Analisis Faktor Penyebab Ketidakakuratan Kode Diagnosis Pasien BPJS Rawat Inap Di RSIA Muhammadiyah Kota Probolinggo

Nurrohmah, Gendis Isnain (2019) Analisis Faktor Penyebab Ketidakakuratan Kode Diagnosis Pasien BPJS Rawat Inap Di RSIA Muhammadiyah Kota Probolinggo. Undergraduate thesis, Politeknik Negeri Jember.

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Abstract

The Codefication Patient Diagnosis of Social Insurance Administration Organization at Mother and Child Hospital Muhammadiyah Probolinggo has inaccuracies. It causing claim files return and postponement of costs for the hospital. This research aims to analyze the factors that causing inaccuracy in diagnosing code for Inpatient Social Insurance Administration Organization Patients at Mother and Children Hospital Muhammadiyah Probolinggo. The data collection was used observation, interviews, documentation and brainstorming. The problem indentify was using fishbone diagram consisted 5M factors (man, money, material, machine and method). The man factors consisted variable of training, workload, knowledge, and duration of work. The moneys factor consisted costs that used for conduct codefication. The material factors consisted ICD-10 books, medical record files, and ICD-9CM books. The machine factors consisted Hospital Management Information System, application for claim of Social Insurance Administration Organization patient, and telephone used by coding staff. The method factors consisted applicable Standar Operating Procedure for Social Insurance Administration Organization patient codefication. The results obtained in order to provide an effort to improve the cause of diagnosis code inaccuracy problems found that the man factor is the officer works more than one job other than coding which makes the officer less efficient and thorough in working and the officer has never done a codefication training, the material factors are incomplete medical record files charging by the staffs and unreadable doctor’s writing in patient diagnosing, and the method factor is there is no available Standar Operating Procedure of codefication for Social Insurance Administration Organization Patients.

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