International Journal of Research in Medical Sciences | May 2018 | Vol 6 | Issue 5 Page 1726 International Journal of Research in Medical Sciences Garg R et al. Int J Res Med Sci. 2018 May;6(5):1726-1729 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Original Research Article Case study on reimbursement process and settlement of bills of patients treated under package charges in super speciality public hospital Ruchi Garg 1 *, Neeraj Garg 2 , Abhinav Wankar 3 , I. B. Singh 4 INTRODUCTION The tertiary care super specialty hospital in north India was established in 1956. Fifty-two departments and seven super-speciality centres manage practically all types of disease conditions with support from pre-clinical and para clinical services. In this public hospital, because of constraints of resources, patients are often asked to buy certain items required for their treatment procedure. Such demands from the hospital, which can be at odd hours, depending on the treatment causes great inconvenience to the patients or their attendants. Various feedback reports received from the patients treated at this hospital have suggested that the hospital should provide the items required for the treatment, and the money for it can be collected by the hospital from the patient in advance. This tertiary care hospital is the premier medical institution in the country, has been quick to understand the requirement of user charges for medical treatment. Recovery of user charges as package charges has been in operation at the cardio thoracic centre since 1995. 1-2 Prior to this, the system was functioning as a patient revolving fund in which the patient has to deposit some money at the of admission which is based on assumed expenditure for his treatment. Adjustments were made at the time of discharge. Detailed accounts had to be maintained for each of the items of the treatment procedure resulting in cumbersome accounting. The package service now 1 Department of Health and Hospital Management, IIHMR University, Jaipur, Rajasthan, India 2 Command Project Officer, Head Quarter South West Command, Ministry of Defence, Government of India, India 3 Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India 4 Additional Medical Superintendent, Cardio Thoracic Neurosciences Centre, Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India Received: 03 March 2018 Accepted: 03 April 2018 *Correspondence: Dr. Ruchi Garg, E-mail: gargruchi2000@yahoo.in Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: In the Government hospitals, because of constraints of resources, patients are often asked to buy certain items required for their treatment procedure. There is an inadvertent delay in bill reimbursement process due to the cumbersome procedure, which causes dissatisfaction among patients. Thus, it was highly imperative to reduce the reimbursement time and improve the level of patient satisfaction by improving quality of services. The present study depicts modifications initiated to reduce causes of delay and improve patient satisfaction. Methods: Process mapping was done for different procedures which are carried out under package system at Cardio Neuroscience Centre. All the available documents were analysed from Operation theatre, Wards, ICU, Billing section, Account office, OPD area etc. and Interviews were taken from consultants, nursing staff, staff working at Billing section, Account office etc. to identify causes of delay. Results: The study helped in improvement in efficiency by 60% percent and reduces the number of resources by 10 percent. Conclusions: The study helped to increase productivity gains and improve accuracy. Keywords: Account section, Billing, Delay, Process mapping, Patient satisfaction, Reimbursement DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20181767