@article { author = {Ershad Sarabi, Roghayeh and Shahsavari, Soodeh and Mohammadi, Ali}, title = {The Impact of the Clinical Miscoding on Inpatient Reimbursement}, journal = {Journal of Kerman University of Medical Sciences}, volume = {27}, number = {2}, pages = {169-176}, year = {2020}, publisher = {Kerman University of Medical Sciences}, issn = {1023-9510}, eissn = {2008-2843}, doi = {10.22062/jkmu.2020.90620}, abstract = {Background: The purpose of this study was to investigate the rate of coding errors and its effect on the amount of correct reimbursement to patients. Methods: This descriptive and cross-sectional study was performed in 2018. Research resources were records in compensation units in medical documents center of social security organization. A total of 546 records were reviewed of which, 118 records met the research criteria and were selected through census method. Instrument for data collection was a checklist composed of six parts. Data were collected by compensation unit coders. Results: In total, 118 records met the inclusion criteria. The highest rate of documentation error was related to unconfirmed errors with 106 items and a coefficient of 3845.44. The cost issued to patients based on tariff codes with a coefficient of 9696.4 was estimated as 3684632000 Rials, which only 2416154000 Rials was reimbursed to the patients with the coefficient of 6358.3. Conclusion: Since coding of diagnostic measures had a high percentage of errors, and the recording of services was not accepted, some proper policies must be adopted to reduce procedure miscoding.    }, keywords = {Coding,Miscoding,Tariffs,Patient reimbursement}, url = {https://jkmu.kmu.ac.ir/article_90620.html}, eprint = {https://jkmu.kmu.ac.ir/article_90620_08cf41c16ed011fce9a47a3627b846f2.pdf} }