Jurnal Rekam Medis dan Informasi Kesehatan
Vol 5, No 1 (2022): Maret 2022

Tinjauan Penyelesaian Dispute Klaim Rawat Inap Pasien Coronavirus Disease 2019 (COVID-19) di RSUD Ajibarang Tahun 2020

Eliyah Eliyah (Poltekkes Kemenkes Semarang)
Aulia Ughti Ratriana (Puskesmas 2 Pekuncen, Kecamatan Ajibarang Kabupaten Banyumas)



Article Info

Publish Date
30 Mar 2022

Abstract

Dispute claim are disagreement between BPJS Kesehatan and health facilities over claims caused by coding or medical. The dispute becomes a workload for the claim submission officers and affects the hospital revenue. We found that there 66 files in dispute category at RSUD Ajibarang in April-July 2020 with a percentage of 50,8%. The purpose of this study is to analyze the causes of disputed claims for inpatient treatment based on inputs and processes, to find the solution overview. This research uses a qualitative descriptive method with case study approach and the research subjects are 4 people. The research on human resources and facilities showed relatively good conditions. Regarding the technological factor, SIMRS development is needed, the planning factor requires the creation of a special SOP to handle the COVID-19 claim dispute issue and the claim process implementation factor is seen from the flow that is in accordance with existing regulations, an introduction to the procedure for inputting COVID-19 claims is needed on INA-CBG's application. So, it can be concluded that it is necessary to prepare SOP related to disaster cases in collecting claims in the INA-CBG's application and providing human resources who have special competencies for medical recorders.

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Journal Info

Abbrev

RMIK

Publisher

Subject

Health Professions

Description

It is aimed at all medical record and health information practitioners and researchers and those who manage and deliver medical record and health information services and systems. It will also be of interest to anyone involved in health information management, health information system, and health ...