{"id":327,"date":"2021-09-06T09:36:32","date_gmt":"2021-09-06T12:36:32","guid":{"rendered":"http:\/\/www.activit.com.br\/site\/?p=327"},"modified":"2021-09-06T14:21:46","modified_gmt":"2021-09-06T17:21:46","slug":"o-que-sao-glosas-medicas","status":"publish","type":"post","link":"https:\/\/www.activit.com.br\/site\/noticias\/o-que-sao-glosas-medicas\/","title":{"rendered":"O que s\u00e3o Glosas M\u00e9dicas?"},"content":{"rendered":"\n<p>Vamos fazer uma s\u00e9rie de mat\u00e9rias falando sobre Glosas m\u00e9dicas. Fique atento ao nosso site para ficar por dentro de tudo. Vamos come\u00e7ar com o que s\u00e3o Glosas M\u00e9dicas:<br><br><strong>Glosa m\u00e9dica<\/strong> \u00e9 quando a operadora de sa\u00fade nega o pagamento de uma conta do paciente, pode ser uma consulta, interna\u00e7\u00e3o, exames laboratoriais ou de imagem, medicamentos e outros servi\u00e7os utilizados pelos benefici\u00e1rios.<\/p>\n\n\n\n<p>Existem 3 tipos de glosas:<br><br><strong>Glosas administrativas:<\/strong> s\u00e3o negativas de pagamentos que envolvem erros em quest\u00f5es administrativas, como a falta ou o preenchimento incorreto das guias de autoriza\u00e7\u00e3o da operadora. Podem ser geradas quando h\u00e1 erros de digita\u00e7\u00e3o e\/ou c\u00e1lculos incorretos. Normalmente s\u00e3o mais facilmente resolvidas, com a corre\u00e7\u00e3o dos dados e reenvio ao conv\u00eanio.<br><br><strong>Glosas t\u00e9cnicas:<\/strong> s\u00e3o as glosas registradas quando algum procedimento m\u00e9dico \u00e9 contestado, como s\u00e3o mais complexas e em alguns casos dependem de alguma interpreta\u00e7\u00e3o, se faz necess\u00e1ria a avalia\u00e7\u00e3o de um Auditor T\u00e9cnico. As Glosas T\u00e9cnicas podem ocorrer quando h\u00e1 inconsist\u00eancia dos dados e conduta aplicadas no atendimento do paciente, desde o per\u00edodo de tratamento, m\u00e9todo do atendimento, registro de informa\u00e7\u00f5es como checagem de prescri\u00e7\u00e3o e medicamentos utilizados. S\u00e3o dif\u00edceis, demoradas e complexas para se resolver pois vai envolver os profissionais de sa\u00fade, m\u00e9dicos, enfermeiros, farmac\u00eauticos, gestores e\/ou auditores m\u00e9dicos.<br><br><strong>Glosas lineares:<\/strong> Normalmente aparecem com uma justificativa que n\u00e3o reflete a realidade. Por exemplo, a operadora pode alegar que o medicamento n\u00e3o faz parte do contrato com a operadora, quando o medicamento est\u00e1 no contrato. <br><br> Em 2020, os hospitais perderam 4,10% de receita l\u00edquida com glosas. <br> Dados do Observat\u00f3rio 2021 \u2013 Relat\u00f3rio da Associa\u00e7\u00e3o Nacional de Hospitais Privados, Anahp.<br><br> Nas pr\u00f3ximas publica\u00e7\u00f5es saiba como evitar glosas m\u00e9dicas e perda de receita l\u00edquida utilizando o PAEEON. <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Vamos fazer uma s\u00e9rie de mat\u00e9rias falando sobre Glosas m\u00e9dicas. Fique atento ao nosso site para\u2026<\/p>\n","protected":false},"author":2,"featured_media":328,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-327","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-noticias"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>O que s\u00e3o Glosas M\u00e9dicas? - Activit<\/title>\n<meta name=\"description\" content=\"Que s\u00e3o glosas m\u00e9dicas?\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.activit.com.br\/site\/noticias\/o-que-sao-glosas-medicas\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"O que s\u00e3o Glosas M\u00e9dicas? 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