THE EFFECT OF COMPLETENESS OF MEDICAL RECORDS OF OUTPATIENT IN THE INTERNAL MEDICINE POLYCLINIC ON BPJS CLAIMS AT MUHAMMADIYAH HOSPITAL BANDUNG

Abstract

For reasons including hospital reporting and BPJS Health claims activities, it is critical that patient medical record files be accurate and comprehensive while handling medical records. The purpose of this research is to find out how the BPJS claim procedure at Muhammadiyah Bandung Hospital is affected by the thoroughness of the MR file of internist poly outpatients. In this work, 98 samples of MR data were analyzed utilizing descriptive techniques that used quantitative methodologies. As a whole, patient files are 80% complete according to this survey, with 5% incomplete in the billing section, 7% in the SEP, 5% in the résumé, 2% in referrals, and 2% in supporting documents. According to the results of the Chi-Square test, there is a correlation between the thoroughness of patient records and the timeliness of BPJS claims; hence, an improvement in the thoroughness of patient records would result in a more rapid processing of BPJS claims. A comprehensive review of patient records prior to BPJS claim submission, prompt communication with DPJP or service providers in the event of incomplete MR files, and evaluation of officers' performance in relation to issues that lead to incomplete BPJS claim filing are all possible solutions.