Abstract
The hospital’s claim collectively and billed done to the BPJS of each month,with complete supporting documents i.e copy of BPJS card,prof nurse, letter of statement, the cost of which must be paid. The function of the claims of BPJS is the submission the cost of patient care BPJS participaty from the hospital to the BPJS, previously the cost of patient care in the responsibility by the hospital. The porpuse of research to find out information on filing a claim general hospital of Anutapura palu to BPJS. This research has been carried out in a Hospital Anutapura palu and implemented in june 2016. Type writer this research with a qualitative approach. The study make’s and overview of the complex, researching the words, the detailed report of the views of respondents, and conduct a study on the situation of the natural. The results showed that the claims of the administration in the hospital Anutapura palu has been running in a coedance with the rules as seen from the claims in the pending was upon agreement of the parties hospital and office of the BPJS that follow the rules No. 28 service system JKN. So based on research it can be deduced that the implementation of the filing the claim of the nation health assurance ( JKN ) in Hospital Anutapura palu are in accoedance with Permenkes No.28 service system ( JKN ). Keyword : Implementation, Claim JKN.
Highlights
Rumah sakit merupakan salah satu instansi yang mampu berikan jasa pelayanan Kesehatan bagi masyarakat, Menurut Undang-Undang No.44 tahun
The results showed that the claims of the administration in the hospital Anutapura palu has been running in a coedance with the rules as seen from the claims in the pending was upon agreement of the parties hospital and office of the BPJS that follow the rules No. 28 service system Jamian Kesehatan Nasional (JKN)
REKOMENDASI Diharapkan kepada dinas terkait agar memiliki komitmen yang kuat dari para pemangku kebijakan di semua tingkatan Rumah Sakit dan kantor BPJS kesehatan dan mempunyai intensitas publik mengenai pengajuan Klaim pasien rawat inap dan rawat jalan Dan mengoptimalisasi fasilitas dan dukungan mitra kerja/stakeholders
Summary
Berdasarkan Umur Berdasarkan hasil penelitian saya di Rumah Sakit Umum Anutapura palu terdapat 3 Informan yang saya wawancarai dengan karakteristik umur yang berbeda-beda. Apa saja syarat-syarat pengajuan klaim rumah sakit umum anutapura sudah sesuai dengan peraturan undangundang?. Pertamakan ini harus ada surat jaminan KTP, surat egibilitas peserta ( SEP) yang di bikin di BPJS center trus kalau sudah ada ee ini bukti klaim nya,Bukti klaimnya itu terdiri dari resume dokter, billing, atau rincian biaya rumah sakit trus sama ini bukti penunjang Tabel 2 Karakteristik Informan ronseng lab dan lain” itu baru kita ajukan. Berdasarkan pendidikan informan 1 orang tamatan sekolah S2 Kesehatan 1 orang tamatan Apoteker 1 Orang, dan 1 orang tamatan D3, itu juga ada bisnis prosesnya sendiri dan jadi memang sudah di jalankan sesuai itu jadi,selama ini sudah berjalan dengan baik. Berdasarkan pendidikan informan 1 orang tamatan sekolah S2 Kesehatan 1 orang tamatan Apoteker 1 Orang, dan 1 orang tamatan D3, itu juga ada bisnis prosesnya sendiri dan jadi memang sudah di jalankan sesuai itu jadi,selama ini sudah berjalan dengan baik. “ ( FR 26 juli 2016 ) “
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