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Performance Indicators for Optimising Hospital Revenue Collection: A Case Study of an Admission and Billing Office in a University Hospital in Morocco

Year: 2026

Type: article

Abstract: The financial stability of hospitals depends largely on the efficiency of revenue collection. In Morocco, the generalisation of compulsory health insurance has placed the admission and billing office at the centre of the hospital value chain, yet high claim rejection rates, delays in dispatching claim files and limited digitalisation persist. This study aimed to diagnose the revenue collection process of the back-office of the admission and billing office of a university hospital in Morocco and to analyse its performance indicators. A mixed-methods case study was conducted, combining documentary analysis of the regulatory framework, two weeks of participant observation of the complete admission, billing, dispatch and collection circuit, semi-structured interviews with 14 staff members, and analysis of monthly indicators from January to June 2025. Process mapping, a responsibility assignment matrix, Pareto analysis, failure modes, effects and criticality analysis, and an interactive Power BI dashboard were used. Over the six months, the net collection rate rose from 75% to 84%, the mean claim dispatch delay fell from 12 to 7 days, and patient identity verification errors decreased from 4.5% to 3.1%. The rejection rate decreased from 18% to 12% but remained high. Billing errors and missing supporting documents accounted for 40% of the causes of delay and rejection, and the manual cash-collection system carried the highest risk criticality. These findings suggest that digital monitoring tools and continuous-improvement methods can strengthen collection performance, although structural harmonisation of procedures with paying organisations remains necessary.

Source: SAS Journal of Medicine

DOI: 10.36347/sasjm.2026.v12i09.031