Article Per Year (5 Year)
p-Index From 2021 - 2026
0.444
P-Index
This Author published in this journals
All Journal Jurnal Comprehensive Health Care Jurnal Mitrasehat Abdimas Polsaka
Lilik Meilany
Unknown Affiliation
Health Professions Medicine & Pharmacology Nursing Public Health

Published : 3 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 3 Documents
Search

 1 
Pengaruh Ketepatan Pengkodean Diagnosa dan Tindakan Medis pada Penyakit Diabetes Mellitus Tipe II terhadap Tarif Ina-Cbgs Unit Rawat Inap Di Rumah Sakit Umum Daerah Kota Makassar Sulawesi Selatan Ari Sukawan; Lilik Meilany
Jurnal Mitrasehat Vol. 10 No. 1 (2020): Jurnal Mitrasehat
Publisher : LPPM STIK Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51171/jms.v10i1.123

Abstract

Dasar pengelompokan dalam INA-CBGs menggunakan system kodefikasi dari diagnosis akhir dan tindakan/prosedur yang menjadi output pelayanan, dengan acuan ICD-10 untuk diagnosis dan ICD-9-CM untuk tindakan/prosedur. Tarif Indonesian-Case Based Groups yang selanjutnya disebut Tarif INA-CBGs adalah besaran pembayaran klaim oleh BPJS Kesehatan kepada Fasilitas Kesehatan Rujukan Tingkat Lanjutan atas paket layanan yang didasarkan kepada pengelompokan diagnosis penyakit dan prosedur. Di Rumah Sakit Umum Daerah Kota Makassar masih terdapat kurang tepat dan tidak tepat pada pengkodean diagnosa dan tindakan medis yang berpengaruh pada tarif INA-CBGs tinggi sedang dan rendah. Pengaruh Ketepatan Pengkodean Diagnosa dan Tindakan Medis Pada Penyakit Diabetes Mellitus Tipe II Terhadap Tarif INA-CBG’s Unit Rawat Inap Di Rumah Sakit Umum Daerah Kota Makassar. Dalam penelitian ini yang digunakan adalah penelitian asosiatif kuantitatif dimana peneliti mendapatkan gambaran dan keterangan-keterangan mengenai ketepatan pengkodean diagnosis dan tindakan medis pada penyakit diabetes mellitus tipe II terhadap tarif INA-CBG’s unit rawat inap di Rumah Sakit Umum Daerah Kota Makassar.. Sampel didapatkan 100 rekam medis pasien rawat inap penderita penyakit diabetes militus type II dibulan Januari 2017 - Juni 2017. Menggunakan uji parsial/uji t dan uji simultan/uji F. Dari hasil penelitian di Rumah Sakit Umum Daerah Kota Makassar. Sulawesi selatan terlihat pada tabel 4.1.1 ketepatan pengkodean diagnosa dan tabel 4.1.2 ketepatan tindakan medis masih terdapat pengkodean kurang tepat dan tidak tepat dalam memberikan kode. terdapat tarif yang dikategorikan tinggi, sedang dan rendah. Dari hasil penelitian terdapat adanya Pengaruh ketepatan pengkodean diagnosa dan tindakan medis terhadap tarif INA-CBGs. Berdasarkan hasil perhitungan, terdapat variabel yang paling berpengaruh terhadap tarif INA-CBG’s adalah ketepatan tindakan medis.
Influence of The Level of Knowledge of BPJS Patients on The Use of JKN Mobile Applications in TP2RJ RSU Thalia Irham Gowa Agustina; Lilik Meilany; Muh Erwin Rosyadi; Asriyanti
Comprehensive Health Care Vol. 8 No. 2 (2024): Comprehensive Health Care
Publisher : Lembaga Penelitian dan Pengabdian Masyarakat, Stikes Panrita Husada Bulukumba

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background : TheMobile JKN application is a new breakthrough developed by BPJS Kesehatan which provides convenience for participants to register or register in health services, take online queues, but there are still very few BPJS patients who use the Mobile application JKN data found that the total number of outpatient visits per day is 100 – 200 at Thalia Irham Goawa Hospital, only 10 – 15 use the JKN Mobile Application. Objective:To determine the influence of BPJS patients' knowledge level on the use of the Mobile JKN Application at TP2RJ. Method: This type of qualitative descriptive research with a simple linear regression analysis technique, a sample of 75 respondents, and an accidental sampling technique. Results: The results of simple linear regression showed a Significance Value = 0.000 < a probability value of 0.05 which means that there is an influence on the BPJS Patient Knowledge Level in TP2RJ, while the correlation value (R) = 0.688 and the determination coefficient (R Square) = 0.473, the following categories of independent variable influence strength (BPJS Patient Knowledge Level in TP2RJ) on the dependent variable show the strength of the influence magnitude is included in the category with a value of 0.30 – 0.50 (Utilization of Mobile JKN Application in TP2RJ): Conclusion: H0 rejected and Ha accepted there is an effect of BPJS patients' knowledge level on the utilization of the Mobile JKN Application, Meanwhile, the Knowledge Level variable has a moderate influence on the variable of the Utilization of the Mobile JKN Application in TP2RJ
Implementation of a Medical Coding Mentorship Program to Reduce BPJS Health Insurance Pending Claims at Sandi Karsa Hospital, Makassar Agustina; Lilik Meilany; Asriyanti; Rosana Dwiyanti Putri
Abdimas Polsaka Vol. 5 No. 1 (2026): Abdimas Polsaka: Jurnal Pengabdian Masyarakat
Publisher : LPPM Politeknik Sandi Karsa

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35816/abdimaspolsaka.v5i1.256

Abstract

Background: In Indonesia’s National Health Insurance (JKN) system, the accuracy of medical coding plays a critical role in determining claim approval and reimbursement through the Indonesia Case Base Groups (INA-CBGs) payment mechanism. Inaccurate coding of diagnoses and procedures often results in pending BPJS Health claims, leading to delayed payments and increased administrative burden for hospitals. This community service activity aimed to implement and evaluate a mentoring program designed to improve medical coding practices and reduce pending BPJS Health claims at Sandi Karsa Hospital, Makassar. Methods: The program was conducted from August to October 2025 using a participatory and problem-solving approach. The activities included initial assessment of pending claims, theoretical training on ICD-10 and ICD-9-CM coding principles, case-based simulations using actual medical records, direct on-site mentoring during coding processes, and the development of a Standard Operating Procedure (SOP) for medical coding. Program evaluation was performed by comparing the number of pending claims related to coding errors before and after the intervention and by observing improvements in coding practices. Results: Prior to the intervention, 85 cases of pending claims were identified as being caused by coding rule errors. After the mentoring program was implemented, the number decreased to 34 cases, representing a reduction of approximately 60%. In addition, qualitative improvements were observed in the consistency of determining principal and secondary diagnoses, the accuracy of ICD-10 and ICD-9-CM code selection, and the overall quality of claim documentation. Conclusion: The mentoring-based intervention effectively improved medical coding accuracy and reduced BPJS pending claims at the hospital. Continuous training, regular coding audits, and the implementation of standardized coding procedures are recommended to sustain these improvements and support more efficient hospital claim management
Co-Authors Agustina Ari Sukawan Asriyanti Muh Erwin Rosyadi Rosana Dwiyanti Putri