As of 1/1/2012 the way services are charged has changed in al Hospitals. Until then, social security covered hospitalization costs for people insured with them, based on the invoices for materials and medication and days of hospital stay. The Ministry of Health implemented the ΚΕΝ-DRGs System concerning Diagnosis Related Groups. This way, charges are based on the Code Number of the category of the patient's condition, which corresponds to a fixed charge for all hospitals.
What does a physician have to do?
1. The attending physician has to fill out a hospitalisation form, on which the patient’s Code Number corresponding to the diagnosis leading to Hospitalisation is entered.
2. The attending physician has to fill out the patient's hospital release form, on which the release diagnosis (ICD-10) and the medical action (more than one diagnoses and medical actions may be selected; however, the main diagnosis must be defined and an effort must be made to avoid recording the Hospitalisation code Number, which is usually a symptom or a sign, as the hospital release diagnosis) are recorded. The ICD -10 Code is obligatory and without it hospital release papers cannot be further processed.
3. The IT department creates an Excel form of the patient’s data from the hospital release documents and forwards it to the Patient Accounts Department (when there is no automated connection via OPSY [Intergraded Health IT system], so that hospitalization charges for the patient in question may be invoiced. This takes place at the beginning of every calendar month for the whole of the previous month (a grand total is calculated for cases until Feb 28, 2012).
4. The Patient Accounts Department, using the Codification Numerical Match System (KAS) application of the Ministry of Health and Social Solidarity (YYKA), can enter the ICD – 10 code/s and medical actions, and the application will produce the KEN-DRGs code/s corresponding to the diagnoses and medical actions concerned.
5. The KEN-DRGs code selected is entered into the information system (OPSY) so that the patient may be invoiced.
6. In cases when the Patient Accounts Department cannot find an appropriate ΚΕΝ- DRGs code, it requests assistance from the KEN-DRGs Management Team, which consists of physicians and nursing staff, so that the appropriate KEN-DRGs code may be chosen without delay.
7. The hospitalized patients' submission form for the previous month is printed at the beginning of every month and sent to insurance fund agencies.
8. In cases when Average Hospital Stay (MDN) exceeds that indicated by DRGs, the information system will charge the extra days on the basis of KYA [Joint Ministerial Decision] tariff, including any extra pharmaceuticals, materials and examinations/tests.
9. For private patients the same process is followed by the Patients’ Office in cooperation with the Patient Accounts Dpt to invoice hospital charges and payment of amounts due.
10. Forms to be submitted to FKA (Social Insurance Agencies) up until 31/12/2011 and to the National Organisation for Healthcare Provision [EOPYY] as of 1/1/2012 are common and have been posted on YYKA's KEN-DRGs page.
For more information visit the website of the Ministry of Health
Download KEN-DRGs for Urology Conditions