Verification of medical records for inpatients
The theme of the 9-year-old inpatient documentation unit was different from other hospital types in 1993 due to the financial nature of the activities and based on the organizational changes, and it continued to operate as a subgroup under the name of the financial management unit.
The basis of this unit’s operation is the preparation of financial and medical documents required to be sent to 3 main insurance companies for medical services, social insurance and the armed forces and 30 different supplementary insurance companies, which includes the preparation and submission of 5000 different documents per month to enable the hospital to deliver all clinical and medical procedures to thousands of patients who are admitted. To the internal parties, to the financial demands of large riyals, to the mentioned insurance companies.
This unit interacts with 3 financial, licensing and information technology units in the hospital to modify, continue and remove defects in documents in order to reduce the financial deficit, and indirectly with all units and types of treatment, clinics and supplementary clinics belonging to the prestigious nursing service office.
In order to protect and defend the rights of the hospital, doctors and dear patients, this unit is committed to the immediate implementation of the changes mentioned in all current documents in the event of any documentary and financial changes in the contracts and transactions of the Cabinet or the Ministry of Health: this requires continuous efforts and close cooperation with the various units. Inside and outside the organization.
Validation type of medical records for outpatients
This unit was established, formed and started working in 1985.
This unit is located on the 1st floor of the 2nd phase of the hospital and includes inpatient and outpatient medical documents, the working process of each part is briefly as follows.
The establishment of this unit and the beginning of the operation in 1985.
This unit is located on the 1st floor of the 2nd section of the hospital and includes medical records for inpatients and outpatients.
The services provided by this department include the following:
1- Preparation and arrangement of contracts for outpatient clinics (all clinical units, laboratories, imaging, nuclear medicine, radiation therapy, and comprehensive clinics), insurance (health insurance, social security, armed forces, banks, and other insurances) on how to perform treatment services for patients and how to pay the costs before the insurance institution and patients.
2- Prepare, arrange and sign contracts of hospital doctors with insurance boards
3- Studying the definitions of health care and following up how to adapt it in the HIS system according to the current instructions and contracts.
4- Receiving instructions and notifications from the Deputy Director of Treatment and Insurance Institutions regarding how to provide services and accept patients, and informing and justifying instructions for all cases of admission to outpatient clinics, including clinical clinics and comprehensive clinics.
5-Coordinating the collection and preparation of documents and copies of foreign hospitals, and then estimating the value of these documents in riyals, which averages about 29,000 documents per month, and sending them to insurance institutions and requesting large sums from contracted organizations.
6- Following up on the required amounts from the insurance companies and following up on the deducted amounts, which are called the medical records, and providing documents to return the deducted amounts to the hospital.
7. Answering patients’ questions and problems at reception