TINJAUAN KELENGKAPAN LAPORAN KRONOLOGIS PASIEN SEBAB LUAR GUNA MENUNJANG KLAIM RAWAT INAP BPJS KESEHATAN DI RSUD AL IHSAN

Abstract

Chronological reports are important supporting documents in the BPJS Health claim process, especially for patients with external causes. This document can be in the form of a chronological sheet of events and/or a Police Report. This study aims to review the extent to which the completeness of the chronological report of patients with external causes category contributes to the smooth process of BPJS Health inpatient claims at Al Ihsan Hospital, West Java Province. The method used in this research is descriptive qualitative, with data collection techniques carried out through observation and interviews, as well as reviewing documentation of patient claim files for inpatients with external cause categories in January 2025. The results showed that the chronological report plays an important role in the document verification process by BPJS Health. There are several obstacles found related to the completeness of the chronological report documents such as the incompatibility of the contents of the chronological sheet, not attaching a rejection letter from Jasa Raharja, and the Police Report format that does not meet the requirements. The incompleteness of these documents caused a number of claim files to be declared ineligible for processing. In addition to having an impact on claim delays, this condition also affects hospital cash flow and increases the workload of officers. Therefore, it is necessary to increase the understanding of patients and officers regarding the importance of chronological reports in the BPJS Health claim system.