withheld financial resources could be effectively
received. In conclusion, the process improvement carried out at the therapeutic clinic
in Natal/RN yielded positive results. |
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