{"id":42559,"date":"2022-08-02T10:33:07","date_gmt":"2022-08-02T13:33:07","guid":{"rendered":"https:\/\/cbr.org.br\/?p=42559"},"modified":"2022-11-08T09:44:35","modified_gmt":"2022-11-08T12:44:35","slug":"como-evitar-glosas-nos-servicos-de-radiologia-e-diagnostico-por-imagem","status":"publish","type":"post","link":"https:\/\/cbr.org.br\/en\/como-evitar-glosas-nos-servicos-de-radiologia-e-diagnostico-por-imagem\/","title":{"rendered":"How to avoid glosses in radiology and diagnostic imaging services"},"content":{"rendered":"

Glosses: many managers may be losing money without knowing it. However, measures can be taken to avoid this damage.<\/em><\/p>\n\n\n\n

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Shutterstock<\/em><\/figcaption><\/figure>\n\n\n\n

The greatest risk of financial losses for a clinic is in receivables, because health insurance companies have historically known about the lack of control of clinics in general to control the receipt of each exam. The glosses in supplementary health were 5,92% in 2021, according to data from the National Supplementary Health Agency (ANS). This means that, a clinic that earns, per year, R$ 16 million, loses almost R$ 1 million of net profit in glosses!<\/strong><\/p>\n\n\n\n\n\n

\u201cFor the managing physician, it is difficult to notice the glosses if he does not have a good process, good control. So, the feeling, at first, is to believe that there is no problem with glosses in the clinic. The truth is that we all have a gloss\u201d, said the economic adviser of the Brazilian College of Radiology and Diagnostic Imaging (CBR), Carlos Moura, during his participation in the \u201cEst\u00fadio ABCDI\u201d program that addressed the issue.<\/p>\n\n\n\n

Presented by the director of the Brazilian Association of Radiology and Diagnostic Imaging Clinics (ABCDI), Lu\u00eds Ronan Souza, the \u201cEst\u00fadio ABCDI\u201d with the theme \u201cGlosas Who are they, where do they live and how do they reproduce?\u201d is available on association website<\/a>.<\/p>\n\n\n\n

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\u201cGlosa is not just the Demonstrative of Gloss. Often, when you speak in gloss, the person says that he received a statement and appealed. But we are talking about a whole chain of loss, which starts with the values met, a part of which is already lost in pre-invoicing, when the invoice is issued to be able to enter receipt, another part is lost, here comes the statement from the paying source to reconcile, one more part is lost and what is actually received is the last part.\u201d
Carlos Moura, economic advisor at CBR, professor of the Clinical Management course at ABCDI, business administrator with an MBA in IT from USP and an International Course on Human Talent Development from the University of Central Florida<\/strong><\/em><\/p>\n\n\n\n

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Predictability and planning<\/strong><\/h2>\n\n\n\n

Effective tools are essential for preparing and monitoring the revenue budget, cost and expense budget, Cash Flow and EBITDA.<\/p>\n\n\n\n

To combat glosses, radiology and diagnostic imaging services must implement a process to control 100% the values met to ensure revenue and outline continuous improvement plans to reduce future glosses.<\/p>\n\n\n\n

CBR's economic adviser explained: \u201cThe Receivables Macroprocess is of great importance, but it has received little attention from clinic managers, not due to ignorance of risk, but due to the complexity and impossibility of resolving the volume of discrepancies that appear every day. . It involves factors such as: Patient Eligibility, Authorization, Check 1 \u2013 Attendance, Check 2 \u2013 Billing, Solving Pending Issues, Check 3 \u2013 Billing, Invoice Issuance, Conciliation, Gloss Resources and Accounts Receivable\u201d.<\/p>\n\n\n\n

ABCDI: partner of the clinics in the fight against glosses and for more efficient management<\/strong><\/h2>\n\n\n\n

With more than 20 years of experience, the Brazilian Association of Radiology and Diagnostic Imaging Clinics (ABCDI) is a partner in the fight against glosses. In addition to addressing the issue in lectures, presentations and at Est\u00fadio ABCDI, the association has one of the modules of its Clinic Management course focused on the segment with the theme \u201cImplementing Financial Management Tools\u201d.<\/p>\n\n\n\n

With open positions<\/strong><\/a>, the course teaches, in a practical way, how to implement an excellent process controlling 100% of the values met to guarantee revenue and draw up continuous improvement plans to reduce future disallowances.<\/p>\n\n\n\n

The syllabus of Module 4 of the ABCDI Clinic Management course includes:<\/strong><\/h2>\n\n\n\n

Receivables Management Processes and Tools<\/strong>
\u2013 Supplementary Health Receivables Scenario
\u2013 Main Steps of the Receivables Macroprocess
\u2013 Reconciliation of Payment Statements and Glosses
\u2013 Implementation of the Gloss and Collection Appeal Process<\/p>\n\n\n\n

EBITDA Calculation and Management Adjustments<\/strong>
\u2013 EBITDA Objective and Its Positives and Negatives
\u2013 Cash Regime X Accrual Regime
\u2013 Concept of Depreciation
\u2013 Fundamental Concepts about Costs and Expenses
\u2013 The Importance of the Chart of Accounts Structure
\u2013 Main Account Groups
\u2013 Adequacy of the Clinic Accounting Plan
\u2013 Definition of the Structure of the DRE (Statement of Economic Income)
\u2013 Calculation of EBITDA and Market References<\/p>\n\n\n\n

Preparation and Application of the Revenue Budget<\/strong>
\u2013 Importance of Revenue Budget
\u2013 Methodology Used to Increase Effectiveness
\u2013 How to Prepare the Revenue Budget (step by step)
\u2013 Monitoring Budget Achievement During the Year<\/p>\n\n\n\n

Elaboration and Application of the Budget of Costs and Expenses<\/strong>
\u2013 Key Points for Budgeting
\u2013 Success Factors in Implementation and Recurring Errors
\u2013 Analysis of the Main Groups of Accounts
\u2013 Budget Simulation Tool
\u2013 How to prepare the Costs and Expenses Budget<\/p>\n\n\n\n

Preparation and Application of Cash Flow<\/strong>
\u2013 Importance of Cash Flow in Clinics
\u2013 Relationship with Financial Institutions
\u2013 Cash Flow Assumptions
\u2013 Cash Flow Analysis and Views
\u2013 How to Prepare the Cash Flow (step by step)
\u2013 Investment Simulation Using Cash Flow<\/p>\n\n\n\n

Calculation of Costing by Absorption by Modality<\/strong>
\u2013 Methodology to calculate EBITDA by Mode
\u2013 Variation in Value per Item Produced in Different Modalities
\u2013 Apportionment needs and their variations
\u2013 Logic of Apportionment of Indirect Costs and Expenses
\u2013 How to Elaborate Absorption Costing (step by step)<\/p>\n\n\n\n

Clinic Loan and Debt Management<\/strong>
\u2013 Learning to Work with Third Party Money
\u2013 Consolidation of Financing and Loans
\u2013 Negotiation of Loans and Debts<\/p>\n\n\n\n

Don't waste any more time or money.<\/p>\n\n\n\n

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Also read | ABCDI: 20 years strengthening diagnostic imaging clinics<\/a><\/strong><\/p>","protected":false},"excerpt":{"rendered":"

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