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All Journal Surya Medika: Jurnal Ilmiah Ilmu Keperawatan dan Ilmu Kesehatan Masyarakat Bali Medika Jurnal Jurnal Komunikasi dan Organisasi (J-KO) Jurnal Ilmiah Perekam dan Informasi Kesehatan Imelda (JIPIKI) Basic and Applied Nursing Research Journal PELS (Procedia of Engineering and Life Science) ADINDAMAS: Jurnal Pengabdian Kepada Masyarakat Media of Health Research Jurnal Akademika Baiturrahim Jambi Jurnal Rekam Medic
Nurul Faidah
FKIP Universitas Pekalongan
Humanities Astronomy Computer Science & IT Control & Systems Engineering Dentistry Economics, Econometrics & Finance Electrical & Electronics Engineering Engineering Environmental Science Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Journal : PELS (Procedia of Engineering and Life Science)

 1 
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.
Assessment of Technology, Organization, and Environment Readiness for Integrated Hypertension Management: Penilaian Kesiapan Teknologi, Organisasi, dan Lingkungan untuk Pengelolaan Hipertensi Terpadu Pradnyantara, I Gusti Agung Ngurah Putra; Faidah, Nurul
Procedia of Engineering and Life Science Vol. 9 (2025): Proceedings of the 2025 Annual Meeting of APTIRMIKI
Publisher : Universitas Muhammadiyah Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Hypertension is one of the most prevalent chronic diseases in Indonesia, affecting 34.1% of adults over 18 years according to the 2018 National Health Survey. Effective hypertension management requires an integrated health information system for continuous monitoring. The Indonesian government, through Ministry of Health Regulation No. 24/2022, mandates hospitals to implement Electronic Medical Records (EMR) and integrate them with the SATUSEHAT national platform. This study aims to analyze the readiness of Dharma Yadnya General Hospital Denpasar to develop an integrated hypertension management module within the EMR system using the Technology-Organization-Environment (TOE) framework. A qualitative approach was employed through in-depth interviews, observations, and document review. Eleven informants participated, representing medical record officers, IT staff, physicians, and hospital management. Findings indicate that from the technological dimension, the hospital has basic infrastructure such as servers, internal networks, and a fully implemented EMR since 2024, though a dedicated hypertension module is absent. From the organizational dimension, management and staff show strong commitment and readiness to adopt the new system with proper training, while limited IT human resources and manual hypertension SOPs remain barriers. From the environmental dimension, government regulations, the SATUSEHAT program, and vendor support are identified as key external drivers. The study concludes that the hospital has strong potential to implement an EMR-based hypertension management module with recommendations on hardware procurement, IT capacity building, and SOP integration.
Co-Authors Adiputra, I Made Sudarma Ahadiyat Suryana , Eka Alamsyah - Ardiyanti, Ni Komang Pande Aridayana, I Putu Mega Asridewi, Ni Putu Vina Astrid, A Fauziah Bindhu, I Putu Bagus Maha Djatmiko, Teguh Folta, Sarah C. Harinto Nur Seha I Gusti Agung Ngurah Putra Pradnyantara Indraswari, Made Ayu Savitri Indriani, Dewa Ayu Dwita Januansyah , Revan M. FAIRUZ ABADI, M. FAIRUZ Mawo, Lidia Wolla Meryadi, Ni Nyoman Mirayanti, Ni Ketut Ayu Muliawati, Ni Kadek Murcittowati, Putu Ayu Sri Nazmah Nazmah, Nazmah Ni Luh Putu Devhy, Ni Luh Putu Purnamasari, Ni Kadek Ayu Resiyanthi, Ni Komang Ayu Sriadi, Ni Nyoman Putri Ubaidillah, Lutfi Wijaya, Made Pratama Yunawati, Ni Putu Linda