Billing is a set of activities whose purpose is to prepare, record, send and collect through an invoice for the health services provided. This process consists of billing the activities, procedures, supplies and medications performed or provided to each of the patients within the institution providing services, in order to subsequently send the invoice to the insurance company with which the affiliate is listed. The objective of this work is to show the opportunities for improvement in the billing procedure within the Empresa Social del Estado Hospital Sandiego de Cereté in the department of Córdoba. For this purpose, a direct observation of the process from the patient's admission to the presentation of the bill to the paying entity was carried out. The techniques and instruments for the collection of information are a checklist to observe the step-by-step billing process in order to identify opportunities for improvement. The step-by-step procedure was described and opportunities for improvement were identified and recommendations were generated. The written report was delivered to the E.S.E. management.