The Impact of Education on Reducing Bill Deductions in a Hospital: A Case Study

Insurance companies do not reimburse all patients’ bills if they find any breach in the agreed contract. Implementing the new hospital tariff increased hospitals’ bill deductions. Reducing bills’ deductions increases hospital income. This study aimed to examine the impact of education on reducing bill deductions in a hospital in Tehran, Iran.
This descriptive and cross-sectional study was conducted using the data collected from bills issued by the hospital for social security insured patients in the second half of 2013, 2014, and 2015. Necessary education was delivered to the staff on how to reduce deductions. Data was analyzed using the SPSS software.
The average of deductions in the second half of 2013, 2014, and 2015 were respectively 2.9%, 11.1%, and 7.3%. The average of deductions in these 3 years were 315138 (9.1 US$), 1876417 (54 US$), and 1645237 (47.2 US$) Rials per inpatient and 5437 (0.2 US$), 66797 (1.9 US$), and 55803 (1.6 US$) per outpatient. In 2013 most deductions were applied to surgical and clinical laboratory services and in 2014, most deductions were related to radiotherapy and chemotherapy services. Hospital bill deductions increased by 282.8% after applying the new tariff. However, it has decreased by 34.2% after providing the education.
Bill deduction has increased after applying the new tariff. However, informing the hospital staff about the reasons for bill deductions’ and training them accordingly could reduce it significantly.