Detail Cantuman

Analisis Faktor-Faktor Penyebab Keterlambatan Pengajuan Klaim BPJS Kesehatan di RS. Perkebunan PTPN X Jember (Marta Indraswaraswanti) (Analysis Of The Factors of Late in submission Claim of BPJS’s Health in Perkebunan PTPN X Jember Hospital)

Marta Indraswaraswanti Medical Record Study Program Health Departement
ABSTRACT
Based on the technique claim verification instructions of BPJS, The slowest claim submitted on the 10th of the next month. Based on preliminary studies on November 8th 2016, the number of files returned in Perkebunan PTPN X Jember Hospital roughly as many as 20 of the 500 files claim submitted in October 2016. Submission a claim to the BPJS’s verificator, the slowest on the 23rd the next month. The purpose of this research is analyzing the factors causing late submission a claim of BPJS Kesehatan in Perkebunan PTPN X Jember Hopital and determine an alternative of problem solving. This type of research is a qualitative research, using data collection by observation , interviews and brainstorming. The results of this research of the 5 factor (man, method, machine, materials and money) that became the cause of the late submitting the claim of BPJS Kesehatan are knowledge of coder about diagnostic code needs to be improved, there isn’t Regulation (SOP) of the hospital related to submitting claims of BPJS, lack of computer that installed by INA CBGs. Based on those results, the researcher discuss by brainstorming with the officer's claims and the others that related to process of submission claims. An alternative problem solving associated delay in the submission of claims are the officers attended the training activities or seminars about BPJS, SOP about the submission claim Of BPJS should be made, planning the addition of 1 unit computer that can be installed INA CBG’s program,and make a budgeting plan related to them and giving appreciation for officers if there are satisfactory.
Keyword : BPJS, Claim, Fishbone, Hospital