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All Journal Syntax Literate: Jurnal Ilmiah Indonesia Jurnal Ekonomi Kesehatan Indonesia
Rabiulyati, May
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Humanities Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Environmental Science Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Public Health Social Sciences Other

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Analisis Klaim Rawat Inap RSUD Kebayoran Baru November 2022 – April 2023: Pendekatan Sistem Rabiulyati, May; Nurwahyuni, Atik; Pujiyanto, Pujiyanto
Jurnal Ekonomi Kesehatan Indonesia Vol. 9, No. 1
Publisher : UI Scholars Hub

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Abstract

Hospitals receive payments through claim submissions with complete documents to the Social Security Administering Agency (BPJS) Health. However, not all inpatient claims have been submitted to BPJS Health, and there are still 16.97% pending inpatient claims. In claims that are not approved, claims can be resubmitted, but time constraints for the claim process have resulted in 2.64% of inpatient cases in 2022 not resubmitted. Qualitative research through in-depth interviews with 15 respondents aims to analyze the management of inpatient claims for BPJS Kesehatan Kebayoran Baru Hospital from November 2022 to April 2023. The study results showed that not all printed Participant Eligibility Letters (SEP) have been submitted for inpatient claims. There were 10.97% pending claims, with the cause being incomplete doctor's medical resumes for 59 inpatient files (32.2%) and inconsistencies in submitting claim files for 81 inpatient files (44.3%). This is due to the suboptimal feedback and monitoring, so it is necessary to establish a claim management monitoring flow. Hospitals must also establish Standard Operating Procedures (SOP) for integrated claim management. This study is expected to be a strategic guide to improve BPJS Kesehatan claim management with Focus Group Discussion (FGD) efforts for collaboration between agencies/units/teams and better cooperation between hospitals and BPJS Kesehatan. All solutions implemented are expected to improve the quality of hospital claims.
Penyusunan Rencana Strategis Bisnis RSUD Kebayoran Baru: Rencana Strategi Pemasaran Rabiulyati, May; Nurwahyuni, Atik; Sulistiadi, Wachyu
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v8i10.13817

Abstract

The Draft Strategic Business Plan for RSUD Kebayoran Baru was formed, where currently RSUD Kebayoran Baru is in cell V Hold and Maintain, with the recommended strategies being market penetration and product development. It is necessary to develop a marketing strategy in order to increase visits from neurological poly patients, in particular, increasing market share through collaboration with private insurance, travel agents, hotels or other companies in the area. Another strategy is to conduct seminars and monitor patient engagement with views, likes, comments, shares and satisfaction figures on Google reviews. Recommendations for improving service quality, increasing advertising/marketing outside the building, and strong commitment from all leaders and staff for the successful implementation of the hospital's strategic plan.
Co-Authors Nurwahyuni, Atik Nurwahyuni, Atik Pujiyanto Pujiyanto Sulistiadi, Wachyu