Optimización del Proceso de Facturación y Radicación de Soportes a EPS mediante Herramientas de Automatización y Control en IPS Ortofísica de Colombia S.A.S

Abstract

IPS Ortofísica de Colombia S.A.S. is an institution dedicated to the manufacturing, adaptation, and commercialization of medical devices such as prostheses, orthoses, and mobility aids. Within its value chain, the billing and submission of accounts to Health Promoting Entities (EPS) constitute a critical component, since the organization’s financial liquidity, timely payroll payments, and sustainability of its administrative and healthcare operations depend on its correct execution. During the review of internal processes, significant shortcomings were identified in the current billing system: errors in the naming of supporting documents, dependence on third parties for the encryption of files required by Resolution 2284 of 2023, lack of standardization in the preparation of MIPRES and RIPS prescriptions, and the absence of clear guidelines for administrative staff. These deficiencies generate claim denials and invoice rejections, causing delays in payments from EPS and directly affecting the institution’s liquidity. To address this situation, the development of automated scripts was proposed for the naming and encryption of supporting documents, together with the design of checklists and standardized diagrams to guide staff in the correct submission of invoices. The main objective is to optimize the billing and account submission process, ensuring regulatory compliance, reducing human error, and strengthening the financial stability of the IPS.