Aurelia Editha Lesmana, . (2025) ANALISIS FAKTOR PENGHAMBAT DALAM KLAIM BPJS KESEHATAN YANG BERDAMPAK PADA STABILITAS KEUANGAN RUMAH SAKIT PERSAHABATAN TAHUN 2024. Skripsi thesis, Universitas Pembangunan Nasional Veteran Jakarta.
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Abstract
BPJS claims submitted at Persahabatan Hospital often face obstacles in the form of pending claims due to documents that fail verification, thereby impacting the hospital's financial stability due to delays and reductions in payments from BPJS. This study aims to analyze the factors hindering pending claims and their impact on hospital finances. The method used is descriptive qualitative through in-depth interviews, observations, and a review of Standard Operating Procedures (SOP) documents related to the claim submission process. The research results indicate that there are obstacles in the human factor, such as ineffective coordination between units and challenges in updating coding by coders. From the machine perspective, obstacles arise due to slow internet connections that delay claim application responses. Method-related obstacles stem from the lack of optimal organization in managing outpatient service standards, thereby hindering administrative staff performance. Additionally, material factors pose challenges, particularly regarding the incompleteness and inconsistency of medical procedure data with patient billing data. The accumulation of these various obstacles causes delays in claim payments, which impacts the cash flow and operations of the hospital and has the potential to disrupt the smoothness and continuity of healthcare services to patients.
| Item Type: | Thesis (Skripsi) |
|---|---|
| Additional Information: | [No. Panggil : 2110713116] [Pembimbing : Een Kurnaesih] [Penguji 1 : PutrI Permatasari] [Penguji 2 : Riswandy Wasir] |
| Uncontrolled Keywords: | Inhibiting Factors, Pending Claims, Hospital Finances |
| Subjects: | R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Fakultas Ilmu Kesehatan > Program Studi Kesehatan Masyarakat (S1) |
| Depositing User: | AURELIA EDITHA LESMANA |
| Date Deposited: | 22 Jul 2025 05:24 |
| Last Modified: | 22 Jul 2025 05:24 |
| URI: | http://repository.upnvj.ac.id/id/eprint/37688 |
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