•  
  •  
 

Abstract

Coders affect hospital revenue due to their ability to determine specific code using ICD for diagnoses and procedures stated in medical record. This study aimed to determine the competence of coder in X Hospital and potential losses that may occur. Quantitative method was used in this study, involving 6 coders who were divided into 2 groups: standard and test groups, based on years of experience and followed trainings. Coding results and the amount of the claim were compared between groups. The study showed coder‘s competence still needs to be improved. This was characterized by a high average under coding result that reached 32.6% and potentially lowering hospital revenue by an average of 4.2% of claims that should be obtained by the hospital.

Bahasa Abstract

Coder mempengaruhi penerimaan rumah sakit karena kemampuannya dalam menetapkan kode menggunakan ICD untuk mengkode diagnosa dan prosedur yang tercatat didalam dokumen rekam medis. Penelitian ini bertujuan untuk mengetahui perbedaan hasil koding coder di Rumah Sakit Pemerintah X Semarang dan potensi kerugian yang mungkin terjadi. Metode yang digunakan adalah kuantitatif, melibatkan 6 orang coder yang dibagi menjadi 2 kelompok yaitu standar dan uji, berdasarkan masa kerja dan pelatihan yang pernah diikuti. Hasil koding dan besaran klaim antar kelompok dibandingkan. Dari penelitian didapatkan kompetensi coder perlu ditingkatkan karena rerata hasil tarif lebih rendah dari kelompok standar yang tinggi 32,6%, berpotensi menurunkan pendapatan rumah sakit rata-rata sebesar 4,2% dari klaim yang seharusnya diterima.

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.