Perda de faturamento por serviços de intervenção em crise não registrados ou não faturados

Definition

Brazil’s mental health system, guided by Law 10.216/2001, prioritizes community‑based care but still relies heavily on clinics, hospitals and psychosocial community centers (CAPS) that provide urgent and crisis‑oriented services.[9] Each crisis event (emergency consultation, risk reassessment, family meeting for safety planning) is a billable encounter under SUS tables or private health plan rules, provided that proper documentation and coding are completed. However, the same professionals are also required to comply with ethical and legal documentation (as supervised by CRP/CRM) and, increasingly, with occupational psychosocial risk recording under NR‑1 for work‑related cases.[3][4] In high‑pressure environments, administrative coding and linkage with billing systems are often delayed or skipped. Logic: if a medium‑sized mental health hospital has 300 crisis‑related encounters per month, and 5–15% are incompletely documented and thus not billed (15–45 encounters), at an average reimbursement of R$200–R$400 per encounter, monthly revenue leakage is R$3.000–R$18.000, or R$36.000–R$216.000 per year. Multi‑site providers or large hospitals can easily see leakage above R$300.000–R$500.000 anuais.

Why This Matters

The Pitch: Clínicas e hospitais de saúde mental no Brasil 🇧🇷 frequentemente deixam de faturar 5–15% dos atendimentos de crise por falhas de registro e autorização. Automation of structured crisis encounter capture and billing validation can recuperar R$100.000–R$500.000 por ano em receitas hoje perdidas.

Affected Stakeholders

Diretor financeiro, Coordenador de faturamento/SUS, Coordenador de CAPS e emergência psiquiátrica, Psicólogos e psiquiatras plantonistas

Related Business Risks