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All Journal J-REMI : Jurnal Rekam Medik dan Informasi Kesehatan
Lutfiatun Nadibah Herman
Politeknik Negeri Jember
Health Professions Public Health

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Tinjauan Keterlambatan Klaim Berkas BPJS Rawat Inap di RSUP dr. Hasan Sadikin Lutfiatun Nadibah Herman; Sustin Farlinda; Efri Tri Ardianto; Agus Setiawan Abdurachman
J-REMI : Jurnal Rekam Medik dan Informasi Kesehatan Vol 1 No 4 (2020): September
Publisher : Politeknik Negeri Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25047/j-remi.v1i4.2030

Abstract

The implementation of the National Health Insurance program in hospitals as referral Health Service Provider in collaborate with the Indonesia Health Insurance Implementing Agency to provided public health services by using a prospective payment system. Based on preliminary study, it known the inpatient claim file had delayed as much 11.38%. It’s not according to hospital standards that claimed should be 100%. This research aimed to provided a preview the causing factors of delayed inpatient claims at RSUP Dr. Hasan Sadikin Bandung based on 5M management elements. This research was descriptive qualitative with expose the results of interviews and observations that had been done in comparison of the theories available. The results showed that the officers still found difficulties to read the diagnosis and the patient's actions due to doctor’s handwrinting difficult to read, incorrect diagnosis codes and actions due to differences in perception between the coder and the doctor, incomplete claimed files such as the result of the patient's supporting examination. There was no standard operational procedure as regulation of inpatient BPJS claimed requirements, computers that been used in the process of filing claims often experiencing long loading and often experiencing network disruptions so it could reduce the performance of officers. In response to those factors, it needs to make a standar operational procedure for completing claim files, to conduct training specifically about National Health Insurance coding at least once a year and doing maintenance on the computer at least once a month. 
Analisis Penyebab Lama Penyediaan Berkas Rekam Medis Rawat Jalan di Puskesmas Mangaran Lutfiatun Nadibah Herman; Rossalina Adi Wijayanti; Atma Deharja; Mochammad Choirur Roziqin
J-REMI : Jurnal Rekam Medik dan Informasi Kesehatan Vol 2 No 1 (2020): December
Publisher : Politeknik Negeri Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25047/j-remi.v2i1.2031

Abstract

The provision of long-term patient outpatient medical record files in Mangaran Public Health Center is one type of service provided to patients. Based on pre-research survey, it known that the time for providing the medical record files that exceed the established standards is 17.70%. This researched aim is to analyze the caused factors of the long duration for supplying medical file records of long-term patient based on individual and situational factors which will the priority causes of the main problems using the Reinke method. This research is qualitative research. The results showed that long waited for supplying medical record files of long-term patient is the searching process of the medical file records that takes a long time due to the attitude of the officer while handling misfile is not optimal, there is no training related to the medical records, less detailed SOP registration does not contain the standard time to provide the medical file records and the absence of SOP to return the medical records, and also the computers that often error and unavailability of tracers in the storage room. In response to those factors, it is necessary to make an improvement and socialization about the registration SOP’s, requesting propose of the medical record file map/folders and the use of tracers, and also held a training specifically about the medical file records at least 2 or 3 times a year and also doing the computer maintenance at least once a month.
Co-Authors Agus Setiawan Abdurachman Atma Deharja Efri Tri Ardianto Mochammad Choirur Roziqin Rossalina Adi Wijayanti Sustin Farlinda