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All Journal Journal of Health Policy and Management Infokes : Jurnal Ilmiah Rekam Medis dan Informasi Kesehatan PELS (Procedia of Engineering and Life Science) OVUM : Journal Of Midwifery and Health Sciences Proceeding of International Conference Health, Science And Technology (ICOHETECH) Prosiding Seminar Informasi Kesehatan Nasional Madani: Jurnal Pengabdian Masyarakat dan Kewirausahaan Jurnal Pengabdian Masyarakat Indonesia (JPMI)
Lilik Anggar Sri Rahayuningsih
Universitas Duta Bangsa Surakarta
Humanities Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Control & Systems Engineering Decision Sciences, Operations Research & Management Education Electrical & Electronics Engineering Engineering Health Professions Industrial & Manufacturing Engineering Medicine & Pharmacology Nursing Public Health Veterinary Other

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ANALYSIS OF FACTORS CAUSING PENDING BPJS CLAIMS IN EMERGENCY CASES AT PANDAN ARANG REGIONAL GENERAL HOSPITAL BOYOLALI Utami, Yeni Tri; Rahayuningsih, Lilik Anggar Sri; Itasari, Pipit; Bobo, Cesilia Juliana da Cruz Tasi; Silva, Densiana Nunes da
Proceeding of the International Conference Health, Science And Technology (ICOHETECH) 2025: Proceeding of the 6th International Conference Health, Science And Technology (ICOHETECH)
Publisher : LPPM Universitas Duta Bangsa Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47701/dfv7e244

Abstract

Pending BPJS claims for emergency cases is one of the obstacles in the healthcare payment process, impacting the smooth operation of the hospital. At Pandan Arang Regional Hospital (RSUD) in Boyolali, the number of pending claims is quite high, with 1,045 pending claims in 2024. This study aims to analyze the factors causing pending BPJS claims for emergency cases at Pandan Arang Regional Hospital in Boyolali. The research method used is descriptive with a retrospective approach. The study population of pending BPJS emergency claims was 1,045, with a sample of 289 individuals using simple random sampling. The results indicate that pending claims were largely caused by factors such as inappropriate emergency conditions (180 cases (62.28%), incomplete documentation (55 cases (19.03%), and other factors (54 cases (18.69%). This situation disrupts hospital cash flow, increases staff workload, and potentially decreases the quality of patient care. Therefore, improved efforts are needed through routine training, the preparation of clear SOPs, increased coordination between units, and the use of information technology so that the claims process runs more optimally and the quality of hospital services is maintained.
Prediksi Gross Death Rate dan Net Death Rate di Rumah Sakit PKU Muhammadiyah Sukoharjo Tahun 2024-2028 Sri Rahayuningsih, Lilik Anggar; Rahmawati, Eni Nur; Fauziah, Fadhilah Jihan Nur
OVUM : Journal of Midwifery and Health Sciences Vol. 4 No. 2 (2024): OVUM : Journal of Midwifery and Health Sciences
Publisher : Universitas Duta Bangsa Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47701/ovum.v4i2.4143

Abstract

Prediksi menggambarkan kondisi dimasa yang akan datang sejumlah kegiatan yang terjadi dalam setiap aspek kehidupan. Trend merupakan data yang disusun berdasarkan urutan waktu atau data yang dikumpulkan dari waktu ke waktu. Berdasarkan hasil survey belum pernah dilakukan penelitian tentang trend indikator mortalitas. Penelitian ini bertujuan untuk mengetahui trend indikator Gross Death Rate (GDR) dan Net Death Rate (NDR) tahun 2019-2023. Serta mengetahui prediksi indikator GDR dan NDR tahun 2024-2028. Jenis penelitian deskriptif dengan Pendekatan retrospektif. Metode pengambilan data observasi dan wawancara. Populasi dari data rekapitulasi sensus harian rawat inap tahun 2019-2023. Teknik pengambilan sampel menggunakan teknik sampel jenuh. Instrument penelitian menggunakan pedoman observasi, pedoman wawancara, alat hitung, tabel kerja, alat tulis. Hasil penelitian diperoleh angka GDR pada tahun 2019-2023 tertinggi tahun 2021 dengan hasil 52,65 ‰ tidak ideal, terendah tahun 2022 dengan hasil 15,19 ‰ ideal. Serta angka NDR pada tahun 2019-2023 tertinggi tahun 2021 dengan hasil 48,34 ‰ tidak ideal, terendah tahun 2022 dengan hasil 11,93 ‰ ideal. Hasil trend dan prediksi angka GDR penurunan sebesar (-1,742) setiap tahunnya, hasil trend dan prediksi angka NDR penurunan sebesar (-0,48) setiap tahunnya. Kesimpulan bahwa trend statistik kematian Tahun 2019-2023 terjadi penurunan trend GDR sebesar (-1,742) dan trend NDR sebesar (-0,48). Prediksi statistik kematian tahun 2024-2028 terjadi penurunan pada prediksi GDR dan prediksi NDR. Sebaiknya rumah sakit mempertahankan dan menjaga mutu pelayanan dengan baik karena nilai GDR dan NDR ada yang belum ideal yang ditetapkan oleh Depkes.
Implementation Of Poac Management (Planning, Organizing, Actuating And Controlling) In An Effort To Reduce The Number Of Pending Claims For Inpatient Bpjs In The Hospital Tri Utami, Yeni; Maryati, Warsi; Sri Rahayuningsih, Lilik Anggar
Proceeding of the International Conference Health, Science And Technology (ICOHETECH) 2024: Proceeding of the 5th International Conference Health, Science And Technology (ICOHETECH)
Publisher : LPPM Universitas Duta Bangsa Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47701/icohetech.v5i1.4207

Abstract

Problems with pending claims in hospitals are mostly caused by incomplete files and discrepancies in the accuracy of diagnosis codes. UNS Surakarta Hospital is known to find around 50-300 BPJS Inpatient claim files pending every month. This study aims to determine management in an effort to reduce the number of pending claims for inpatient BPJS patients in hospitals. This type of research is descriptive qualitative, with a cross sectional approach. The subjects of this research include claims coordinators, coders, internal verification officers and medical committee members (doctors). The research object is the claim file for Trimonths 4 of 2023. The instruments used are interview guidelines, observation guidelines, checklists. The research results showed that of the 2289 claim files submitted, 168 files (7.34%) were pending, which were divided into 3 factor classifications, namely Medical Aspects 62 files (36.90%), Administrative Aspects 57 files (33.93%) and Coding Aspect 49 files (29.17%). The process of handling pending claims based on planning, organizing, actuating and controlling aspects is still not running optimally. This is caused by the lack of clear division of job descriptions and the absence of SOPs related to handling pending claims which are only manifested in official notes, in general evaluations are still carried out based on cases but not based on users which causes there to be no rewards and punishments for officers who do not comply. It would be better for hospitals to prepare SOPs for filling out BPJS claim requirements files, and make clear job desk divisions, especially the BPJS coding section, and implement Inpatient RME immediately.
Review Of Workforce Needs In The Filing Section Based On The ABK – Kes Method At RSJD Dr. Arif Zainudin Surakarta In 2024 Cahyaningrum, Nopita; Andriani, Rika; Rahayuningsih, Lilik Anggar Sri; Refin, Joanne Kayla
Procedia of Engineering and Life Science Vol. 6 (2024): The 3rd International Scientific Meeting on Health Information Management (3rd ISMoHI
Publisher : Universitas Muhammadiyah Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21070/pels.v6i0.1977

Abstract

The ABK - Kes method is one way of calculating health human resource needs based on the workload carried out by each type of SDMK in accordance with their main duties and functions. Dr Arif Zainudin Surakarta Regional Mental Hospital has 2 filing officers. There are several problems including filing officers having to sort documents manually, the transition of manual medical records to electronic medical records, and limited medical record document folders in medicolegal services. This study aims to determine the number of labour requirements in the medical record unit of the filing section using the ABK - Kes method. This research is a descriptive research, with a cross sectional approach. The subjects in this research are 2 filing officers while the object in this research is the workload of filing officers. Data collection methods were carried out by observation and interview. The results of this research are a health facility of the type of regional psychiatric hospital owned by the Central Java provincial government with the type of SDMK medical records unit in the filing section, available work time of 75.600 minutes/year, workload components totalling 13 main tasks and 3 additional tasks, workload standards of 285.773 minutes/year, FTP value of 2.75% and STP value of 1.03 and the need for SDMK in the filing section after being calculated using the ABK - Kes method is 4 officers. The number of officers of the medical record unit in the filing section at Dr Arif Zainudin Surakarta Hospital currently amounts to 2 officers, from the results of calculations using the ABK-KES method resulting in 4 officers. The suggestion that researchers can give is that they should add 2 medical record officers in the filing section, so that the workload of filing officers is not high which will result in the quality of officer performance.
Peningkatan Pengetahuan Orang Tua Mengenai Deteksi Dini Gangguan Perilaku Pada Anak Berbasis Sistem Informasi Pada Kelas Balita Desa Dlingo Nurhayati, Nurhayati; Rahayuningsih, Lilik Anggar Sri
Madani: Jurnal Pengabdian Masyarakat dan Kewirausahaan Vol. 4 No. 1 (2025): Oktober 2025
Publisher : LPPM Universitas Internasional Batam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37253/madani.v4i1.11412

Abstract

Perkembangan balita sangat penting karena menjadi dasar bagi tumbuh kembang fisik, kecerdasan, kemampuan bersosialisasi, dan emosinya. Oleh karena itu, orang tua perlu dibekali pengetahuan tentang gangguan perilaku anak, cara mengenali sejak dini, serta keterampilan menggunakan teknologi untuk membantu proses tersebut. Kegiatan ini dilakukan melalui beberapa tahap, seperti persiapan, penyusunan materi, penyuluhan, pelatihan, pendampingan, dan monitoring. Hasilnya, orang tua menjadi lebih paham tentang jenis dan gejala gangguan perilaku anak, mengerti cara mendeteksi secara mandiri, mengerti langkah-langkah penanganan yang tepat, serta mampu memanfaatkan teknologi untuk memantau perkembangan perilaku anak dengan lebih baik.
Co-Authors Andriani, Rika Aprilliana, Dinda Ayyu Dwi Bhisma Murti Bobo, Cesilia Juliana da Cruz Tasi Cahyani, Elvira Sinta Didik Tamtomo, Didik Fanny, Nabilatul Fauziah, Fadhilah Jihan Nur Itasari, Pipit Katarina Dewi , Bety Maryati, Warsi Ma’rifatul Fitria Ulfah Nopita Cahyaningrum Nur Rahmawati, Eni Nurhayati Nurhayati Refin, Joanne Kayla Sari, Sella Yulia Silva, Densiana Nunes da Tri Utami, Yeni Triutomo, Arif Nugroho Utami, Yeni Tri Wahyu Indarwati , Putry Wulandari, Fitria Ika