The study, published in the Indonesian Journal of Interdisciplinary Research in Science and Technology (MARCOPOLO), examined how well health professionals understand medical billing procedures and how they perceive the fairness, transparency, and efficiency of billing at RSUTH. The researchers also examined whether better billing knowledge was associated with more positive perceptions of the billing system.
Why Medical Billing Matters in Hospital Services
Medical billing is more than collecting payments from patients. It connects clinical services with financial accountability by documenting the services provided, assigning appropriate charges, processing insurance claims, and communicating costs to patients.
In Nigeria, the billing process can involve service coding, insurance verification, claims processing, invoicing, and internal auditing. Errors at any stage can create financial discrepancies, reimbursement delays, disputes with patients, or losses for healthcare institutions.
The authors note that these challenges become more important as hospitals move toward digital and more accountable administrative systems. Healthcare professionals need sufficient knowledge of billing procedures because doctors, nurses, pharmacists, record officers, and administrative personnel may all interact with information that ultimately affects a patient’s bill.
At RSUTH, the researchers identified concerns about discrepancies between service documentation and patient billing. They argue that understanding healthcare workers’ knowledge and perceptions is therefore important for improving billing accuracy, transparency, and service quality.
Study Involved 180 Healthcare Professionals
The research used a descriptive cross-sectional survey at Rivers State University Teaching Hospital in Port Harcourt.
The hospital population was estimated at 420 professionals, from which 180 respondents were selected. Participants included healthcare professionals and administrative personnel representing different professional groups. The researchers used proportional sampling to ensure that different categories of staff were represented.
Participants completed a structured questionnaire covering demographic characteristics, knowledge of medical billing, and perceptions of billing procedures. The questionnaire had a reliability coefficient of 0.82, indicating acceptable internal consistency according to the study.
The researchers analyzed the responses using SPSS version 26. They summarized the responses using averages and other descriptive measures and then tested the relationship between billing knowledge and perception using correlation analysis.
Staff Understand Documentation but Struggle with Coding
The results show that health professionals at RSUTH had moderate-to-high knowledge of medical billing overall, but their understanding differed considerably across specific areas.
The strongest knowledge area was billing documentation, which recorded a mean score of 4.21. Awareness of billing ethics followed at 4.06, while understanding of the patient invoicing process reached 3.91.
However, two more technical areas received lower scores:
- Insurance claim procedures: mean score 3.48
- Familiarity with coding systems: mean score 3.12
The coding result represented the lowest knowledge score in the study. The authors associate this gap with limited training and differences in professional responsibilities. Staff who work more directly with medical records and billing may have greater exposure to coding systems than clinical personnel.
The researchers point out that inadequate understanding of standardized diagnostic and procedure codes can contribute to inconsistent documentation and financial discrepancies in hospital billing.
Staff Value Billing but Question Its Transparency
Healthcare professionals generally viewed medical billing positively. The highest perception score, 4.32, was recorded for the statement that billing promotes accountability.
This suggests that staff largely recognize billing as an important mechanism for documenting services, tracking financial resources, and strengthening institutional accountability.
But the findings also reveal important concerns.
The statement that the billing system is transparent received a mean score of 3.48, indicating a more mixed perception. Staff also moderately agreed that billing increases their administrative workload, with a mean score of 3.76.
The weakest perception concerned patient communication. The statement that patients are adequately informed about bills received a mean score of only 3.11, the lowest among the perception indicators.
This finding is particularly important for patient-centered healthcare. If patients do not understand what they are being charged for, they may experience confusion or distrust, even when the underlying services and charges are legitimate.
At the same time, respondents generally agreed that effective billing can strengthen patient confidence. The statement that billing enhances patient trust recorded a mean score of 3.87.
Better Knowledge Is Linked to Better Perceptions
One of the clearest findings was the relationship between healthcare professionals’ knowledge and their perceptions of billing.
The analysis found a positive and statistically significant relationship, with a correlation coefficient of r = 0.624 and a p-value of 0.002. In practical terms, professionals with greater knowledge of billing procedures tended to have more favorable perceptions of the billing system.
The researchers interpret this result as evidence supporting the importance of continuous professional education. Improving employees’ understanding of billing may also improve their attitudes toward compliance, transparency, and proper billing practices.
Sunny Toanyie Kpowugah, Ikpoko-Ore-Ebirien Dike Isaruk, and Bademosi Adetomi argue from their respective healthcare and academic affiliations that staff competence is closely connected with the effectiveness of hospital billing. Their analysis indicates that billing education should not be treated as a one-time administrative exercise but as part of ongoing professional development.
Digital Training Could Improve Hospital Billing
The findings have practical implications for hospitals, healthcare administrators, and policymakers.
The authors recommend regular training covering billing documentation, medical coding, and insurance claim processing. They also call for stronger coordination between clinical, financial, and administrative departments so that information moves accurately across the billing process.
Digital transformation is another important area. Automated billing systems and electronic health records could potentially reduce manual errors, improve processing speed, and make billing information easier to track. The authors recommend that future research examine how these technologies affect billing accuracy, efficiency, and patient experience.
For patients, the most immediate improvement would be clearer communication. Hospitals could provide billing guidelines and explanations that are understandable to both staff and patients. Greater clarity could help reduce disputes and strengthen trust in healthcare institutions.
The study also suggests that future research should compare different hospitals, examine the influence of professional experience and educational background, and assess whether continuous training produces lasting improvements in billing competence.
Author Profile
Sunny Toanyie Kpowugah is affiliated with the Faculty of Basic Medical Sciences, Rivers State University. Ikpoko-Ore-Ebirien Dike Isaruk is affiliated with Rivers State College of Health Science and Management Technology, while Bademosi Adetomi is affiliated with the Department of Community Medicine, Rivers State University. Their article focuses on healthcare administration, medical billing, professional knowledge, billing transparency, and hospital service efficiency. The supplied article does not state the authors’ academic degrees, so no degrees are attributed without supporting evidence.
Research Source
Article Title: Knowledge and Perception of Health Professionals on Medical Billing Procedures at Rivers State University Teaching Hospital, Port Harcourt
Authors: Sunny Toanyie Kpowugah, Ikpoko-Ore-Ebirien Dike Isaruk, and Bademosi Adetomi
Journal: Indonesian Journal of Interdisciplinary Research in Science and Technology (MARCOPOLO)
Publication: Volume 4, No. 1, 2026, pp. 61–70
DOI: https://doi.org/10.55927/marcopolo.v4i1.13
Official Journal: https://journalmarcopolo.my.id/index.php/marcopolo
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