Dolan A, Moscovice I
Health Serv Res. 1980 Summer;15(2):93-104.
The performance of the Washington State Medicaid agency in processing Medicaid claims was compared with that of hospital providers for one year. We found that the in-hospital processing time was approximately twice that of the Medicaid processing agency. In-agency processing time was found to be significantly related to the size and disposition of a claim, while in-hospital processing time showed a significant relation to hospital dependence on Medicaid reimbursement, the amount of the claim not allowed reimbursement by the Medicaid agency, hospital expense per admission, and the question whether the claim was submitted by the university hospitals. We concluded that lengthy turnaround time for Medicaid reimbursement of hospitals in Washington State was primarily related to hospital speed in submitting claims.
对华盛顿州医疗补助机构处理医疗补助申请的绩效与医院供应商进行了为期一年的比较。我们发现，医院内的处理时间约为医疗补助处理机构的两倍。研究发现，机构内处理时间与申请的规模和处理情况显著相关，而医院内处理时间与医院对医疗补助报销的依赖程度、医疗补助机构不允许报销的申请金额、每次入院的医院费用以及申请是否由大学医院提交等问题显著相关。我们得出结论，华盛顿州医院医疗补助报销周转时间过长主要与医院提交申请的速度有关。
