PESHAWAR: An inquiry has reportedly uncovered significant discrepancies in laboratory billing records at Khyber Teaching Hospital (KTH) in Peshawar, with more than 135,000 laboratory tests allegedly missing from the invoicing record and estimated monthly revenue losses of Rs7 million.
The alleged irregularities involve a medical information technology (IT) system associated with Shaukat Khanum Memorial Cancer Hospital and Research Centre, according to the report. The findings have raised questions about billing procedures, data access, financial oversight and the hospital’s internal controls.
The allegations have not been independently verified, and the available information does not establish that any individual or organisation deliberately committed financial wrongdoing.
More Than 135,000 Tests Missing From Billing Records
The issue reportedly came to light after a professor noticed an unusual decline in revenue generated by the hospital’s pathology laboratory.
An inquiry committee, headed by the official responsible for institutional practice, was subsequently formed to examine the discrepancies.
According to the reported inquiry findings, the laboratory had conducted approximately 930,000 tests, while only 794,000 invoices were recorded. The difference amounted to approximately 136,000 tests that could not be accounted for in the billing records.
The discrepancy was reportedly associated with estimated monthly financial losses of Rs7 million.
The report further claims that when the inquiry sought the original records from Shaukat Khanum Hospital, the corresponding entries for the missing tests could not be located there either.
The findings have raised questions about whether all laboratory tests were properly recorded, billed and accounted for in the hospital’s financial system.
Laboratory Revenue Reportedly Rises by More Than 130%
Another significant development was an alleged increase of more than 130 per cent in laboratory revenue shortly after the inquiry committee began its work.
The sudden rise has prompted questions about whether changes were made to billing procedures, collection monitoring or the recording of laboratory services.
However, the available report does not establish the precise reasons for the increase or whether it resulted from corrective measures, changes in patient billing or other factors.
A detailed audit would be required to determine the reasons behind the change and establish whether any financial irregularities occurred.
Questions Raised Over Patient Classification and Billing
The inquiry report also reportedly identified changes to the classification of approximately 100 patients daily.
According to the allegations, some patients’ records were transferred from the evening outpatient department (OPD) to the morning OPD, potentially affecting the prices applied to their laboratory tests. The report also alleges that additional fees were collected in connection with these changes.
The available information does not clarify who authorised the changes, how the billing calculations were affected or whether the additional charges were officially recorded.
These questions remain central to determining whether the reported practices involved administrative errors, weaknesses in billing controls or deliberate misconduct.
Dispute Over Access to Records
The report alleges that after the inquiry committee recommended further examination and possible legal action, the hospital director issued a formal letter instructing the relevant IT section at Shaukat Khanum Hospital not to provide additional records.
The reported restriction on access to information has raised concerns about whether investigators were able to complete their examination.
A senior KTH official, responding to the allegations, reportedly maintained that the software had been provided free of charge and that the matter amounted to a minor IT error rather than an issue requiring further investigation.
The official also said that decisions concerning hospital records fell within the hospital director’s discretionary authority.
In contrast, an inquiry official, speaking on condition of anonymity, reportedly said the investigation remained incomplete and that further scrutiny was necessary.
The conflicting accounts leave important questions about the completeness of the inquiry and the availability of supporting documentation unanswered.
IT Controls and Data Security Under Scrutiny
The report states that the software is also used at other medical teaching institutions in Khyber Pakhtunkhwa, including Lady Reading Hospital and Hayatabad Medical Complex, as well as other hospitals operating under the Medical Teaching Institutions Act, 2015.
According to the report, control over the system rests with the relevant IT section, while local hospital staff have limited authority to access or modify the data.
The arrangement has prompted questions about accountability, audit trails and the ability of hospital administrations to independently verify their billing records.
The reported absence or inadequacy of a modern barcode-based laboratory tracking system has also raised concerns. Such systems can link each test to a patient’s record, the relevant billing entry and the final laboratory report, making discrepancies easier to identify.
Independent technical and financial audits could help establish whether the reported gaps resulted from software limitations, inadequate procedures, unauthorised changes or other causes.
Patient Privacy and Accountability Concerns
The allegations have also raised concerns about the handling of sensitive patient information. Medical records should be accessed and shared only by authorised personnel for legitimate purposes, with appropriate safeguards in place.
A transparent investigation would need to establish how the records were managed, who had access to the relevant data and whether any unauthorised disclosure or alteration occurred.
The reported inquiry has not yet provided a conclusive account of the missing test entries or identified individuals responsible for the discrepancies.
Calls for an Independent Investigation
The allegations have prompted calls for a comprehensive, impartial investigation into laboratory billing, revenue collection, software access and the hospital’s internal oversight mechanisms.
A detailed audit of test records, invoices, patient classifications and system logs would be necessary to reconcile the reported discrepancy of approximately 136,000 tests and determine the basis of the estimated Rs7 million in monthly losses.
The investigation would also need to examine the reported increase in laboratory revenue and clarify why additional records were allegedly withheld.
Until the relevant records are independently examined and the findings formally established, the case remains one of alleged financial and administrative irregularities rather than proven corruption.
