Analisis Perjanjian Kerjasama Antara Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan Dan Rumah Sakit Terhadap Penentuan Klaim Tunda (Klaim Pending) Di Rumah Sakit Umum Daerah Datu Beru Takengon Aceh Tengah

Analisis Perjanjian Kerjasama Antara Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan Dan Rumah Sakit Terhadap Penentuan Klaim Tunda (Klaim Pending) Di Rumah Sakit Umum Daerah Datu Beru Takengon Aceh Tengah, BPJS Cooperation Agreement, Deferred Claims...

Author: DR. EKO CIPTA BURNAMA
Date: 2024
Keywords: BPJS Cooperation Agreement, Deferred Claims
Type: Jurnal
Category: penelitian

This study examines the Cooperation Agreement between the the Social Security Provider (BPJS) for Health and Hospitals and how it impacts the delay in claim payments at RSUD Datu Beru Takengon in 2023. The research employs a juridicalempirical method focusing on the analysis of the Cooperation Agreement documents. The findings reveal that coding discrepancies are the major cause of claim delays, with a total of Rp 4,370,529,800 in delayed claims throughout 2023. While the cooperation agreement outlines rights and obligations for both parties, it lacks specific attention to resolving delayed claims. Therefore, the agreement needs improvement by emphasizing the prevention of claim delay cases to avoid negative impacts on hospitals and healthcare services

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