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Submitted
2 January 2024
Published
30 June 2024
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Abstract

A CT Scan Simulator is a tool used to determine the size, shape, and location of a tumor to help the radiotherapy team determine the next treatment plan. Vina Estetica General Hospital is a public hospital that provides CT Scan Simulator services based on the permission of Perka BAPETEN as radiotherapy management and follow-up in malignancy cases. This study uses a descriptive method through a quantitative approach, aiming to describe the inefficiency of CT-Scan Simulator billing used as a support for diagnosis enforcement based on the Indonesian-Case Based Groups (INA CBGs) tariff costs. The technique used was purposive sampling with inclusion and exclusion criteria. Secondary data collection was carried out retrospectively in the form of claim files for the period January 2020 - November 2023 as many as 308 samples were taken randomly. The results showed that there were 283 (83%) CT Scan Simulator billing claims aimed at supporting diagnosis enforcement and resulting in billing inefficiencies in the INA CBGs claim rates being higher

Keywords

Inefficiency CT Scan Simulator Claims Administration Audit Radiotherapy Malignancy

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How to Cite
Yusti, R. (2024). Inefficiency CT Scan Simulator Billing as an Audit Initiative of National Health Insurance Claims Administration at Vina Estetica General Hospital: GAMBARAN INEFESIENSI PENAGIHAN CT SCAN SIMULATOR SEBAGAI INISIASI AWAL AUDIT ADMINISTRASI KLAIM (AAK) BPJS KESEHATAN PADA RS VINA ESTETIKA. Jurnal Jaminan Kesehatan Nasional, 4(1), 77–84. https://doi.org/10.53756/jjkn.v4i1.192
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