BPJS Claims Pending Case Coding Training at AISYIYAH PADANG RSU
Pelatihan Pengodean Kasus Pending Klaim Bpjs Di RSU AISYIYAH PADANG
Abstract
Hospital health facilities are required to complete BPJS claim documents before submitting them to BPJS Health to get reimbursement for treatment costs according to the Indonesian Case Base Groups (INA-CBG's) rates. The BPJS claim process already uses the INA-CBGs program. With this payment method, the accuracy of clinical and procedure code data determines the financing of health services. Service of Community Activities (PKM) aim to provide education regarding ICD-10 coding regulations in minimizing cases of pending claims that occur at Aisyiyah General Hospital, Padang. This PKM did at Aisyiyah Hospital Padang on 06-07 October 2022 Service of Community in the form of outreach regarding the urgency of using the ICD-10 then followed up in the form of practicing ICD-10 coding cases of pending claims to partners. This activity was attended by 18 participants from the medical team and case-mix. Result of pre-test and post-test showed, increasing the team's understanding of ICD-10 coding regulations and cases pending claims.
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References
Bowman, E, & Abdelhak, Mervat. (2001). Coding, classification, and reimbursement systems. Health information: management of a strategic resource. 2nd edition. Philadelphia: WB Saunders Company, 229-258.
Cut Juli Muroli, T. B. (2019). Faktor-Faktor Yang Mempengaruhi Terjadinya Pending Klaim Rawat Inap Oleh BPJS Di RSAB Harapan Kita Jakarta Barat. Jurnal Manajemen dan Administrasi rumah Sakit Indonesia, 196
Faik Ahgiwayuanto, S. O. (2019). Analisis Implementasi Total Quality Management (TQM) Pada Kasus Pending Klaim Jaminan Kesehatan Nasional (JKN) Di RSUD Kendal Tahun 2018. Jurnal manajemen Kesehatan Indonesia, 5-6.
Firyal Nabila, S., Weka Santi, M. and Deharja, A. (2020) ‘Analisi Faktor Penyebab Pending Klaim Akibat Koding Berkas Rekam Medis Pasien Rawat Inap di RSUPN DR. Cipto Mangunkusumo’, Jurnal Rekam Medik dan Informasi Kesehatan, 1(4), pp. 519–528
Nabila, S. F., Santi, M. W., Tabrani, Y., & Deharja, A. (2020). Analisis Faktor Penyebab Pending Klaim Akibat Koding Berkas Rekam Medis Pasien Rawat Inap di RSUPN Dr. Cipto Mangunkusumo. J-REMI : Jurnal Rekam Medik Dan Informasi Kesehatan, 1(4), 519–528. https://doi.org/10.25047/j-remi.v1i4.2157
Naga, dr. Mayang Anggraini. (2013). Buku Kerja Praktik Pengkodean Klinis Berdasarkan Rules dan Konvensi ICD-10, WHO.
Nuraini, N. (2019). Optimalisasi Manajemen Penanganan Klaim Pending Pasien Bpjs Rawat Inap Di Rumah Sakit Citra Husada Jember. Jurnal Kesmas Indonesia, 3-9.
Nuryati, Niko Tesni Saputro. (2015). Faktor Penyebab Ketidaktepatan Kode Diagnosis di Puskesmas Mojolaban Sukoharjo Jawa Tengah. Jurnal Manajemen Informasi Kesehatan Indonesia, ISSN:2337-585X, Vol.3, No.1, Maret 2015.
Oktamianiza and Reza, I.A. (2022) ‘Tinjauan Ketepatan Kode dengan Pending Klaim Pasien Rawat Inap BPJS Kesehatan di RSUD dr . Adnaan Wd Payakumbuh Tahun 2021’, Jurnal Rekam Medis dan Informasi Kesehatan, 5(1), pp. 37–46.
Republik Indonesia, Undang-Undang 2004, Undang-Undang No.40 Tahun 2004 tentang Sistem Jaminan Sosial Nasional.
Susan, F. O., Arso, S. P. and Wigati, P. A. 2016. Analisis Administrasi Klaim Jaminan Kesehatan Nasional Rawat Jalan RSUD Kota Semarang Tahun 2016. Jurnal Kesehatan Masyarakat (e-Journal), vol 4, no 4, hal 32–43. [7 April 2020]
Supriadi, & Rosania, S. (2019). Tinjauan Berkas Klaim Tertunda Pasien Jkn. 7, 19–26.
