A Study of the Inpatient Charge System at Hillcrest Baptist Hospital, Waco, Texas

This study was undertaken to estimate the incidence of inaccuracies and delays in an automated inpatient charge system. A random comparison of clinical charts and statements of patient charges revealed an approximately equal occurrence of overcharges and undercharges to patients accounts. The hospital was experiencing a five-day delay in the preparation of final statements following a patients discharge. This compared to a three-day delay in the previous manual system. Observation and analysis of the flow of charge tickets during this study revealed that 98 per cent of patient charges were posted to patients accounts within three days after the service was provided. The cause of the delay in closing discharged patients accounts was traced to the follow-up verification of computer edit checks. The major recommendation of the study involved the creation of an additional computerized control file to assure that all charge tickets prepared on the wards are posted to patients accounts.