An example of unlawful optimized reporting in a certain sojourn institution of social services

Summary

In the last years we encountered even unscrupulous attacks of directors of professional deputies of sojourn institutions of social services (PZSS) against medical insurance companies, especially against the General Medical Insurance Company of the Czech Republic. These attacks declare that the audits, which are aimed at correct and authorized accounting of the expenditures of care and the official attitude to provide substantiation of the reimbursed medical services for securing oral administration causes economic liquidation of the providers and thereby endanger the availability of quality of the necessary medical care of the population [1]. The inspection is a legal obligation of medical insurance companies and should be attacked as such. The revision civil servants are even the object of a personal criticism, being bound by taciturnity and having a minimal space for public defense and even dramatic control observations cannot be made public. The article deals with the case of a fraudulent procedure of a certain PZSS in indication, documentation and reporting of medical services, detected during a pointed revision of correctness of the reported care.

Keywords:
sojourn institution of social services – optimization of reporting – fraudulent reporting – treatment with a bio-lamp – training of tonus deviations