Methods of Healthcare Reporting

Garant předmětu:

Lecturer:

Tutor:

Supervisor:

Department of Health Care Disciplines and Population Protection

Synopsis:

Get familiar with basic principles of a general system for health care coverage.

System of health care coverage in the Czech Republic.

Legislation on health care coverage in the Czech Republic.

Means of regulation of health care coverage.

Methods for health care reporting.

IT systems supporting health care reporting.

Performance coverage, lump-sum payments, capitalization payments, payments for diagnosis.

Cost record and coverage of especially high-priced items.

Prescription of pharmaceuticals and medical devices, and their coverage. Means of data transfer to health insurance companies.

Auditing health care coverage; inspectors in health insurance companies.

Health insurance companies in the Czech Republic.

System of regressive refunds.

Health documentation.

Requirements:

credit, examination:

Written test with 20 questions, 50% credit for correct answers, for exam 70-100%.

caution: intervals between repeated examinations must not be shorter than seven days.

Syllabus of lectures:

1st week - Introduction, getting to know the problem area, specifications of the topic, health care coverage systems

2nd week - .Health care coverage system in the Czech Republic, health insurance companies, enforceable laws

3rd week - System for performance-related health care coverage, flat-rate payment systems

4th week - Payment for diagnosis system (DRG)

5th week - Methodics for health care reporting

6th week - Systems of data capturing for health care reporting in medical care facilities

7th week - IT systems supporting health care reporting

8th week - Contractual relations with health insurance companies

9th week - Management of medical documentation in view of health care reporting

10th week - Inspection activities of the health insurance companies

11th week - Regression procedure, reporting, responsibility

12th week - List of performances, its amendments, conciliation procedure

13th week - Health care reporting in various segments

Conclusion - summary of the topic

Syllabus of tutorials:

N/A

Study Objective:

Pass knowledge basics of

- health care payment system

- health insurance system in the Czech Republic

- relationships with health insurance companies

- health care reporting

Study materials:

Standing procedures in creating and handling with VZP documents - www.VZP.cz

Act on Health insurance in the Czech Republic, as amended

Definition manual DRG , DRG alfa ( NRC)

Current procedures in reporting of health care

List of medical performances in force,

Cost sheets of medical performances

Note:

Further information:

No time-table has been prepared for this course

The course is a part of the following study plans:

• Biomedical Informatics - combined study (compulsory course)