ANALISIS KEPATUHAN PETUGAS ADMINISTRASI RUANG RAWAT INAP DALAM UPAYA PENYUSUNAN REKOMENDASI PENYELESAIAN BERKAS KLAIM ASURANSI KESEHATAN BPJS RAWAT INAP DI RSD dr. SOEBANDI JEMBER

Abstract

dr. Soebandi Jember Public Hospital was held JAMKESMAS program since 2009 which later changed into BPJS. Based on obtained data, there 0,8% inpatient JAMKESMAS unclaimed data from 199.566.419 IDR in 2013. Crosssectional, descriptive observational approach was used to find the influencing factors. Data collected by questionnaires and claims data that stored in Social Health Insurance Board Center. The sample were all inpatient administration officers as many as 21 people. The Result revealed that obedience in the completion of the claim data was low. There were 28,5% respondents assessed that the policy weren't good enough for completion of existing claims, assessment of unsupported peer workers (28.5%), low knowledge in terms of completeness claim data prerequisite (33.3%), deadline of stored claims data (66.7 %), the uses claims data (23.8%), the motivation is to get service's pay, and a work ethics wasn't optimal. The lack of knowledge on claims data, policies and peer support wasn't optimal. Recommendations for improving the completion claims data were made SPO for supporting administrative officers unit in term of Social Health Insurance Board claims data, make SPO on work relationship among administration officers, held an regular meeting at least once a month to evaluate the implementation of a policy and SPO, conduct a training and coaching to improve knowledge about administration officer claim data and policies, provide feedback on the successful realization Social Health Insurance Board claim, make a checklist sheet, increase the role of head unit as a completeness verificator claims data, use the inpatient administration officer's obedience in completion claims data as one of the performance indicators used in the calculation of Employee Performance Goals (SKP), emphasis on job description clear report n punishment according to the each level obedience.