| Objective: The current study aims to provide valid information about
the causes and types of hospital deduction records via a systematic
review.
Method: This systematic review was performed by searching the
databases including PubMed, Scopus, Science Direct, Ovid, Medline,
Cochrane, ProQuest, and IranMedex, Magiran, Sid, and Medlib
databases for studies without time limitation. Updates were added
to the searches during the study. Search strategies included the
combination of keywords including “Billing error” OR “Deductive” OR
“Error payment” OR “Insurance claim” OR “Medical claim” OR “Improper
payment” OR “Insurance reimbursement” OR “Medical payment” OR
“payment error” with “Hospital” and “medical records”. The reference
lists of each article were manually searched to find additional
relevant articles. All records without time limitation, those written
in Persian and English, and the ones investigating the types and
causes of deductions in hospital inpatient bills records were included.
To determine the eligible records, two authors extracted the data
independently; and discrepancies were resolved through discussion or,
if required, through consultation with a third author. The quality of the
articles was analyzed using STROBE checklist.
Results: The search strategy yielded 1,264 records from electronic
databases, and 15 records were identified by the manual search. After
removing the duplicates and screening the database by titles and
abstracts, 39 of these records remained. The full text of these 39 records
was checked and, finally, 22 of them met inclusion criteria. The major
causes of deductions in the documentation included human errors,
incomplete document registration, documentation errors, added
prices, added request, and calculation errors.
Conclusions: Education and cooperation of staff and collaboration of
all stakeholders such as hospitals, insurance organizations, and related
staff in this field are necessary for conducting a substantial action to
reduce hospital deduction. |