Analisis Faktor-Faktor Penyebab Keterlambatan Proses Klaim BPJS Pada Berkas Rekam Medis Pasien Rawat Inap Dan Rawat Jalan Di RSUD Dr.Abdoer Rahem Situbondo

Rony, Ulan Novence (2017) Analisis Faktor-Faktor Penyebab Keterlambatan Proses Klaim BPJS Pada Berkas Rekam Medis Pasien Rawat Inap Dan Rawat Jalan Di RSUD Dr.Abdoer Rahem Situbondo. Undergraduate thesis, Politeknik Negeri Jember.

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Abstract

Submission of BPJS claims based on PERMENKES No.28 of 2014 that is health facility filed a claim every month no later than the 10th of the following month. Based on a preliminary survey conducted on April 1, 2016, RSUD dr.Abdoer Rahem Situbondo filing a claim file to BPJS no later than the 25th of the ensuing month. The purpose of this research is to analyze the factors causing the delay of BPJS claim process on the medical record file of inpatients and outpatients in RSUD dr.Abdoer Rahem Situbondo. The research is qualitative by using data collection method of observation, interview, and brainstorming. The results of fishbone research (man, method, machine, minute, material, money) that cause the delay of BPJS claim submission process is the ability of the coding officer to be improved again, the absence of Standard Operating Procedure (SOP) from the hospital related to the implementation BPJS claims process, lack of computer facilities performed in verification process, return of medical record file from ward or from poly late to one month since patient finished treatment process, claim submission not yet following PERMENKES rule No.28 year 2014, printer available only one and often damaged. Based on these results, researchers conducted brainstorming activities with officers involved in the claim process. Problem solving related to the delay of claims process is make claims according to PERMENKES rules No.28 year 2014.

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