THE INFLUENCE OF COMPLETENEES OF PATIENT MEDICAL RESUME ON THE TIMELINESS OF BPJS CLAIM AT HOSPITAL X

Abstract

Problem: If the medical resume is found to be incomplete in terms of filling it out, it can slow down the BPJS claim process because the medical resume contains a diagnosis of the patient's illness which is a benchmark for coding officers to determine the diagnosis code which affects the claim Objective: To determine the effect of the completeness of the medical resume of inpatients on the timeliness of BPJS claims at Hospital X. Method: This type of research is quantitative descriptive with a cross-sectional approach with an observation checklist method. The number of samples is 100 medical resumes with the inclusion criteria of BPJS inpatient medical resumes in December 2023. Results: incomplete medical resumes filled out with timely BPJS claim submissions were 98 medical resumes (98%), while complete medical resumes filled out with timely BPJS claim submissions were 2 medical resumes (2%). So no conclusion can be drawn regarding the influence of the completeness of the medical resume on the timeliness of BPJS claims. The suggestion given by the researcher is that there is an SOP specifically for filling out inpatient medical resumes which is addressed to all medical personnel responsible for filling them out, Medical personnel responsible for medical resumes are expected to increase their accuracy in filling them out and there is an SOP from the hospital specifically for submitting BPJS claims in accordance with the rules of the BPJS Kesehatan Health Facility Administration Practical Guidebook