Akuntabilitas BPJS Kesehatan Cabang Utama Yogyakarta Dalam Penanganan Klaim Asuransi Program Jaminan Kesehatan Nasional Januari – April 2014

Abstract

Healthcare and Social Security Agency (BPJS) is a government program, that started on January 1,  2014. at the Early
Implementation is not yet completed. and has shor tcomings, among others payment of  claims insurance JKN to
Government’s Partner hospitals (BPJS). The aims of  this research was to describe Healthcare and Social Security
Agency (BPJS) accountability in claims insurance handling and factors that influence, This study used descriptive and
qualitative data, While the research analysis using the da ta analysis process based on the result of  in depth interview
and documents.. the result showed that accountability in claims insurance handling generally the result has been
accountable (80,5 %) although several indicators to measure showed any discrepancy / not accountable. when
measured with indicator refers to a predetermined scheduler that is not accountable. The presence indicator adher-ence to rules and procedures have not been fully accountable. while ability indicator for do performance evaluation
and Transparency Indicator in decision-making and to implement effecti veness and cost-eff iciency perf ormance of  its
duties has been accountable. Then, to determine the factor s that the effect of  accountability in claims insurance
handling used a variable factor of  service rules, factor of bureaucratic apparatus and factors of  priority interests and
service users. Application and implementation of  the third factor have relevance and has a causal impact that influ-ence the Healthcare and Social Security Agency (BPJS) in claims insurance handling.