SOCIALIZATION : ACCURACY OF THE CODE OF PHYSIOTHERAPY ACTIONS SUPPORT PASSING BPJS CLAIM VERIFICATION

Authors

  • Nofri Heltiani Sekolah Tinggi Ilmu Kesehatan Sapta Bakti
  • Khairunnisyah Sekolah Tinggi Ilmu Kesehatan Sapta Bakti Bengkulu, Indonesia
  • Azizah Abdillah Sekolah Tinggi Ilmu Kesehatan Sapta Bakti Bengkulu, Indonesia
  • Ismail Arifin Sekolah Tinggi Ilmu Kesehatan Sapta Bakti Bengkulu, Indonesia
  • Liza Putri Sekolah Tinggi Ilmu Kesehatan Sapta Bakti Bengkulu, Indonesia
  • Dwi Widyawati Sekolah Tinggi Ilmu Kesehatan Sapta Bakti Bengkulu, Indonesia

DOI:

https://doi.org/10.51851/jsm.v4i1.488

Keywords:

Action Code, BPJS, Physiotherapy, Socialization, Training

Abstract

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.

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Published

2024-06-30

How to Cite

Heltiani, N. ., Khairunnisyah, Azizah Abdillah, Ismail Arifin, Liza Putri, & Dwi Widyawati. (2024). SOCIALIZATION : ACCURACY OF THE CODE OF PHYSIOTHERAPY ACTIONS SUPPORT PASSING BPJS CLAIM VERIFICATION. JURNAL SAPTA MENGABDI, 4(1), 15-22. https://doi.org/10.51851/jsm.v4i1.488