Effect of Medical Record Completeness and Timeliness on Inpatient Claim Processing at a Primary Healthcare Facility

Ilma Nuria Sulrieni, Nurul Abdillah, Alfita Dewi, Masdalena Masdalena, Herman Susilo

Abstract


Completeness of filling out the claim submission file must be considered because it is the main requirement in submitting a claim. In addition to being complete, the files must also be entered on time so that the verification process passes and the claim runs smoothly. Initial survey data in 2024 showed that UPT Puskesmas Sangir Batang Hari was the second highest in pending claims and untimely claim submissions in South Solok. This study aims to determine the relationship between the completeness of filling out the claim submission medical record file and the timeliness of entry on the smoothness of inpatient claims. This research used an analytic observational method with a cross-sectional approach. The population was 159 claim submission files, with 67 samples taken by simple random sampling. Data were collected using observation with a checklist and analyzed using univariate and bivariate analysis with the Chi-square test. The results showed that completeness and timeliness significantly affected the smoothness of inpatient claims. This research can be a basis for policy-making to improve service quality in health centers.

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References


Brodin, and Yunengsih, “Tinjauan Kelengkapan Pengisian Resume Medis,” Jurnal Rekam Medis Indonesia, vol. 8, no. 2, pp. 76–83, 2021.

Karyadi, “Resume Medis dan Hubungannya dengan Klaim BPJS,” Jurnal Informasi Kesehatan, vol. 9, no. 1, pp. 12–20, 2022.

BPJS Kesehatan KC Malang, Panduan Administrasi Klaim Non Kapitasi FKTP, Malang: BPJS Kesehatan, 2022.

BPJS Kesehatan, Petunjuk Teknis Verifikasi Klaim FKTP, Jakarta: BPJS Kesehatan, 2016.

Melawati, “Faktor Penyebab Pending Klaim BPJS di Rumah Sakit,” Jurnal Pelayanan Kesehatan, vol. 10, no. 1, pp. 55–63, 2021.

Rahmatiqa, C., et al., “Analisis Proses Klaim BPJS Kesehatan,” Jurnal Administrasi Rumah Sakit Indonesia, vol. 6, no. 1, pp. 25–32, 2020.

UPT Puskesmas Sangir Batang Hari, Laporan Pending Klaim Rawat Inap 2024, Solok Selatan, 2024.

Sarake, “Aspek Hukum dalam Rekam Medis,” Jurnal Etika Kedokteran, vol. 7, no. 1, pp. 50–57, 2019.

Handayuni, “Manajemen Rekam Medis,” Jurnal Administrasi Kesehatan Indonesia, vol. 8, no. 2, pp. 145–152, 2020.

Ministry of Health of the Republic of Indonesia, Regulation No. 24 of 2022 on Medical Records, Jakarta: Kemenkes RI, 2022..

M. Notoatmodjo, Metodologi Penelitian Kesehatan, Jakarta: Rineka Cipta, 2018.

S. Arikunto, Prosedur Penelitian: Suatu Pendekatan Praktik, Jakarta: Rineka Cipta, 2019.

UPT Puskesmas Sangir Batang Hari, Laporan Klaim Rawat Inap BPJS, Solok Selatan, 2024.

BPJS Kesehatan KC Malang, Panduan Administrasi Klaim Non Kapitasi FKTP, Malang: BPJS Kesehatan, 2022.

C. Rahmatiqa, et al., “Analisis Proses Klaim BPJS Kesehatan,” Jurnal Administrasi Rumah Sakit Indonesia, vol. 6, no. 1, pp. 25–32, 2020.

BPJS Kesehatan, Petunjuk Teknis Verifikasi Klaim FKTP, Jakarta: BPJS Kesehatan, 2016.

Sugiyono, Statistik untuk Penelitian, Bandung: Alfabeta, 2019.

L. Ghozali, Aplikasi Analisis Multivariate dengan Program IBM SPSS, Semarang: Badan Penerbit UNDIP, 2021.

Kemenkes RI, Peraturan Menteri Kesehatan No. 66 Tahun 2013 tentang Komite Etik Penelitian Kesehatan, Jakarta: Kemenkes, 2013.

Ministry of Health of the Republic of Indonesia, Regulation No. 24 of 2022 on Medical Records, Jakarta: Kemenkes RI, 2022.

Handayuni, “Manajemen Rekam Medis,” Jurnal Administrasi Kesehatan Indonesia, vol. 8, no. 2, pp. 145–152, 2020.

BPJS Kesehatan, Petunjuk Teknis Administrasi Klaim, Jakarta: BPJS Kesehatan, 2023.

Mardan, “Pengelolaan Kelengkapan Rekam Medis di Pelayanan Kesehatan,” Jurnal Rekam Medis, vol. 13, no. 1, pp. 34–42, 2021.

Rahmatiqa, C., et al., “Analisis Proses Klaim BPJS Kesehatan,” Jurnal Administrasi Rumah Sakit Indonesia, vol. 6, no. 1, pp. 25–32, 2020.

Karyadi, “Resume Medis dan Hubungannya dengan Klaim BPJS,” Jurnal Informasi Kesehatan, vol. 9, no. 1, pp. 12–20, 2022.

UPT Puskesmas Sangir Batang Hari, Laporan Pending Klaim Rawat Inap 2024, Solok Selatan, 2024.

BPJS Kesehatan KC Malang, Panduan Administrasi Klaim Non Kapitasi, Malang: BPJS Kesehatan, 2022.

Ministry of Health of the Republic of Indonesia, Regulation No. 28 of 2014 on JKN Implementation, Jakarta: Kemenkes RI, 2014.

BPJS Kesehatan, Technical Guidelines for Inpatient Claims Verification, Jakarta: BPJS Kesehatan, 2016.

Rahayu, L., and Sugiarti, “Manajemen Pengajuan Klaim BPJS Kesehatan di FKTP,” Jurnal Kebijakan Kesehatan, vol. 5, no. 2, pp. 67–74, 2021.

Melawati, “Faktor Penyebab Pending Klaim BPJS di Rumah Sakit,” Jurnal Pelayanan Kesehatan, vol. 10, no. 1, pp. 55–63, 2021.

uma, and Hatta, “Pengaruh Kelengkapan Rekam Medis Terhadap Klaim,” Jurnal Manajemen Kesehatan, vol. 4, no. 1, pp. 20–27, 2008.

Pardede, “Kesesuaian Kode Diagnosa dan Klaim BPJS,” Jurnal Koding Kesehatan, vol. 3, no. 2, pp. 88–95, 2020.

Sarake, “Aspek Hukum dalam Rekam Medis,” Jurnal Etika Kedokteran, vol. 7, no. 1, pp. 50–57, 2019..


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Publish by Universitas Syedza Saintika Padang(Jl. Prof. Dr. Hamka No. 228 Air Tawar Timur Padang)

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Chamy Rahmatiqa, M.Ph
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Herman Susilo, M.Kom
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