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Abstrak :
ABSTRAK
On January 1, 2014, the government began to implement the National Health Insurance (NHI) program to realize social welfare for the whole community. Midwifery and neonatal care in the NHI program involves Puskesmas/family doctors and Private Practice Midwife (PPM) as its network. PPM participation in the NHI program in Bungo District was still lacking, only 12 (54.5%) PPM have cooperated with family doctors from 22 existing PPM. This study aimed to get an overview of PPM participation in the NHI program in Bungo District, Jambi Province. The study used qualitative research approach with Rapid Assessment Prosedur design, purposive sampling, and conducted in-depth interview to 10 PPM, Head of Health Office, MPKP BPJS Health Manager, and Chairman of Bungo Regency Section of Indonesian Midwife Organization (IMO). The study was conducted from January to July 2017. The study found that the knowledge, perceptions and attitude towards NHI program were good, but the perceived toward the claim and predetermined tariff procedures were not so good. PPM motivated to join the NHI program as many patients had become NHI participants. Support from the Government, NHI, and IMO were low, either in the form of socialization, or policies. Therefore, the study suggest an improvement in claims procedures, tariffs, and an increase of socialization from government, NHI and IMO on NHI program related to obstetric and neonatal care.

Abstrak :
Piutang merupakan harta lancar yang terbesar pada organisasi kesehatan dan berdampak dana investasi. Kegagalan pengelolaan piutang di rumah sakit akan mengganggu cash flow dan kegiatan operasional rumah sakit. Penelitian ini bertujuan mengetahui penyebab saldo piutang pasien jaminan pihak keti- ga yang tinggi, meliputi dinas dan langganan di RS Port Medical Center. Penelitian operasional ini melakukan pengamatan langsung dan telaah dokumen pa- da proses pengelolaan piutang pada tahap penerimaan, pembebanan biaya, penataan rekening, penagihan dan penutupan rekening. Informan adalah para pejabat dan pelaksana yang terlibat. Didapatkan bahwa tidak ada standar atau persyaratan kredit yang berlaku sebelum kerja sama. Potongan harga, jang- ka waktu pembayaran dan sanksi yang tertera dalam perjanjian kerja sama tidak dapat dijalankan. Telah ada upaya penagihan, tetapi belum optimal. Belum ada prosedur tentang cara penagihan bila pembayaran terlambat. Pada lima tahap pengelolaan piutang terlihat beban tugas penata rekening yang tinggi. Dan SOP hanya tersedia pada tahap pembebanan biaya. Proses seleksi yang menggunakan sistem billing online mempermudah pekerjaan tetapi menuntut ketelitian tinggi. Jumlah tagihan dan saldo piutang terbesar adalah dinas. Perusahaan asuransi mempunyai saldo piutang terkecil dan proporsi pembayaran terkecil adalah Jamsostek. Proses penagihan pada dinas, perusahaan umum dan perusahaan asuransi relatif sama (20 hari). Lama proses penagihan dan umur piutang terlama adalah Jamsostek.

Account receivables is the biggest current assets in health organization including hospitals and will influence investation fund management. Failure in ac- count receivables management will confound the cash flow and operational activities. The purpose of this study is to know the causes of high account re- ceivables of patients insured by third party. This operational research used direct observations and documents review regarding the management process of the insured patient account receivables at the stage of admission, charge capture, account billing, collecting and account writing off. An in-depth interview was conducted to the involved persons and officers. The result of the study shows that the current credit policy prevails at PMC hospital seems to be linient since no credit standard or credit terms given before colaboration. Discount, payment period and sanctions are included in the agreement but not effective. There are efforts for claiming, but it has not been done optimally. There is no procedure that can be used in collecting account if there were delay. There is a shor- tage of staff on the account arrangement and overlapped tasks of staff at central opname. The only available standard operating procedure was at the stage of charge capture. Although the completion process has used on line billing system, to simplify the task, it still needs high accuracy to get accurate data. The highest claim goes to the state owned company. The highest account receivable also goes to the state owned company. From four health insurance compa- nies, Jamsostek has the lowest payment percentage. It is also found that the length of the collecting process is 20 days for state owned companies, public companies and insurance companies and 60 days for Jamsostek. The length of billing process and account receivable days for Jamsostek was the longest.