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All Journal Jurnal Penelitian Pendidikan IPA (JPPIPA) PELS (Procedia of Engineering and Life Science)
Yunawati, Ni Putu Linda
Unknown Affiliation
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Computer Science & IT Control & Systems Engineering Education Electrical & Electronics Engineering Engineering Materials Science & Nanotechnology Physics

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Analysis of Verification Aspects Associated with the Return of BPJS Health Claims for Inpatients at RSU Surya Husadha Denpasar: Analisis Aspek-Aspek Verifikasi yang Berhubungan dengan Pengembalian Klaim BPJS Kesehatan Pasien Rawat Inap di RSU Surya Husadha Denpasar Yunawati, Ni Putu Linda; Aridayana, I Putu Mega; Faidah, Nurul; Murcittowati, Putu Ayu Sri
Procedia of Engineering and Life Science Vol. 7 (2025): Prosiding Seminar Nasional dan Rakernas PORMIKI X
Publisher : Universitas Muhammadiyah Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21070/pels.v7i0.2093

Abstract

Submission of claims by hospitals to the Social Security Agency (BPJS) Health will go through a verification process and requires compliance with verification aspects. However, they often experience refunds or delays in payments due to non-compliance with established regulations. This results in negative impacts such as disruption to hospital cash flow, increased workload, and failure to achieve service quality indicators. It is necessary to have claim data ready before submitting a claim by the hospital. The aim of this research is to determine the relationship between aspects of membership administration, service administration and health services with the return of BPJS Health claims. This type of research uses quantitative descriptive analysis with a cross sectional approach. This research was conducted on 145 pending claims selected using a simple random sampling technique. Based on the results of the discrepancy analysis in the aspects of membership administration, namely 6 files (4.1%), service administration, namely 103 files (71%), and health services, namely 36 files (24.8%). These three aspects of verification are related to the return of BPJS Health claims, resulting in a p-value = 0.000, meaning H0 is rejected. To increase efficiency and reduce the number of claim returns, it is necessary to carry out internal verification before claims are sent to BPJS Health.
Nutrition Training Policy among Health Professionals in Community Health Centers and Sub-Centers in Indonesia Murcittowati, Putu Ayu Sri; Dharmawan, Ni Ketut Supasti; Kartika, I Gusti Ayu; Yunawati, Ni Putu Linda; Perwira, Kadek Yuda
Jurnal Penelitian Pendidikan IPA Vol 9 No 12 (2023): December
Publisher : Postgraduate, University of Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jppipa.v9i12.5721

Abstract

Professional health workers in community health centers and sub-centers are required to provide nutrition services. However, nowadays not all community health centers and sub-centers have nutritionists, so all health workers need to have strong teamwork to ensure nutrition programs can occur effectively. This study aimed to describe the types of professional health workers and their history of receiving training in nutrition. This study used IFLS (Indonesia Family Life Survey) 2014-15 from the Community Facility Book to address the health worker's experience in nutrition training. The result of this study revealed that medical doctors had more experience in attending the training in nutrition. Even though there was limited training in the last 12 months. This situation might occur due to the limited number of health workers who can join the training or the limited budget to provide training to all health workers. Education about nutrition is essential to all health workers, not only nutritionist because community health center/sub-centers is the closest health services in the community. Preventing the prevalence of stunting and other health-related nutrition problems can be done by educating health workers immediately.
Co-Authors Aridayana, I Putu Mega I Gusti Ayu Kartika, I Gusti Ayu Murcittowati, Putu Ayu Sri Ni Ketut Supasti Dharmawan Nurul Faidah Perwira, Kadek Yuda