Glosas Médicas por Erros no Faturamento TISS
Definition
Manual processes in patient collections cause frequent glosas due to coding errors, incomplete documentation, or incorrect patient data, delaying payments from health plans.
Key Findings
- Financial Impact: R$ thousands per month in rejected payments (glosas); typical 10-30% of billed value lost without recovery[1][2]
- Frequency: Recurring per billing cycle (monthly repasses)
- Root Cause: Manual review of medical records, coding (CBHPM), and XML lote generation prone to inconsistencies
Why This Matters
The Pitch: Physicians in Brasil waste R$ thousands annually on glosas from patient collections. Automation of TISS guias and coding eliminates this risk.
Affected Stakeholders
Gestor de Clínica, Faturista Médica, Recepcionista
Deep Analysis (Premium)
Financial Impact
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Current Workarounds
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Methodology & Sources
Data collected via OSINT from regulatory filings, industry audits, and verified case studies.
Related Business Risks
Atrasos em Repasses Médicos e Inadimplência em Planos de Pagamento
Rejeição de NF-e em Cobranças Particulares por Erros Fiscais
Rejeições NF-e e Multas SEFAZ em Faturamento de Serviços Médicos
Custos Excessivos com Preparação Manual de Auditorias Fiscais
Atrasos em Reembolsos de Planos de Saúde
Recibos Eletrônicos Obrigatórios para Reembolso
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