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All Journal Jurnal Kebijakan Kesehatan Indonesia VISIKES Jurnal Transformatika Jurnal Manajemen Kesehatan Indonesia HIGEIA (Journal of Public Health Research and Development) Journal of Health Education Jurnal Kesehatan Vokasional Media Ilmu Kesehatan Jurnal Riset Informatika Care : Jurnal Ilmiah Ilmu Kesehatan Unnes Journal of Public Health Jurnal Kesehatan Jurnal Manajemen Informasi Kesehatan Indonesia (JMIKI) Afiasi : Jurnal Kesehatan Masyarakat J-REMI : Jurnal Rekam Medik dan Informasi Kesehatan

Agiwahyuanto, Faik

Universitas Dian Nuswantoro

Author-ID : 3780304

Computer Science & IT Decision Sciences, Operations Research & Management Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

Published : 33 Documents Claim Missing Document

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PATIENT CLAIM FINANCING AT RSUP DR. KARIADI SEMARANG DURING THE COVID-19 PANDEMIC Faik Agiwahyuanto, S.Kep.,M.Kes; Evina Widianawati; Widya Ratna Wulan; Via Ayusasmita; Deddy Setiadi
VISIKES: Jurnal Kesehatan Masyarakat Vol 21, No 1 (2022): VISIKES
Publisher : Dian Nuswantoro Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33633/visikes.v21i1Supp.5819

RSUP Dr. Kariadi Semarang sees both outpatients and inpatients to assess their health status and condition. Patient's health status and condition are classified into two groups: comorbid and co-incident. Patient claims are funded based on status and health conditions of comorbid and co-incident patients. The objectives this research is to know about the patient claim financing procedures of RSUP Dr. Kariadi Semarang during covid-19 pandemic. This research is descriptive qualitative using phenomenological. Primary data sources quotations were chosen using either purposeful sampling or criterion-based selection. The research informants are the primary informants. Informants are Hospital's first primary informant, the Coordinator of Coding Casemixes, and the second primary informant, the Nurse Coordinator of the Covid-19 Handling Room, as well as the first triangulation informant, the Head of the Medical Record Unit, and the second triangulation informant, the Head of the Covid-19 Handling Task Force. Interviews is methods for gathering data. Source triangulation is used for data triangulation. Data analysis using flow model of analysis and interactive analysis model. The result of this research are covid-19 with comorbidity or covid-19 with co-incident in patients because the guarantor is different, the case will be entered twice if it is a co-incident. If the condition is comorbid, the claim is handled separately. Previously, a claim was made for the covid-19 case, and if the covid-19 case was completed but the comorbidities persisted, the guarantor was changed from the Ministry of Health to BPJS Health. The conclusion is during the covid-19 pandemic, the procedures of RSUP Dr. Kariadi Semarang's patient claim financing process are two, such as the guarantor from the Ministry of Health and BPJS Health. Keywords: Patient claim, financing, process

GAMBARAN TINGKAT PENGETAHUAN PRAKTIK VULVA HYGIENE SAAT MENSTRUASI PADA SISWA KELAS VIII SMP NEGERI 25 SEMARANG TAHUN PELAJARAN 2017-2018 Faik Agiwahyuanto
VISIKES: Jurnal Kesehatan Masyarakat Vol 17, No 01 (2018): APRIL 2018
Publisher : Dian Nuswantoro Semarang

ABSTRACT: Adolescence is a time of growth or the transition from childhood to time up, this is known by the term puberty, this occurs at 9-15 years age. Symptoms arising in puberty is menstruation. Vulva hygiene is an act which by woman to keep the health and cleanliness of her vulva area. The patterns and habits of students in Semarang SMP 25 do not yet controlled by vulva hygiene school parties, while the school has been doing its job to provide reproductive health education about vulva hygiene, but has never carried out an evaluation of the knowledge students to do vulva hygiene during menstruation.The purpose of this research is to know the level of vulva hygiene practice upon knowledge of menstruation.Population studies 128 respondents, with sampling stratified random sampling, so retrieved 97 respondents. Engineering data collection using primary data and secondary data. The research results of 97 students of class VIII SMP 25 Semarang in obtaining results from the 72 respondents (74,2%) in both the category and the category quite 25 respondents (16%).Conclusions in this study is that most students of class VIII in SMP 25 Semarang have good knowledge about the practice (74,2%) vulva hygiene during menstruation. The advice of the author is respondents are expected to apply the vulva hygiene while mestruating regularly and properly.Keywords: knowledge, adolescence, vulva hygieneABSTRAK: Masa remaja adalah masa pertumbuhan atau peralihan dari masa kanak-kanak ke masa ke atas, hal ini dikenal dengan istilah pubertas, ini terjadi pada usia 9-15 tahun. Gejala yang timbul saat pubertas adalah menstruasi. Vulva hygiene adalah tindakan yang dilakukan oleh wanita untuk menjaga kesehatan dan kebersihan area vulvanya. Pola dan kebiasaan siswa di SMP Negeri 25 Semarang belum dikendalikan oleh pihak sekolah kebersihan vulva, sementara sekolah telah melakukan tugasnya untuk memberikan pendidikan kesehatan reproduksi tentang kebersihan vulva, tetapi belum pernah melakukan evaluasi terhadap pengetahuan siswa untuk melakukan kebersihan vulva selama menstruasi. Tujuan penelitian ini adalah untuk mengetahui tingkat praktik kebersihan vulva pada pengetahuan menstruasi.Â Studi populasi 128 responden, dengan pengambilan sampel stratified random sampling, sehingga diambil 97 responden. Teknik pengumpulan data menggunakan data primer dan data sekunder. Hasil penelitian 97 siswa kelas VIII SMP 25 Semarang dalam memperoleh hasil dari 72 responden (74,2%) baik dalam kategori maupun kategori cukup 25 responden (16%). Kesimpulan dalam penelitian ini adalah bahwa sebagian besar siswa kelas VIII di SMP 25 Semarang memiliki pengetahuan yang baik tentang praktik (74,2%) kebersihan vulva selama menstruasi. Saran dari penulis adalah responden diharapkan untuk menerapkan kebersihan vulva saat berjajar secara teratur dan benar.Kata Kunci : Pengetahuan, Remaja, Kebersihan Vulva

Perbedaan Sistem Pelayanan Medis Dokter dengan Standar INA-CBGs (Studi Kualitatif Pasien Ketuban Pecah Dini di RS X) Faik Agiwahyuanto
VISIKES: Jurnal Kesehatan Masyarakat Vol 16, No 1 (2017): VisiKes
Publisher : Dian Nuswantoro Semarang

BPJS (Social Insurance Administration Agency) Health will pay the irst-level health facilities with capitation. For advanced level referral health facilities, Health BPJS pay package system Indonesia Case Base Groups (INA-CBGs). INA-CBGs system is a classiication of patient care episode that designed to create classes that are relatively homogeneous in terms of resources used and contained patients with similar clinical characteristics. Hospitals will receive payments based on the average amount spent on a group diagnosis.This was qualitative study. The informants were 6, devided into 3 person as main informants and 3 triangulation informant, they were selected by snowball sampling techniques. The indepth interview data was transcripted in March 2016 then analyzed by the content analysis.Diferent diagnoses and medical procedures for standard medical services of doctors in hospitals with INA-CBGs standards, for example, premature infarction (KPD) should be performed by Sectio Caesarea (SC) up to 6 hours while INA-CBGs for early SC delivery within 24 hours. The hospital needs to increase the number of coding teams, hospital veriiers, and BPJS officer, and monitor and evaluate doctors, medical records, and hospital internal veriiers by clinical micro system under SIM-RS and coding units.Keywords: medical diagnosis, INA-CBGs, Premature rupture of membranes.

Analisis Implementasi Total Quality Management (TQM) Pada Kasus Pending Klaim Jaminan Kesehatan Nasional (JKN) Di RSUD Kendal Tahun 2018 Faik Agiwahyuanto; Shinta Octaviasuni; Moh. Umar Nauful Fajri
Jurnal Manajemen Kesehatan Indonesia Vol 7, No 3 (2019): Desember 2019
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jmki.7.3.2019.15-24

Background: Improvements in hospitals are needed to become a going concern hospital. One strategy that can be applied is Total Quality Management (TQM). TQM seeks continuous improvement of all hospital functions. The National Health Insurance Program (JKN) has been run by the Regional Hospital General Hospital (RSUD) Dr. H. Soewondo Kendal as of January 1st, 2014. Health financing is the most important part of implementing JKN held in hospitals by BPJS Kesehatan through submission of claims. During the implementation of JKN in Kendal General Hospital, problems were found between the difference between the visits of BPJS Health patients to hospitalizations and the Health BPJS visits claimed, thus causing pending cases of late claims. File claims that are late in submission will be included in the claim process the following month.Objective: Analyze the pending causes of the Health BPJS file based on TQM implementation.Method: This type of research uses qualitative phenomenological methods and case study research designs. The research subjects were 7 officers who were directly involved in the claim process. The research instrument is the patient claim file by paying BPJS Kesehatan. Data analysis using the Importance Performance Analysis (IPA) technique.Summary: Pending causes of claims from casemix manpower factors with educational background not medical records and lack of coding staff. The factor of the casemix section method is no Standard Operating Procedure (SOP) for claiming BPJS Health. Material factors still have claims files that cannot be submitted due to inappropriate SEP numbers or often purif. Casemix machine factors (INA CBGs) already use computers and printers. The money factor for hospital income was delayed due to pending claims and claims that failed to purify.Conclusion: The process of implementing the BPJS Health claim in Dr. Hospital H. Soewondo Kendal is in accordance with the theory but there are still file claims that are pending.Suggestion: Organize education to officers intensively and standardize the time of collecting investigations and operating reports to medical records so that the files will be claimed as soon as possible and sent to BPJS.

Upaya Pencegahan Perbedaan Diagnosis Klinis Dan Diagnosis Asuransi Dengan Diberlakukan Program Jaminan Kesehatan Nasional (JKN) Dalam Pelayanan Bpjs Kesehatan Studi Di Rsud Kota Semarang Faik Agiwahyuanto; Sudiro Sudiro; Inge Hartini
Jurnal Manajemen Kesehatan Indonesia Vol 4, No 2 (2016): Agustus 2016
Publisher : Magister Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Diponegoro

Percentage of clinical and insurance diagnosis differences at Semarang City Public Hospital tended to increase. If this condition remained, it would lead to upcoding (fraud). The aim of this study was to explain a process of clinical and insurance diagnosis at a hospital in the implementation of Healthcare and Social Security Agency (Health BPJS). This was a qualitative study. Main informants consisted of doctors at an emergency room, surgeons, and internists. Informants for triangulation purpose consisted of a Hospital Director, a hospital verifier, and a head of Medical Record Unit. Data were analysed using content analysis.The results of this research showed that there were any differences in clinical and insurance diagnosis at Semarang City Public Hospital. The cause of these differences was due to differences in diagnosis and medical treatment between medical service standard of doctors at the hospital and a standard of INA-CBGs. To prevent the differences of clinical and insurance diagnosis, the Semarang City Public Hospital had formed an internal verifier team of the hospital and a Clinical Micro System team. A medical committee had a role to minimise the occurrence of upcoding by multiplying kinds of Clinical Pathway as a reference for doctors in diagnosing and determining kinds of treatments for patients.The differences of clinical and insurance diagnosis must be equated to prevent the occurrence of upcoding and disadvantage of the hospital. Efforts to prevent these differences are by adding officers, training coding, making and multiplying algorithm of clinical pathway, forming a team of Clinical Micro System, and monitoring and evaluating medical services.

TINJAUAN TARIF INA-CBGS PADA PASIEN KASUS INFARK MIOKARD AKUT DI RSUD K.R.M.T WONGSONEGORO KOTA SEMARANG BULAN JANUARI–JUNI TAHUN 2018 FAIK AGIWAHYUANTO
Afiasi : Jurnal Kesehatan Masyarakat Vol. 4 No. 3 (2019): Afiasi
Publisher : Universitas Wiralodra

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31943/afiasi.v4i3.65

Dari hasil Riset Kesehatan Dasar tahun 2013, penyakit jantung adalah penyakit tidak menular tertinggi di Indonesia. Jumlah pasien BPJS Kesehatan dengan kasus serangan jantung di Rumah Sakit Umum Daerah K.R.M.T Wongsonegoro Semarang, pada Januari-Juni 2018 adalah 53 pasien. Penelitian ini bertujuan untuk mengetahui perbedaan dalam tingkat INA-CBGs pada pasien dengan kasus Acute Myocard Infarct (AMI) di K.R.M.T. Rumah Sakit Umum Daerah Wongsonegoro Semarang pada semester 1 tahun 2018 (Januari-Juni). Penelitian deskriptif ini dilakukan dengan metode observasi. Objek penelitian adalah laporan indeks penyakit infark miokard akut dan hasil pengelompokan INA-CBGs. Analisis data menggunakan teknik univariat atau persentase. Hasilnya adalah jenis kelas perawatan tertinggi adalah kelas 3 (58,49), kelas 1 tingkat INA-CBGs antara 5.495.300 hingga 14.138.500, kelas 2 antara 4.710.300 hingga 8.410.800, kelas 3 antara 3.925.200 hingga 10.099.000. Saran, rumah sakit harus membuat jalur klinis untuk penyakit infark miokard akut sehingga dokter memiliki pedoman untuk memberikan pengobatan yang tepat, sehingga kualitas dan biaya dapat dikendalikan. Memberikan informasi kepada dokter untuk menulis diagnosa sesuai dengan aturan ICD 10 dan ICD 9 CM. Kata kunci: Tingkat INA-CBGs, Serangan Jantung, Deskriptif

TINJAUAN PENYEBAB PENGEMBALIAN BERKAS KLAIM BPJS KESEHATAN INSTALASI RAWAT JALAN KASUS FISIOTERAPI Faik Agiwahyuanto; Sylvia Anjani; Sherly Candra Stacey
Care : Jurnal Ilmiah Ilmu Kesehatan Vol 9, No 3 (2021)
Publisher : Universitas Tribhuwana Tunggadewi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33366/jc.v9i3.2205

Hospital claims towards BPJS Health were demands for compensation for services provided by hospital through its workforce, both doctors, nurses, pharmacists and others for BPJS Health participants who seek treatment or are treated at hospital. Claims were made by hospitals or other health facilities through claims administration process. Claims returned are claims that have been verified but have not been able to be paid by BPJS Health due to incomplete claim documents. This study purpose was to determine causes of returning BPJS Health claim files to outpatient physiotherapy cases. Research type was qualitative with descriptive design. Research was conducted in January 2020. Data were obtained by in-depth interviews, processing and research data analysis used content analysis. Results showed that coding accuracy was cause of inconsistency due to provision of action codes, completeness of medical diagnosis files, and completeness of medical action files. The conclusion was BPJS Health claim files in outpatient installation for physiotherapy cases will be returned to hospital if it is incomplete.

MUTU PELAYANAN STANDAR PELAYANAN MINIMAL (SPM) PENDAFTARAN PASIEN DI TEMPAT PENDAFTARAN PASIEN RAWAT JALAN (TPPRJ) PUSKESMAS NGALIYAN KOTA SEMARANG Faik Agiwahyuanto; Ferdiansyah Hari Noegroho
MEDIA ILMU KESEHATAN Vol 8 No 3 (2019): Media Ilmu Kesehatan
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/mik.v8i3.330

Background: Minimum Service Standards (SPM) in outpatient services at the Ngaliyan Community Health Center reads the standard time to serve old patients ie 5 minutes while patients are only 7 minutes. Based on the initial survey of 10 outpatients in the Ngaliyan Health Center divided into 5 old patients and 5 new patients, it was found that on average the officers served the old patients ie 18 minutes 17 seconds and the new patients were 18 minutes 32 seconds. Objective: This study aims to analyze the service quality minimum (SPM) of TPPRJ inpatient registration at the Ngaliyan Health Center Semarang City. Methods: This study used an observational analytic research design with cross-sectional approach at Ngaliyan Public Health Center Semarang City. The sampling technique used purposive sampling with total sample are 20 respondents. Analysis data using univariate with percentage. Result: The results showed that in 1st stage average time service old patients is 6 minutes 13 seconds and new patients is 12 minutes 6 seconds. In 2nd stage average time service old patients is 11 minutes 3 seconds and new patients is 12 minutes 6 seconds. Conclusion: SPM service quality of inpatients registration influenced by inpatient waiting time.

Tinjauan Penyebab Pengembalian Klaim Rawat Jalan Kasus Radioterapi di RSUD Tugurejo Semarang Periode Mei-Desember Tahun 2019 Faik Agiwahyuanto; Sri Setyana; Jaka Prasetya; Sylvia Anjani
Jurnal Kesehatan Vokasional Vol 7, No 2 (2022): Mei
Publisher : Sekolah Vokasi Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkesvo.72216

Latar Belakang: Sejak ditetapkannya Program Jaminan Kesehatan Nasional (JKN) pada Januari 2014, polemik tentang permasalahan BPJS Kesehatan masih sangat mendominasi, salah satunya pengembalian klaim di rumah sakit. Berdasarkan survei awal, dari 10 berkas klaim pasien radioterapi yang dikembalikan, 2 berkas tidak memiliki keterangan jadwal radioterapi, 4 berkas tidak melampirkan protokol radioterapi, dan 4 berkas lainnya tidak melampirkan jadwal maupun protokol pelayanan radioterapi.Tujuan: Mengetahui penyebab pengembalian klaim pada pasien rawat jalan kasus radioterapi di RSUD Tugurejo Semarang periode Mei-Desember tahun 2019.Metode: Jenis penelitian ini adalah deskriptif observasional dengan pendekatan cross sectional. Data dikumpulkan dengan metode observasi dan wawancara.Hasil: Dari 111 berkas klaim yang ditolak, 98,19% dikembalikan karena ketidaklengkapan berkas, yang terdiri dari tidak adanya keterangan hasil CT Scan (21,10%), tidak terdapat keterangan jadwal radioterapi (32,43%), dan tidak terdapat protokol radioterapi (45,04%), dan klaim dikembalikan karena ketidaktepatan kode (1,83%).Kesimpulan: Berkas klaim yang dikembalikan disebabkan karena ketidaklengkapan berkas dan ketidaktepatan kode.

Tinjauan Penyebab Penolakan Klaim Jaminan Kesehatan Nasional (JKN) pada Kasus Bronchopneumonia Pediatri Faik Agiwahyuanto; Lucas Anggoro Setiawan; Via Ayusasmita
Jurnal Kesehatan Vol 8 No 1 (2020): April
Publisher : Politeknik Negeri Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25047/j-kes.v8i1.134

Kasus bronkopneumonia di Kota Semarang masih berada dalam peringkat 10 penyakit paling umum (2015 = 53,31%, 2016 = 54,3% dan 2017 = 50,5%) dan ini merupakan masalah kesehatan utama bagi anak-anak di negara berkembang. Pneumonia merupakan penyebab utama morbiditas dan mortalitas pada anak di bawah 5 tahun (balita). 9,63% kasus dengan diagnosis utama bronkopneumonia di Rumah Sakit Panti Wilasa Dr. Cipto ditolak oleh BPJS. Tujuan dari penelitian ini adalah untuk menjelaskan penolakan pengajuan klaim untuk kasus-kasus dengan diagnosis utama bronkopneumonia di rumah sakit dalam pelaksanaan Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan. Metode pengumpulan data menggunakan observasi. Analisis data menggunakan teknik univariat atau persentase. Hasil penelitian menunjukkan bahwa penolakan diagnosis utama bukan bronkopneumonia di Rumah Sakit Panti Wilasa Dr. Cipto Semarang adalah 36 kasus (9,63%). Ini karena diagnosis dokter adalah bronkopneumonia tetapi diagnosis tidak mengikuti pedoman manual verifikasi INA-CBGs dan hasil rontgen tidak menunjukkan diagnosis bronkopneumonia. Penolakan terhadap diagnosis utama harus segera diatasi untuk mencegah upcoding. Upaya pencegahan yang dapat dilakukan antara lain sosialisasi diagnosis oleh petugas koding dan pembuatan Clinical Pathway untuk kasus bronkopneumonia yang sesuai dengan kriteria BPJS sehingga hasil klaim rumah sakit dapat berkelanjutan.

Co-Authors Adelia Ayu Sabrina Adian Khoironi Andi Hallang Lewa Aries Setiawan Arinda Juwita Aris Puji Purwatiningsih Ayu Ashari Ayusasmita, Via Baju Widjasena Baju Widjasena Cesara Kharismaharani Komara Deddy Setiadi Deddy Setiadi Dimas Angga Febian Dyah Ernawati Dyah Ernawati Dyah Ernawati Enny Rachmani Ester Widhiatmi Sutiningary Evina Widianawati Evina Widianawati Evina Widianawati Evina Widianawati Ferdiansyah Hari Noegroho Fitria Wulandari Fitria Wulandari Hari Noegroho, Ferdiansyah Indriati - - Inge Hartini Jaka Prasetya Khamna Diah Oktavia Chalimah Layla Nur Azizah Lucas Anggoro Setiawan Maulana Tomy Abiyasa Moh. Umar Nauful Fajri Putri, Rizqi Basuki Ramadhany, Nur Azizha Retno Astuti Setijaningsih Sasono Wibowo Sherly Candra Stacey Shinta Octaviasuni Shinta Octaviasuni Sri Setyana Sudiro Sudiro Suharyo Suharyo Sutrisno Sutrisno suyoko suyoko Sylvia Anjani Tri Indah Sari Trianni Trianni Umi Hanik Umi Maftukhah Via Ayusasmita Via Ayusasmita Widianawati, Evina Wulan, Widya Ratna Zaenal Sugiyanto

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