Klaim Pelayanan Kesehatan Peserta Jaminan Kesehatan Nasional-Kartu Indonesia Sehat (JKN-KIS) Non Penerima Bantuan Iuran (Non PBI) Di Rumah Sakit Umum Ananda Purwokerto Kabupaten Banyumas

KAOKAB KURNIAWAN, Dwi Haryati, S.H.,M.H.

2018 | Skripsi | S1 HUKUM

Penulisan hukum ini bertujuan untuk mengetahui dan mengkaji pelaksanaan dan kendala dalam pelaksanaan klaim pelayanan kesehatan peserta program JKN-KIS Non PBI di Rumah Sakit Umum Ananda Purwokerto, serta upaya yang dilakukan untuk menjaga aliran dana Rumah Sakit Umum Ananda dikarenakan pelaksanaan klaim dan adanya kendala dalam proses pelaksanaan klaim tersebut yang menjadi penyebab aliran dana Rumah Sakit menipis. Penelitian hukum ini bersifat deskriptif, dengan menggunakan jenis penelitian hukum empiris, yang didasarkan pada norma hukum yang berlaku, selanjutnya dikaji pelaksanaannya apakah sudah sesuai dengan penerapan di lapangan, yang dianalisis menggunakan analisis kualitatif dan dipaparkan secara deskriptif. Berdasarkan data yang didapat dari hasil penelitian, dapat disimpulkan bahwa pelaksanaan klaim pelayanan kesehatan peserta program JKN-KIS Non PBI di Rumah Sakit Umum Ananda Purwokerto telah dilaksanakan dan masih terdapat kendala dalam proses pelaksanaannya. Kendala yang dihadapi berupa pengajuan berkas penagihan yang kurang dan ada berkas yang menyusul. Adanya hambatan dari sistem jaringan internet pada aplikasi v-claim pada saat input data oleh Rumah Sakit Ananda, dan keterlambatan pembayaran klaim oleh pihak BPJS Kesehatan karena anggaran dana klaim defisit. Untuk menjaga aliran dana Rumah Sakit dilakukan upaya yaitu inisiatif dari pihak Rumah Sakit Umum Ananda untuk mencari dana talangan dan mendapatkan dana tersebut dari bank mandiri dengan bunga yang dibebankan kepada pihak Rumah Sakit.

The writing of law aims to understand and assess the implementation of of and obstacles in in the implementation of a claim health services was ability to participate in the program JKN-KIS non chairperson in a public hospital ananda purwokerto , as well as the that is made to keep the flow of funds a public hospital ananda claims and the deserted condition was because the implementation of the government would make every effort in this region to implement behind these claims fact become the cause of the flow of funds the hospital was reduced . Research present at the time of descriptive is right beside the road , by the use of the kind of research empirical law , who based on the norms law and order were pretty , once the review will include six office channeling the implementation of these programs so they settled the matter in accordance with the application of the in the field , that have been analyzed using analysis qualitative and were presented a sort of descriptiveset . Based on the data be gleaned from the results of the study , it can be concluded that the implementation of a claim health services was ability to participate in the program JKN-KIS non chairperson in a public hospital ananda purwokerto had been conducted were and theres obstacles that will emerge if during the implementation process .Abstacle that face in the form of file in accordance with their proposal amount of debt of those not sufficient and the any of the files to the bonds because of .To the obstacles in of a system of the internet network on the application v-claim at the time of data input by the hospital ananda , and delayed payment of a claim to by parties health management agency bpjs since the budget claim funds a deficit in its state .In order to maintain the flow of funds the hospital attempts to pt pgn promised to supply the initiative from a house party regional hospital owned by the ananda in order to search for advance funds dana talangan and and get of these funds from bank mandiri with an interest rate of that are imposed on the hospital .

Kata Kunci : Klaim Pelayanan Kesehatan, Peserta JKN KIS Non PBI, BPJS Kesehatan / a claim the provision of health services , would be reduced participants KIS non chairperson , health management agency BPJS