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All Journal JIMKesmas (Jurnal Ilmiah Mahasiswa Kesehatan Masyarakat) J-SAKTI (Jurnal Sains Komputer dan Informatika) Health Information : Jurnal Penelitian PREPOTIF : Jurnal Kesehatan Masyarakat Jurnal Manajemen Pendidikan Al Hadi J-SAKTI (Jurnal Sains Komputer dan Informatika) EduStream: Jurnal Pendidikan Dasar Journal of Pharmaceutical Care and Sciences Padma: Jurnal Pengabdian Kepada Masyarakat Jurnal Infokes (Informasi Kesehatan) Riwayat: Educational Journal of History and Humanities EDU RMIK Jurnal Edukasi Rekam Medis Informasi Kesehatan
Ulfah, Annisa
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Humanities Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Control & Systems Engineering Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Energy Engineering Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Social Sciences Veterinary Other

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Journal : Riwayat: Educational Journal of History and Humanities

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The Effect of the Accuracy of Inpatient Disease Codification on BPJS Health Claims At Hermina Arcamanik Hospital Awalia*, Rahma Kurnia; Ulfah, Annisa
Riwayat: Educational Journal of History and Humanities Vol 6, No 4 (2023): Educational, Historical Studies and Humanities
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jr.v6i4.34543

Abstract

The accuracy of codification of patient diseases is one of the fundamental things in medical record governance. Discrepancies in the provision of disease codes and actions could have an impact on the health service financing claim process. The goals of this study are to find out about the effect of the accuracy of inpatient disease codification on BPJS Health claims at Hermina Arcamanic Hospital. A descriptive approach in quantitative methods was used in this study with 98 samples of pending RM files. The problem found was data discrepancies in the claim process. Problems related to codification include the occurrence of repeated codification inputs, actions that do not need to be coded, other supporting files that do not meet the claim criteria, the occurrence of action 88.78 recording, and inaccuracies in the selection of Main Condition. The results showed that the difference in tariffs obtained by Hermina Arcamanik Hospital was 55.87 with a negative difference. The efforts to overcome these problems include conducting a thorough check on the disease to be coded and the necessary supporting files, evaluating the performance of the case mix section, and evaluating the number of hospital rates so that there is no too significant cost gap with INA-CBGs rates.
Co-Authors Abdussalaam, Falaah Afriansyah, Robby Ali Rakhman Hakim Arifin, Ifran Asep Kurniawan Awalia*, Rahma Kurnia Azmi, Muhammad Rizky Dinanti, Annisa Surya Diniari, Septia Ede Surya Darmawan Elicukia Fadila, Tiwi Fajriawan, Difari Febrianti, Nur Aini Gunawan, Erix Hamid Bashori, Abdul Irda Sari Iswaliyah, Rabialda Janah, Niatri Nurul Khairunnisa, Nadya Kurniawati, Darini Maemunah Nastiti, Kunti Nuryani, Serly Putri, Medina Hasna Ridhani, Muhammad Ikhwan Rufi'i, Rufi'i Sabariah Sabariah Sakinah Soelistijaningroem, Matoeari Supian Waluyo, Marcel Pesa Dwi Wawan Gunawan Yuda Syahidin Yunengsih, Yuyun