Murat Atalay’s scientific contributions

Hospital billing process is a crucial component for hospital management. Due to the complexity of the hospital billing processes, billing errors may result in costly financial losses. In Turkish social security system, Social Security Institution (SSI) provides health insurance, which ensures maintenance of health statuses of individuals and the financing of costs that arise in case the individuals experience health risks. Accordingly, SSI developed billing procedures for hospitals in financing the healthcare needs of individuals. Hospitals need to comply with the standards set by SSI in order to prevent stoppages and fines in financing their costs. In the following, Hacettepe University Hospitals’, where 95 % of the healthcare service payments are made by the SSI, are studied. Nevertheless, there is a huge amount of financial losses from SSI because of the errors occurring during billing process. Here, the aim is to minimize Hacettepe University Hospitals’ billing errors. To realize this aim, Lean Six Sigma framework and problem solving methods of DMAIC are used. The billing process of the hospital is studied first and critical points are determined. After meetings with the hospital IT personnel and hospital administration, some important data, including the past billing errors are retrieved. The main billing errors, their reasons and the financial costs of the errors are analyzed with statistical and graphical tools. To solve the problems and remove the errors, work flow and standard operating procedures of the hospital billing process is prepared.