Racine Vergara, FabiánMartínez Cogollo, Luis Enrique2020-11-202020-11-202020-11-20https://repositorio.unicordoba.edu.co/handle/ucordoba/3682The medical accounts audit process improves the billing process through the performance of technical, evaluative and preventive procedures, basing its activities on the components of structure, process and result, constituting within the process, the clinical record or the medical history the cornerstone. In addition, its responsibility to issue corrective measures or continuous improvements aimed at quality of care is established, all in order that the entity responsible for payment does not find any flaw when performing the external audit of the account and thus carry out the respective payment of care. Thus, the audit is conceived as the expert analysis and systematic evaluation of the billing of the health services provided by the IPS, carried out by the Medical Auditors with the fundamental objective of identifying and solving deviations in the billing process and the relationship between The different actors in the health system have as their starting point the agreements established between the Benefit Plan Management Entities (EAPB) and the IPS. The audit of medical accounts observes the need for EPS and IPS to integrate the health care process with the invoices that demonstrate their collection. This activity manages to interrelate the validation of: the provision of services, application of the scientific knowledge of professionals, the use of diagnostic and therapeutic aids and the real costs of the services billed, among others. The objective of this research is to evaluate the audit of medical accounts as a fundamental axis for the good process of billing in health, identifying the generalities of the audit of medical accounts to avoid glosses or returns by the entities responsible for payment, in turn medical account protocols are verified for detailed review before being filed with the entity in charge of payment and finally the billing process in the entities providing health services is explainedINTRODUCCIÓN...........................................................................................111. GENERALIDADES DE AUDITORÍA Y FACTURACIÒN....................................141.1. ANTECEDENTES DE LA AUDITORÍA Y FACTURACIÓN EN SALUD...........141.2. CONCEPTOS BÁSICOS DEL PROCESO DE AUDITORÍA............................161.2.1. Clasificación de la auditoría........................................................171.2.2. Objetivo del proceso de auditoría................................................................181.3. CONCEPTOS DEL PROCESO DE FACTURACIÓN ......................................191.3.1. Objetivos del proceso de facturación. .........................................................192. ASPECTOS NORMATIVOS Y TEÓRICOS EN AUDITORÍA Y FACTURACIÓN EN SALUD..........................................................212.1. NORMATIVIDAD FACTURACIÓN EN SALUD ...............................................212.2. ASPECTOS TEÓRICOS EN AUDITORÍA Y FACTURACIÓN EN SALUD.....................................243. PROCESO DE AUDITORÍA Y FACTURACIÓN EN LAS IPS................................................283.1.INSUMOS Y PRODUCTOS DEL PROCESO DE FACTURACIÓN ................................................313.2. INSUMOS Y PRODUCTOS DEL PROCESO DE AUDITORÍA DE CUENTAS MÉDICAS .................................................................334. DISCUSIÓN...............................................................................345. CONCLUSIONES................................................................37REFERENCIAS BIBLIOGRÁFICAS...........................................39application/pdfspaCopyright Universidad de Córdoba, 2020Trabajo de grado - Pregradoinfo:eu-repo/semantics/restrictedAccessAtribución-No Comercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)Facturación en saludCuentas médicasGlosasAuditoríaHealth billingMedical billsGlossesAudit