SOCIALIZATION : ACCURACY OF THE CODE OF PHYSIOTHERAPY ACTIONS SUPPORT PASSING BPJS CLAIM VERIFICATION
DOI:
https://doi.org/10.51851/jsm.v4i1.488Keywords:
Action Code, BPJS, Physiotherapy, Socialization, TrainingAbstract
The accuracy of action codes plays an important role in supporting the passing of claim verification and is the basis for approval of billing by BPJS to hospitals, however, Hospital X physiotherapy case claim files are always pending every time a BPJS claim is submitted because the majority of action codes are inaccurate. This is because the coding information (related to actions and codes entered does not comply with the coding rules in the 2023 BPJS Health Circular Letter and Minutes of Agreement when verifying claims by the BPJS Health verifier, which has the effect of delaying the claim payment process, causing material losses for the Hospital. This Community Service activity aims to convey information from research results in the form of an analysis of the accuracy of action codes in supporting the passing of BPJS Health claim verification with counseling and training by discussing physiotherapy action codes written in medical records. The method for this Community Service activity is in the form of socialization/counseling by delivering material, discussions in the form of questions and answers and providing sample practice questions to participants, as well as training on verifying the accuracy of action codes for physiotherapy cases. Community Service Activities ran smoothly and the results of these activities showed that medical record officers in the casemix section began to understand the factors influencing the smooth verification of BPJS claims during discussions and post-tests.
References
Arifin, I., Heltiani, N., Anggita, F., Putri, F. A., & Prasetya, A. E. (2022). PENTINGNYA TRACER REKAM MEDIS SEBAGAI SARANA PELACAK REKAM MEDIS YANG KELUAR DARI RAK FILING DI PUSKESMAS JALAN GEDANG KOTA BENGKULU. PAKDEMAS : Jurnal Pengabdian Kepada Masyarakat, 1(3), 121-128. https://doi.org/10.58222/pakdemas.v1i3.56
Heltiani, N & Nababan, L. 2023. Analisis Kelancaran Pengajuan Klaim BPJS Kasus Melahirkan di RS.X Kota Bengkulu. J-REMI Vol.4 No.3 Juni 2023.
Heltiani, N., Arifin, I., Budiarti, A., Asroni, N., & Pradana, R. P. (2022). PENTINGNYA PROSEDUR KERJA PENYUSUTAN BERKAS REKAM MEDIS GUNA MENJAGA KUALITAS PELAYANAN REKAM MEDIS DI RS.X KOTA BENGKULU. PAKDEMAS : Jurnal Pengabdian Kepada Masyarakat, 1(3), 107-116. https://doi.org/10.58222/pakdemas.v1i3.55
Herlinda, . . H., Nilawati, I. ., Sari, N. L. ., Zainal, E. ., & Parwito, P. (2023). Mentoring Kader Terhadap Pencegahan Stunting Di Desa Sari Mulyo Kecamatan Sukaraja . Jurnal Pengabdian, 2(1), 7–12. https://doi.org/10.58222/jp.v2i1.145
Kementerian Kesehatan RI. Peraturan Menteri Kesehatan No. 28 Tahun 2014 Tentang Pedoman Pelaksanaan Program Jaminan Kesehatan Nasional.
Keputusan Menteri Kesehatan Republik Indonesia Nomor 1363/Menkes/SK/XII/2001 Tentang Registrasi dan Izin Praktik Fisioterapi.
Kusumawati, A.N dan Pujiyanto. 2018. Analisis Kinerja Dokter Verifikator Internal dalam Menurunkan Angka Klaim Pending di RSUD Koja Tahun 2018. Jurnal ARSI Vol.6 No.1.
Nasution, N. 2020. Sosialisasi Kelengkapan Dokumen Rekam Medis Rawat Jalan di Puskesmas Andalas Kota Padang. Logista Jurnal Ilmiah Pengabdian kepada Masyarakat Vol.4 No.1.
Nofri Heltiani, Ismail Arifin, Khairunnisyah, K., & Liza Putri. (2023). SOSIALISASI PENTINGNYA PROSEDUR KERJA PENGELOLAAN REKAM MEDIS TEBAL (VOLUMENIOUS BULKY) DI RSKJ SOEPRAPTO PROVINSI BENGKULU. PAKDEMAS : Jurnal Pengabdian Kepada Masyarakat, 2(3), 221-226. https://doi.org/10.58222/pakdemas.v2i3.152
Parwito, P., Nilawati, I., & Lasmadasari, N. . (2022). Sinergisitas Kampus Merdeka dan Merdeka Sampah Di Kelurahan Cempaka Permai Kecamatan Gading Cempaka Kota Bengkulu. Jurnal Pengabdian, 1(1), 7–16. https://doi.org/10.58222/jp.v1i1.2
Peraturan Badan Penyelenggara Jaminan Sosial Kesehatan nomor 7 Tahun 2018 Tentang Pengelolaan Adminitrasi Klaim Fasilitas Kesehatan dalam Penyelenggaraan Jaminan Kesehatan. 2018. Peratran BPJS Tentang Pengelolaan Klaim.
Peraturan Menteri Kesehatan Republik Indonesia Nomor 36 Tahun 2015 Tentang Peratu Pencegahan Kecurangan (Fraud) Dalam Pelaksanaan Program Jaminan Kesehatan Pada Sistem Jaminan Sosial Nasional.
Peraturan Presiden Republik Indonesia Nomor 12 Tahun 2013 Tentang Jaminan Kesehatan.
Pradani, E. A., Lelonowati, D & Sujianto. 2017. Keterlambatan Pengumpulan Berkas Verifikasi Klaim BPJS di RS.X: Apa Akar Masala dan Solusinya?. Jurnal Medicoetocolegal dan Manajemen Rumah Sakit Vol.6 No.2.
Yastori. 2020. Sosialisasi Kasus-Kasus Terkait Manual Coding dan Modern Coding pada Dispute Claim. Journal of Community Enganement in Health Vol.3 No.2 Sep 2020.
