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All Journal Jurnal Ilmiah Perekam dan Informasi Kesehatan Imelda (JIPIKI) Jurnal EduHealth Indonesian Journal of Health Information Management Services (IJHIMS) Zadama: Jurnal Pengabdian Masyarakat Jurnal Ilmiah Pengabdian Kepada Masyarakat Aspirasi : Publikasi Hasil Pengabdian dan Kegiatan Masyarakat
Mei Sryendang Sitorus
Universitas Imelda Medan
Agriculture, Biological Sciences & Forestry Humanities Civil Engineering, Building, Construction & Architecture Computer Science & IT Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Engineering Health Professions Medicine & Pharmacology Nursing Public Health Social Sciences Veterinary

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Journal : Jurnal EduHealth

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Factors Causing Pending Claims in BPJS Participant Patients at Imelda Worker General Hospital Indonesia Medan Year 2022 Mei Sryendang Sitorus; Puput Melati Hasibuan; Erlindai Erlindai; Johana Christy; Joel Roganda Manik
Jurnal EduHealth Vol. 14 No. 02 (2023): Periode April-June, 2023
Publisher : Sean Institute

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Abstract

BPJS Health claims are the submission of hospital patient care costs by the hospital to the BPJS Health party which is carried out collectively and billed by the hospital to the BPJS Health every month. Based on an initial survey conducted at the Indonesian Workers' Imelda RSU, it was one that caused the pending claim file (unclaimed), namely the incompleteness of recording Medical Records. As for the pending claim (unclaimed) it is found more in hospitalizations, and based on information that researchers found it is known that the number of inpatients at Indonesian Workers' Hospital in 2021 had 8,004 patients. Inpatient file data submitted in the last month, April 2022, was 472 files. A total of 371 files (78.6%) were successfully claimed, 100 files (21.2%) were pending claims, and 1 file (0.2%) which failed purif. The method used in this study is quantitative descriptive with a cross section approach, and by univariate data analysis. Research results show factors that cause pending claims in BPJS participant patients in Indonesian Workers' Hospital are coding mismatches there are as many as 25 medical records (50%), incompleteness of administrative data of 10 medical records (20%), and incompleteness and or inaccuracy in filling medical records of 15 medical records (30%). Suggestions put forward are making regulations in the form of policies, rules, or SOPs, as well as adding training and attending seminars related to coding and enforcement of diagnoses.
Efficiency Of Bed Utilization By Class Type Using Barber Johnson Chart In RSU Imelda Pekerja Indonesia Medan In 2023 Mei Sryendang Sitorus; Nila Sari; Anna Nadiyas Kristiani Lase
Jurnal EduHealth Vol. 14 No. 01 (2023): Jurnal eduHealth, Periode Januari-Maret, 2023
Publisher : Sean Institute

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One indicator of service quality in hospitals is the efficiency of inpatient services, especially in the use of beds. The efficiency of bed utilization can be seen from the Barber Johnson chart based on the calculation of Bed Occupancy Rate (BOR), Length Of Stay (LOS), Turn Over Interval (TOI) and Bed Turn Over (BTO). The initial survey conducted, medical record officers of RSU Imelda Pekerja Indonesia Medan have never analyzed the efficiency of bed utilization based on class type using the Barber Johnson chart. The purpose of this study was to determine the efficiency of bed utilization based on class type using the Barber Johnson chart. This type of research is Mix Methods. Primary data in this study are the results of researcher observations and secondary data data obtained from the medical records work unit and SIRS RSU Imelda Pekerja Indonesia Medan. Data collection in this study was carried out using interview and observation techniques. The results of the study were that the BOR value did not meet the Barber Johnson standard, namely class I inpatient rooms (48%), class II (38%) and class III (60%). The LOS value has met the Barber Johnson ideal value standard, namely class I inpatient rooms (4.2 days), class II (4.5 days) and class III (4.2 days). The TOI value still exceeds the Barber Johnson standard value, namely class I inpatient rooms (7.7 days), class II (8.7 days), class III (3.3 days). The BTO value in class I (28 times) and class II (25.5 times) inpatient rooms is still not in accordance with the Barber Johnson standard, while class III (43.5 times) is in accordance with the Barber Johnson ideal value standard. the meeting point on the Barber Johnson graph of class I, class II and class III inpatient rooms is still outside the efficient area so that the indicators of the RSU Imelda Pekerja Indonesia inpatient room are still not efficient.
Co-Authors Anna Nadiyas Kristiani Lase Azizah Putri Syafa Harahap Bella Siringo-ringo Erlindai Esraida Simanjuntak Joel Roganda Manik Johana Christy Johanna Christy Khairani Lisa Anggriani Marta Simanjuntak Nila Sari Puput Melati Hasibuan Puput Melati Hutauruk Theresia Hutasoit Valentina Valentina Valentina Yeyi Gusla Nengsih