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All Journal Jurnal Manajemen Kesehatan Indonesia Jurnal Admmirasi Jurnal Ilmiah Manusia dan Kesehatan Jurnal Pengabdian Kesehatan Infokes : Jurnal Ilmiah Rekam Medis dan Informasi Kesehatan Jurnal IPTEK Bagi Masyarakat Jurnal Pemberdayaan dan Pendidikan Kesehatan Prima Wiyata Health Promotor: Jurnal Mahasiswa Kesehatan Masyarakat Jurnal Abdimas BSI: Jurnal Pengabdian Kepada Masyarakat
Nella Tri Surya
Fakultas Ilmu Kesehatan, Universitas Kusuma Husada Surakarta
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Education Environmental Science Health Professions Languange, Linguistic, Communication & Media Mechanical Engineering Medicine & Pharmacology Nursing Physics Public Health Social Sciences Veterinary Other

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FACTORS ASSOCIATED WITH DELAYS IN BPJS HEALTH E-CLAIM SUBMISSION AT A GOVERNMENT HOSPITAL IN SRAGEN REGENCY Sri Nurul Kuraini; Anggi Napida Anggraini; Nella Tri Surya
PRIMA WIYATA HEALTH Vol 7 No 2 (2026): Prima Wiyata Health: Juli 2026
Publisher : LPPM STIKES HUSADA JOMBANG

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60050/pwh.v7i2.140

Abstract

Background: Delays in BPJS Health e-claim submission remain an administrative challenge that may affect hospital cash flow and operational sustainability. The complexity of claim processes requires effective management of human resources, medical documentation, information systems, regulations, and organizational support. Objectives: This study aimed to identify factors associated with delays in BPJS Health e-claim submission at a government hospital in Sragen Regency. Methods: This quantitative study used a cross-sectional design involving 19 officers directly involved in the BPJS e-claim process. Total sampling was applied. Data were collected using Likert-scale questionnaires and claim document observations. Variables included human resource quality, completeness of medical documents, information system quality, BPJS regulations, and hospital management support. Data were analyzed using descriptive analysis and Fisher’s Exact Test due to the small sample size. Results: Most respondents were aged 31–40 years (52.6%), female (68.4%), had a bachelor’s degree (52.6%), and had long work experience (42.1%). Fisher’s Exact Test showed significant associations between claim delays and human resource quality (p=0.000), completeness of medical documents (p=0.001), information system quality (p=0.045), and hospital management support (p=0.018). No significant association was found between BPJS regulations and claim delays (p=0.650). The most prominent factors related to claim delays were human resource quality and medical document completeness. Conclusion: Delays in BPJS Health e-claim submission were associated with human resources, medical document completeness, information system quality, and hospital management support. Strengthening staff competency, improving real-time medical record completeness monitoring, and optimizing BPJS e-claim system integration are recommended to improve claim submission efficiency and hospital financial management.
Co-Authors Agnes Prawistya Sari Agustina Pujilestari Anggi Napida Anggraini Anggi Putri Aria Gita Aryanti Seyaningsih Aulia Siti Nur Rahmah Deonisio Da Costa Ernawati Ernawati Frieda Ani Noor Intan Nurcahyaningsih Oliva Virvizat Prasastin Olivia Virvizat Prasastin Pri Handini Setyoningsih Sri Nurul Kur'aini Sri Nurul Kuraini Sri Nurul Kur’aini Sufina Pinto Sufina Pinto