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DELAYS IN HEALTH INSURANCE CLAIMS AT A THIRD-PARTY ADMINISTRATOR (TPA) PT. XYZ IN 2024 Wulandari, Reny Yulita; Purnamawati, Dewi
HEARTY Vol 13 No 4 (2025): AGUSTUS
Publisher : Fakultas Ilmu Kesehatan, Universitas Ibn Khaldun, Bogor

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32832/hearty.v13i4.20409

Abstract

Third-Party Administrators (TPA) play a crucial role in managing health insurance claims. However, delays in claim processing remain a major issue that negatively affects customer satisfaction. This study aims to describe the occurrence of delayed health insurance claims at one TPA in Indonesia in 2024. A descriptive quantitative approach was used, analyzing 442,279 secondary claim records to determine the frequency, type, and underlying causes of delayed claims. The findings revealed that 34% of all claims were classified as pending. Most pending claims involved outpatient and cashless services. The leading cause of the delay was incomplete documentation (55%), followed by invoice revisions and further claim investigations. These delays were largely attributed to unresolved administrative issues. Improving claim service quality in TPA requires the implementation of digital processing systems, enhanced staff competencies, and real-time document monitoring mechanisms.
Perilaku Pencegahan Penyakit Menular Seksual di Kalangan Wanita Pekerja Seksual Langsung Purnamawati, Dewi
Kesmas Vol. 7, No. 11
Publisher : UI Scholars Hub

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Abstract

Penyakit menular seksual, merupakan pandemi yang menimbulkan dampak kesehatan, sosial, ekonomi dan politik. Pekerja seks berperan penting dalam peningkatan kasus HIV/AIDS di Indonesia, posisi tawar wanita pekerja seksual langsung yang rendah dalam penggunaan kondom dan perilaku berisiko membuat perluasan penyebaran kasus penyakit menular seksual (infeksi menular seksual dan HIV/AIDS) semakin meningkat. Penelitian ini bertujuan untuk mengetahui secara mendalam perilaku wanita pekerja seksual langsung dalam pencegahan penyakit menular seksual di Kabupaten Karawang. Penelitian ini menggunakan pendekatan kualitatif dengan teknik wawancara mendalam. Informan adalah wanita pekerja seksual langsung, mucikari dan tenaga kesehatan. Dari hasil wawancara mendalam diketahui bahwa hampir semua wanita pekerja seksual langsung tidak mengetahui tentang penyakit menular seksual dan pencegahannya, sebagian besar mereka melindungi diri dengan menggunakan jelli, meminum antibiotik, jamu sehat, atau mencuci alat kemaluan dengan daun sirih. Penggunaan kondom didasarkan kesepakatan dengan pelanggan. Diperlukan upaya promosi dan pendekatan yang lebih efektif, bukan hanya pada wanita pekerja seksual langsung tapi juga untuk para pengguna jasa layanan seks. Sexually Transmitted Disease (STD) is a pandemic impacting social, economic and political aspests of life. Sex workers play an important role in the growth of AIDS cases in Indonesia, the low bargaining power of direct sex workers in the use of condom and the risk behavior of sex workers increased cases of sexually transmitted infections (STIs), HIV and AIDS. This study aimed to know district sex worker behavior to sexually transmitted disease behavior. Qualitative study design with in-depth interview techniques were used in this study. The informants are direct female sexual workers, pimps, and health providers. The results of in-depth interviews showed that almost all direct sexual workers are not knowledgeable on STD such as HIV and AIDS and how to prevent them. Most of them, protected themselves by using jellies, antibiotics, herbal medicine, or washing their genital with leaves of betel plant. Condom is used agreements with customers. Promotions and more effective approach are needed, not only for the sex workers but also for the users of sexual customers.
Konsumsi Jamu Ibu Hamil sebagai Faktor Risiko AsfiksiaBayi Baru Lahir Purnamawati, Dewi; Ariawan, Iwan
Kesmas Vol. 6, No. 6
Publisher : UI Scholars Hub

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Abstract

Jamu merupakan obat tradisional yang dibuat dengan cara mengolah bahan alamiah yang mempunyai khasiat obat dengan beberapa bahan campuran. Efektivitas dan efek samping pengobatan tradisional sebagai upaya pelayanan kesehatan masih perlu dibuktikan, khususnya jika digunakan oleh ibu yang sedang hamil. Penelitian ini bertujuan untuk mengetahui pengaruh konsumsi jamu pada ibu hamil terhadap kejadian asfiksia pada bayi baru lahir di Bekasi tahun 2008. Desain penelitian adalah kasus kontrol dengan metode kuantitatif dan kualitatif. Hasil penelitian menunjukkan hubungan yang signifikan antara konsumsi jamu terhadap kejadian asfiksia pada bayi baru lahir (nilai p = 0,005; odds ratio (OR) = 7,1; 95% CI = 4,23 – 11,9; (AFE) = 0,85; dan (AFP) = 0,43). Terdapat hubungan antara jumlah antenatal care (ANC) dan asfiksia pada bayi baru lahir dengan jumlah ANC = 4-8 kali (nilai p = 0,052; OR = 1,68; dan 95% CI = 0,99 – 2,83) sedangkan jumlah ANC kurang dari 4 kali (nilai p = 0,019; OR = 3,02; dan 95% CI = 1,2 – 7,58). Berdasarkan hasil wawancara mendalam diketahui bahwa mayoritas ibu hamil belum paham tentang perilaku sehat selama hamil dan tidak mendapatkan penjelasan yang cukup dari petugas kesehatan. Oleh karena itu, perlu ada peningkatan kualitas pelayanan kesehatan pada saat kehamilan dan persalinan serta perlu standardisasi penggunaan jamu untuk ibu hamil. Jamu are traditional medicine which is made by natural ingredience which has medicational effect combining with several ingrediences. The successful of traditional medicine as self medication in health care still need to prove for its efectiveness and the side effect especially if it used by pregnant women. The goal of this study is to know how the effect of consuming jamu for pregnant women with birth asphyxia in Bekasi in 2008. Quantitaive and qualitative study designs were used in this study. Case control design used to see how the odds ratio of the mother who have experience to take jamu during pregnancy. The result showed that there are relation and risk of consume jamu with birth asphyxia (p value = 0,000; odds ratio (OR) = 7,1; 95% CI = 4,23 – 11,9) and frequencies of antenatal care (ANC) with birth asphyxia (4 – 8 times during pregnancy, p value = 0,052; OR = 1,68; and less than 4 times during pregnancy, p value = 0,019; OR = 3,02). The result of indepth interview tells us that majority of mother doesn’t know about the health attitude during pregnancy and doesn’t have enough information from providers about it. Therefore increase the quality of health services during pregnancy and birth delivery and standart for using jamu for pregnant women are needed.
Alternative Recommendation For Fingerprint Registration Policies And Waiting Times On Revisit Compliance Of Schizophrenia Patients At Tangerang City Hospital Masithoh, Dewi; Fauziah, Munaya; Purnamawati, Dewi
Enrichment: Journal of Multidisciplinary Research and Development Vol. 3 No. 7 (2025): Enrichment: Journal of Multidisciplinary Research and Development
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/enrichment.v3i7.516

Abstract

Background: The fingerprint registration system has been implemented at Tangerang City Hospital since 2024 for all clinics as an effort to digitize outpatient services. However, the implementation of this system for patients with mental disorders such as schizophrenia has created access barriers, such as anxiety, ignorance, and emotional resistance. Long waiting times also hinder patient compliance with follow-up visits. Objective: This study aims to explore the experiences of schizophrenia patients and their family caregivers regarding the fingerprint registration system, waiting times, and interactions with healthcare professionals. This study also develops policy recommendations based on the experiences of service users. Methods: This qualitative study used a phenomenological approach using in-depth interviews with 20 informants (family members, healthcare professionals, registration coordinators, the Head of Medical Records and the Head of the Yanmed Work Team), as well as non-participatory observation and focus group discussions (FGDs). Analysis was conducted based on content. Results: Patients with schizophrenia experienced emotional, technical, and psychological barriers in the fingerprinting process. This non-inclusive system caused stress and discomfort, resulting in low compliance with follow-up visits. Waiting times exceeding two hours also worsened patients' psychological well-being. Most informants suggested a dedicated pathway and standard operating procedures (SOPs) for mental-friendly services as alternative policies. Conclusion: The fingerprint-based outpatient service policy is not yet inclusive of vulnerable groups such as schizophrenia patients. Reformulation of SOPs and policies for mental-friendly services based on empathy, efficient service duration, and alternative identity verification methods is needed.
Analysis of Factors Influencing Inpatient Satisfaction with Nutrition Services at RSKIA Sawojajar Bogor Sari, RD Yunina Endang; Purnamawati, Dewi; Ernyasih, Ernyasih; Fajrini, Fini; Permatasari, Tria Astika Endah
Enrichment: Journal of Multidisciplinary Research and Development Vol. 3 No. 7 (2025): Enrichment: Journal of Multidisciplinary Research and Development
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/enrichment.v3i7.534

Abstract

Patient satisfaction with hospital nutrition services is a crucial indicator of healthcare quality and recovery outcomes. Despite its importance, many hospitals still face challenges in meeting patient expectations regarding food quality and nutrition service delivery. This study aims to examine the factors affecting inpatient satisfaction with nutrition services. Using a descriptive-analytic method with a cross-sectional approach, the study involved 132 inpatients who met specific inclusion criteria. Data were collected through a structured questionnaire covering two main variables: patient perception of hospital food services and satisfaction with nutrition services, measured using a 4-point Likert scale. The results showed that most patients rated their perceptions and satisfaction positively, though some aspects received lower ratings from a small group of respondents. Statistical analysis revealed associations between satisfaction levels and demographic characteristics such as age, education, occupation, class of care, and length of stay, with varying levels of influence. Overall, food quality, service responsiveness, and personalized nutrition delivery emerged as key factors shaping patient satisfaction. This study provides valuable insights for improving nutrition service quality and promoting patient-centered care. Theoretically, it contributes to the understanding of healthcare service quality in nutrition services, while practically, it offers evidence-based recommendations for hospital management to enhance service delivery and patient care outcomes.
Pengaruh Promosi Kesehatan Menggunakan Cyberspace dalam Meningkatan Pola Hidup Sehat Lansia Diabetes Mellitus Parlaungan, Jansen; Tambunan, Sulastri GP.; Purnamawati, Dewi; Muhtar, Muhtar; Hasbi, Muhammad
Bima Nursing Journal Vol. 5 No. 1 (2023): November
Publisher : Poltekkes Kemenkes Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32807/bnj.v5i1.1426

Abstract

Peningkatan jumlah penduduk lansia ini akan berdampak terhadap berbagai kehidupan. Makin bertambah usia, makin besar kemungkinan seseorang mengalami permasalahan fisik, jiwa, spiritual, ekonomi dan sosial. Salah satu permasalahan yang sangat mendasar pada lanjut usia adalah masalah kesehatan akibat proses degeneratif, hal ini ditunjukkan oleh data pola penyakit pada lanjut usia penyakit terbanyak pada lanjut usia terutama adalah penyakit tidak menular antara lain hipertensi, osteo artritis, masalah gigi-mulut, Penyakit Paru Obstruktif Kronis (PPOK) dan Diabetes Mellitus (DM).  Tujuan penelitian ini untuk meningkatan pengetahuan menggunkan promosi kesehatan cyberspace dalam meningkatkan pola hidup sehat pada lansia  Diabetes Mellitus di Puskesmas Remu Kota Sorong Tahun 2023. Penelitian ini merupakan penelitian Quasi Eksperimen  dengan menggunakan rancangan kelas pembanding one group pretest-posttest design dengan menggunakan teknik pengembilan sampel Non Randomized Control Group Pretest-Posttest Design. Sampel dalam penelitian ini adalah 30 responden lansia  Diabetes Mellitus di Puskesmas Remu Kota Sorong yang menjadi kelompok intervensi. Intervensi yang digunakan adalah media promosi kesehatan cyberspace. Hasil penelitian menunjukkan nilai Sig. (2-tailed) pengetahuan lansia 0,012 < 0,05 maka dapat disimpulkan ada pengaruh metode Cyberspace media komunikasi kesehatan dalam penerapan pola hidup sehat lansia tentang Diabetes Mellitus di wilayah kerja Puskesmas Remu Tahun 2023. Pemanfaatan teknologi berupa media sosial dapat memicu peningkatan pengetahuan masyarakat tentang preventif penyakit, pemanfaatan akses kesehatan, perilaku patuh terhadap pengobatan dan partisipasi dalam menentukan keputusan kesehatannya. Penggunaan media dunia maya mampu meningkatkan social support serta berbagi dukungan dengan orang lain sehingga masyarakat dengan sadar secara spontan berbagi hal yang baik sekaitan dengan perubahan perilaku untuk menjadi sehat yang dialaminya.
Peningkatan Keterampilan Ibu dalam Memantau Perkembangan Batita dan Deteksi Dini Stunting Menggunakan Simulasi Game Jumanji Flash Card Hasbi, Muhammad; Wijayanti, G. A Sri Puja Warnis; Jafar, Sitti Rusdianah; Purnamawati, Dewi; Zulkifli, Zulkifli; Sentana, Aan Dwi; Mufida, Nur Aini
Bima Nursing Journal Vol. 5 No. 2 (2024): Mei
Publisher : Poltekkes Kemenkes Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32807/bnj.v5i2.1550

Abstract

Stunting is a serious public health problem faced by several countries, including Indonesia. The reality found in the field is that mothers do not know what child development is and how to assess it. One way to improve mothers' skills in integrating battery development using KPSP as an early detection of stunting is by simulating the Jumanji flash card game. This research aims to find out an overview of the Jumanji flash card game simulation on improving mothers' skills in integrating toddler development using KPSP as an early detection of stunting. Method: This research uses a Pre Experimental design with a One Group Pretest-Posttest design. The research population was mothers of toddlers who had stunting toddlers in the Jempong Barat area, Jempong Village, Karang Pole Community Health Center area. The total sample was 43 respondents. The sampling technique used purposive sampling technique. The results of statistical tests using the Wilcoxon sign shelf test showed that there was an influence of the Jumanji flash card game simulation on increasing mothers' skills in detecting their child's growth and development. Conclusion: The Jumanji flash card simulation game can improve mothers' skills in monitoring toddler development using KPSP as an early detection of stunting. Suggestion: It is recommended that mothers apply the skills of integrating toddler development to determine if the child's development is normal or whether there are deviations.
Pengaruh Pendidikan Kesehatan Dengan Media Flashcard Terhadap Pengetahuan dan Sikap Pasien DM Tipe 2 Tentang Perawatan Kaki Wati, Aprillia Erni; Sumartini, Ni Putu; Arip, Moh; Cembun, Cembun; Purnamawati, Dewi
Bima Nursing Journal Vol. 6 No. 1 (2024): November
Publisher : Poltekkes Kemenkes Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32807/bnj.v6i1.1648

Abstract

Diabetes meningkat dari tahun ketahun dan menimbulkan ancaman bagi kesehatan global, dengan prevalensi diabetes tipe 2 mencapai 90% dari semua diabetes, salah satu prevalensi tertinggi di dunia. Diabetes melitus adalah suatu gangguangan metabolisme karbohidrat, protein dan lemak akibat dari ketidak seimbangan antara ketersediaan insulin dengan kebutuhan insulin. Gangguan tersebut dapat berupa defisiensi insulin absolut, gangguan pengeluaran insulin oleh sel pankreas, ketidakadekuatan atau kerusakan pada reseptor insulin, produksi insulin yang tidak aktif dan kerusakan insulin seblum bekerja. Diabetes melitus merupakan penyakit kronik, progresif yang dikarakteristikan dengan ketidakmampuan tubuh untuk melakukan metabolisme karbohidrat, lemak, dan protein awal terjadinya hyperglikemia (kadar gula yang tinggi dalam darah) Tujuan penelitian ini untuk mengetahui pengaruh pendidikan kesehatan dengan media flashcart terhadap pengetahuan dan sikap pasien DM Tipe 2 tentang perawatan kaki di puskesmas cakranegara Penelitian ini menggunakan desain pre-experimental dengan pendekatan one group pre test-post test. Sampel dalam penelitian ini sebanyak 35 orang yang diambil dengan teknik puposive sampling. Pengumpulan data dalam penelitian ini menggunakan kuesioner kemudian data dianalisis dengan uji wilcoxon. Hasil penelitian sebelum diberikan pendidikan kesehatan dengan media flashcard diperoleh hasil bahwa 21 orang (60%), memiliki pengetahuan yang kurang tentang perawatan kaki, 11 orang (31%) memiliki pengetahuan yang cukup tentang perawatan kaki, 3 orang (9%) memiliki pengetahuan yang baik tentang perawatan kaki, 22 orang (63%) memiliki sikap negatif (Unfavorable) dan 13 orang (37%) memiliki sikap positif (favorable) tentang perawatan kaki. Setelah diberikan pendidikan kesehatan dengan media flashcard diperoleh hasil bahwa 28 orang (80%) memiliki pengetahuan yang baik tentang perawatan kaki, 7 orang (20%) memiliki pengetahuan yang cukup tentang perawatan kaki dan 35 orang (100%) memiliki sikap positif (favorable) tentang perawatan kaki. Hasil uji statistik diperoleh hasil ρ value 0.000 < 0.05 sehingga menunjukkan ada pengaruh pendidikan kesehatan dengan media flashcard terhadap pengetahuan dan sikap tentang perawatan kaki di puskesmas cakranegara.
The Influence of Dhikr on Anxiety in Acute Coronary Syndrome (ACS) Patients at Dr. Chasbullah Abdulmadjid Hospital, Bekasi City Sulistiyowati, Heppy; Jumaiyah, Wati; Purnamawati, Dewi; Sofiani, Yani; Susanto, Budi; Prima, Ashar; Hamdah, Hamdah
Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal) Vol. 10 No. 1 (2024): JURNAL KEPERAWATAN KOMPREHENSIF (COMPREHENSIVE NURSING JOURNAL)
Publisher : STIKep PPNI Jawa Barat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33755/jkk.v10i1.616

Abstract

Aims: This study was to determine the effect of dhikr on anxiety in ACS patients at Dr. Chasbullah Abdulmadjid General Hospital, Bekasi City. Methods: The research method used pre- and post-quasy experiments in the control group and the intervention group. This study used the HARS questionnaire and family support for 76 respondents. Result: Data analysis using multiple logistic regression tests The results showed that the proportion in the control group with mild-moderate anxiety was 31.6% and severe anxiety was 18.4%; the proportion in the intervention group with mild-moderate anxiety was 46.1% and severe anxiety was 3.9%. Dhikr (p = 0.006) and history of heart disease (p = 0.023) significantly influence anxiety after being controlled by age (p = 0.244) (p = 0.001 omnimbus). The dominant factor that influences anxiety is dhikr (OR 10.674).  Conclusions : Dhikr is an act of remembering Allah that can be used to reduce anxiety in SKA patients. This can be done independently by reading istigfar, tasbih, hauqalah, and takbir for 15 minutes in the morning and evening. Therefore, nursing services using dhikr as an effort to reduce anxiety in ACS patients.
Peran Telenursing dalam Peningkatan Mutu Pelayanan Keperawatan Zuliatika, Pratiwi; Purnamawati, Dewi
PubHealth Jurnal Kesehatan Masyarakat Vol. 3 No. 1 (2024): Edisi Juli
Publisher : Ilmu Bersama Center

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56211/pubhealth.v3i1.574

Abstract

Pelayanan keperawatan akan selalu berkembang seiring perkembangan teknologi informasi dan komunikasi. Tenaga perawat dituntut untuk memberikan pelayanan yang profesional dan berkualitas serta bisa memanfaatkan teknologi informasi dan komunikasi salah satunya adalah telenursing. Tujuan studi ini adalah untuk mendeskripsikan telenursing dan berfokus pada manfaatnya dalam pelayanan keperawatan. Metode yang digunakan dalam penelitian ini adalah kajian literature. 6 artikel diperoleh melalui penelusuran online database Google Scholar antara tahun 2016 hingga 2023 yang membahas telenursing dalam keperawatan. Hasil studi menemukan penggunaan teknologi informasi dalam layanan telenursing dapat memberikan fasilitas komunikasi jarak jauh dan memberikan peringatan pada pasien Telenursing harus dimanfaatkan secara tepat dan terpadu agar tujuan utama pemenuhan kesehatan masyarakat khususnya bagi mereka yang jauh dari pelayanan kesehatan dapat tercapai sehingga dapat meningkatkan mutu pelayanan kesehatan khususnya pelayanan keperawatan baik di Fasilitas Kesehatan maupun Homcare.
Co-Authors - Zulkifli A'Sentana, A'an Dwi AA Sudharmawan, AA Agus Triyono Agustianti, Erika Akaputra, Risky Almaududi, Abul A’la Amalia, Karina Amin, Ahmad Farid Andriyani Andriyani Aning Subiyatin Anom, Ngurah Antasyia, Nur Lailia Aragar Putri Ardiani, Kristi Ariani, I Gusti Ayu Devi Arip, Moh Ashar Prima Aswani, Yan Hadi Kustomo Atlantic, Mia Auliany, Diah Awaliah, Awaliah Baktiansyah, Abdul Burmanajaya, Bram Cembun, Cembun Damailita, Keumala Kusuma Dessylindra, Herningrum Deviyanti, Luckyana Dewi, Erlitha Azhari Djauharoh, Siti Nur Aisyah Endah, Tria Astika Ernawati, Any Ernyasih, Ernyasih Erwin Erwin Fadhilah Fadhilah Fajrini, Fini Fauziyah, Munaya Fitrijaningsih, Fitrijaningsih Hamdah, Hamdah Hamid, Irfany Nurul Hamidah . I Putu Suiraoka Iwan Ariawan Jansen Parlaungan Januar Ariyanto Jumaiah, Wati Jumaiyah, Wati Mardian, Okbi Mas'adah, Mas'adah Masithoh, Dewi Masykur Khair MAWADDAH, ELY Mayangsari, Denny Novita Meidora, Alfiani Hana Moh. Heri Kurniawan Mufida, Nur Aini Mufidah, Nur Aini MUHAMMAD HASBI Muhasidah, - Muhtar Muhtar Munaya Fauziah Ningrum, Amelia Pebria Nurfadhilah , Nurfadhilah Nursanah, Nursanah Nursardjan, Nursardjan Oktavina, Risa Olyvia, Novy Pratama, I Nyoman Wirya Pujawarnis W, Gusti Ayu Sri Purwana, Eka Rudy Putri, Linda Wahyuni Qolbah, Hayuning Ritonga, Yusniar Robalais, Ailla Nur Rowi, Armein Sjuhary RUSMINI Sari, RD Yunina Endang Sembiring, Rinawati Sentana, Aan Dwi Sepriyanti, Yuke Siswahyudianto Siti Nurfadhilah, Siti Sitti Rusdianah Jafar Sofyani, Yani Soraya, Apriliana Kartini Srisantyorini, Triana Sugiatmi, Sugiatmi Sulaeman, Ridawati Sulistiyowati, Heppy Sumartini, Ni Putu Sumedi Sumedi Tambunan, Sulastri GP. Thaha, Ahmad Razak Toha Muhaimin Tria Astika Endah Permatasari Ulfah, Rona Utomo, Muhammad Wiji Viga, Renjistian Wati, Aprillia Erni Wijayanti, G. A Sri Puja Warnis Wijayanti, Gusti Ayu Sri Pudja Warnis Wulandari Wulandari Wulandari, Reny Yulita Yani Sofiani Yuliarti Yuliarti Yuliawati, Suci Yunus, Muhammad Iqbal Zahrani, Azura Zuliatika, Pratiwi Zulkifli Zulkifli