Analisis Pengelolaan Berkas Klaim Rawat Jalan BPJS Kesehatan Di Rumah Sakit Haji Medan Estate

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Published: 28-08-2024
DOI: https://doi.org/10.37274/mauriduna.v5i3.540
Keywords:
Claim File, BPJS Health

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Rusgianti Rusgianti
Universitas Nahdatul Ulama Sumatera Utara, Indonesia
Fatimah Pohan
Universitas Nahdatul Ulama Sumatera Utara, Indonesia
Rara Astili Siregar
Universitas Nahdatul Ulama Sumatera Utara, Indonesia

Abstract

This research is a descriptive research. Respondents in this research were the registration department and verifiers. The data collection method was carried out using questionnaires and observation. The data analysis used is descriptive statistics with the presentation of data in tabular and textular form. The results of this study show how the process of managing BPJS Health outpatient claim files at RS Haji Medan Estate. This process activity includes service, file processing, coding and submitting claims to the BPJS health verifier. In the service process, outpatient BPJS participants must fulfill documents consisting of BPJS patient identity and a referral letter. A problem that often occurs in the service process is that officers do not completely fill in patient documents. In the data processing process, files from patients are checked for the completeness of the files and checked for conformity of the Service Proof Sheet (LBP) with billing. If it is complete and according to the file. The conclusion from this study is that the management of outpatient claim files is delayed due to the lack of verifier officers, and poly officers are incomplete in filling out files. Based on the results of this study, it is hoped that the Haji Medan Hospital will increase the number of verifier officers, improve the performance of police officers and provide a comfortable work space for verifiers.

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Vol. 5 No. 3 (2024): Mauriduna : Journal of Islamic Studies, August 2024

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How to Cite

Analisis Pengelolaan Berkas Klaim Rawat Jalan BPJS Kesehatan Di Rumah Sakit Haji Medan Estate. (2024). Mauriduna : Journal of Islamic Studies, 5(3). https://doi.org/10.37274/mauriduna.v5i3.540

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