Kesesuaian Prosedur Pelayanan Kesehatan Rujukan Tingkat Lanjut Pasien Jaminan Kesehatan Nasional (JKN) dengan Program Badan Penyelenggara Jaminan Sosial (BPJS) di Unit Pendaftaran Rawat Jalan Rumah Sakit Permata Depok Tahun 2024

Alignment of Advanced Referral Healthcare Service Procedures for National Health Insurance (JKN) Patients with the Social Security Administering Body (BPJS) Program at the Outpatient Registration Unit of Permata Depok Hospital in 2024

Abstract

Introduction: BPJS is an institution formed to administer social security programs in Indonesia. BPJS Health has been in operation since January 2014 and is a national health insurance provider that offers affordable health benefits to the entire community. This study aims to determine the suitability of patient administration requirements in conjunction with the BPJS program in hospital outpatient settings. This research was conducted to understand the implementation of patient administration policies, measure the level of compliance with administration requirements, evaluate patient satisfaction, and identify factors that influence the efficiency of patient administration

Methods: The research method used involved interviews with hospital administration officers and data collection through observation of checklist sheets by patients using the BPJS program.

Results: The result of this research: 83% of BPJS patient administration requirements in the form of a BPJS card file are compliant, and 17% of BPJS patient administration requirements are compliant in a life in form of a BPJS card, 88% of BPJS patient administration requirements are compliant in the form of a referral letter file and 88% of them are inconsistent 12% of BPJS patient administration requirements in the file in the form of a referral letter, 82% of BPJS patient administration requirements in the form of an Identity Card (KTP) are compliant and 18% of BPJS patient administration requirements are in the form of an ID card are 18% inconsistent, there is procedural conformity services for BPJS patients in obtaining Participant Eligibility Letters (SEP) from advanced health facilities.

Discussion: The suitability of service procedures for BPJS patients in obtaining further referral letters for First Level Health Facilities (FKTP) is examined, based on the recommendation of the examining doctor. Additionally, the suitability of service procedures for BPJS patients in signing letters of proof of service from advanced health facilities is assessed.