Patient's Claim Financing at Kariadi Hospital Semarang during the Covid-19 Pandemic

ABSTRACT

Findings on health status and condition of patients who came to Kariadi Hospital were classified into two categories comorbid and co-incident. For patient claims to be funded, an assembling process and case-mix coding are carried out for the submission process based on the results of checking the status and health conditions of comorbid and co-incident patients. This study is to know the process of financing the patient's claim at Kariadi Hospital Semarang during the Covid-19 pandemic. The research was conducted in a phenomenological descriptive qualitative manner with the data sources coming from primary informants. Sampling technique with the selection according to the criteria then conducted an interview. Content analysis was used to analyze the data. For Covid-19 patients with comorbidities, previously a claim was made for Covid-19 cases, and if the Covid-19 case was completed but the comorbidi-ties persisted, the guarantor switched from the Ministry of Health to BPJS Health. In the process of financing a patient's claim at Kariadi Hospital Semarang during the Covid-19 pandemic there were two guarantees from the Ministry of Health and BPJS Health. © 2022, Universitas Negeri Semarang. All rights reserved.