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October 5, 2025Jurnal Rekam Medis dan Informasi Kesehatan Indonesia.Open Access

Factors Causing Delays in BPJS Health Inpatient Claims at Dr. Harjono S Regional General Hospital in Ponorogo Regency

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Authors

ISIke Wahyu SeptianDNDwi Nurjayanti

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Overview

Descriptive qualitative analysis identifies causes of delays in inpatient claims at BPJS Health hospitals, suggesting improvement areas.

Key Points

  • Pending inpatient claims are primarily due to incomplete medical documentation and inaccurate coding, which complicates hospital operations.
  • Out of 1,335 total claims, 228 pending claims were identified, indicating a significant operational challenge for the hospital.
  • Descriptive qualitative methods were employed through direct observation and interviews with claims officers to gather data.
  • Improvements in staff training and system integration between hospitals and BPJS Health may enhance claim processing efficiency.

Cite This Study

Septian et al. (2025) studied this question.

synapsesocial.com/papers/68e22da774308421369af00dhttps://doi.org/10.62951/jurmiki.v4i2.101
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