<![CDATA[Implementation of the National Health Insurance (JKN) through the Indonesia Case Based Groups (INA-CBGs) payment mechanism demands hospitals to ensure clinical service quality while maintaining claim administration accuracy. The anatomical pathology laboratory holds a strategic role in establishing definitive diagnoses, which form the basis for diagnosis and medical procedure coding. However, studies examining the role of anatomical pathology in supporting hospital service quality and the success of BPJS Kesehatan claims remain limited. This study aims to analyze the role of the anatomical pathology laboratory in realizing the service quality at Patologi Medis Diagnostik Laboratory to support the INA-CBGs-based BPJS claim process. The study used a descriptive qualitative approach with in-depth interviews with key informants involved in anatomical pathology services and the BPJS claim process, including anatomical pathologists, laboratory analysts, clinicians, medical record officers, and the claim team. Data were analyzed thematically through coding, categorization, and interpretation processes, and validated using source and document triangulation. The results showed that anatomical pathology plays a vital role in ensuring the accuracy of definitive diagnoses, improving the accuracy of INA-CBGs coding, and supporting the fulfillment of hospital accreditation standards. The integration of anatomical pathology results with medical records and claim systems proved to contribute to a decrease in pending claims. Main constraints identified include limited human resources and sub-optimal information system integration. Optimizing the role of the anatomical pathology laboratory is a key element in improving hospital service quality and the effectiveness of BPJS claims. Strengthening governance, system integration, and quality-oriented managerial policies are required to support the sustainability of hospital financing within the JKN system.]]>
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