| Summary: | Background: To apply BPJS program, the health institutions, especially
hospitals must show their quality in providing good service and exact to the
consumer that is based on standards of professionalism, which is expected to
fulfill the expectations of the people (consumers). At PKU Muhammadiyah Bantul
General Hospital, particularly at medical record installation not perform BPJS
preparation optimally and service provided will be less than the maximum. So
how far it must be the extent to which the implementation is carried out so as to
show the quality in providing good service and exact to the consumer.
Objective: To determine flow implementation of patient service and claim with
the National Social Security System (SJSN) 2014 at Medical Record Installation
General Hospital PKU Muhammadiyah Bantul.
Methods: This type of research is a descriptive study with a qualitative approach
with a cross-sectional study design. The subjects in this research were the head
of the medical record, medical record officers, insurance officers, relation officer,
coder, physicians, nurse, BPJS verifier. Objects in this research is the
implementation flow of the patient service, file medical records as one of the
requirements of the insurance claim, work instructions used in connection
charging medical record file, work instructions related to the implementation of
Social Security, and the implementation of a medical record document
management as supporting documents smoothness patients claim National
Social Security System 2014. Mechanical Data collection by observation,
interviews, and documentation studies.
Results: The results of this research indicate that the implementation of patient
service are in accordance with the rules, but there are still misconceptions about
the flow of patient service related to the collection of patient files and information
assurance requirements regarding working hours counter guarantee. Lack of
work instructions regarding a flow of BPJS claim because the rules of BPJS flow
still changed makes the medical record officers insufficiently know about what the
continuation BPJS claim process. Necessary requirements related to claim BPJS,
there are still patients who do not carry the full requirements and health workers
who have not been filled with a complete medical record file. Additionally PKU
Muhammadiyah Bantul General Hospital have not revised the work instructions of
registration and coding implementation, then LAN network that often trouble or
errors.
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