Ditemukan 3 dokumen yang sesuai dengan query :: Simpan CSV
Ricard Rivaldo Pasalli; Pembimbing: Mardiati Nadjib; Penguji: Adik Wibowo, Agus Rahmanto
Abstrak:
Terealisasinya keadaan sehat merupakan keinginan semua orang, juga dari keluarga, perkumpulan dan masyarakat. Perusahaan asuransi dan lembaga asuransi adalah lembaga ekonomi, yaitu lembaga pengalihan risiko. Tingkat risiko dapat diukur dengan nilai produk dimana peristiwa itu terjadi. Penelitian ini dilakukan untuk mengetahui penyelesaian klaim asuransi kesehatan nasional. Penelitian ini menggunakan metode literature review. Pada pencarian studi menggunakan tiga online database yaitu PubMed, Google Scholar, dan Science Direct. Ada 7 studi yang terinklusi dalam penelitian ini. Hasil penelitian menunjukkan dalam menyelesaikan klaim terdapat bentuk-bentuk penyelesaian klaim asuransi kesehatan nasional, faktor pendukung dan faktor penghambat. Faktor pendukung diantaranya adalah ketepatan penyelesaian klaim, tingkat penyelesaian klaim, klaim rasio dan keluhan ganti rugi. Adapun faktor penghambat klaim diantaranya adalah staf yang kurang memenuhi kualifikasi dalam memproses klaim, tata cara pengecekan yang kurang jelas dan peserta asuransi baru menyadari saat membuat klaim bahwa tidak mencakup penyakit tertentu.
The realization of a healthy condition is the desire of everyone, also from families, associations and communities. Insurance companies and insurance institutions are economic institutions, namely risk transfer institutions. The level of risk can be measured by the value of the product where the event occurs. This study was conducted to determine the settlement of national health insurance claims.method literature review. The study search used three online databases , namely PubMed, Google Scholar, and Science Direct. There are 7 studies included in this study. The results showed that in resolving claims there are forms of settlement of national health insurance claims, supporting factors and inhibiting factors. Supporting factors include the accuracy of claim settlement, level of claim settlement, claim ratio and compensation complaints. The factors inhibiting claims include staff who do not meet the qualifications in processing claims, procedures for checking that are not clear and insurance participants only realize when making a claim that it does not cover certain diseases.
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The realization of a healthy condition is the desire of everyone, also from families, associations and communities. Insurance companies and insurance institutions are economic institutions, namely risk transfer institutions. The level of risk can be measured by the value of the product where the event occurs. This study was conducted to determine the settlement of national health insurance claims.method literature review. The study search used three online databases , namely PubMed, Google Scholar, and Science Direct. There are 7 studies included in this study. The results showed that in resolving claims there are forms of settlement of national health insurance claims, supporting factors and inhibiting factors. Supporting factors include the accuracy of claim settlement, level of claim settlement, claim ratio and compensation complaints. The factors inhibiting claims include staff who do not meet the qualifications in processing claims, procedures for checking that are not clear and insurance participants only realize when making a claim that it does not cover certain diseases.
S-11059
Depok : FKM-UI, 2022
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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Shamim Thahir Ahmad; Pembimbing: Kurnia Sari; Penguji: Mardiati Nadjib, Edu Parningotan Aritonang
Abstrak:
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Durasi penyelesaian klaim menjadi indikator penting dalam menilai efisiensi pelayanan asuransi, terutama pada produk santunan harian rawat inap. Keterlambatan dalam proses klaim dapat menurunkan kepuasan dan kepercayaan nasabah terhadap perusahaan asuransi. Penelitian ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan durasi penyelesaian klaim santunan harian rawat inap di PT. X berdasarkan data tahun 2023–2024. Penelitian menggunakan desain cross-sectional dengan pendekatan kuantitatif dan memanfaatkan data sekunder sebanyak 299 klaim. Analisis dilakukan secara univariat dan bivariat menggunakan regresi logistik ordinal. Hasil menunjukkan bahwa sebagian besar klaim diselesaikan dalam waktu 6–14 hari (39,1%) dan 0–5 hari (37,5%). Terdapat dua variabel yang memiliki hubungan signifikan secara statistik terhadap durasi klaim, yaitu asal daerah dan kelengkapan dokumen. Peserta dari luar Pulau Jawa cenderung mengalami durasi klaim lebih lama, sedangkan klaim dengan dokumen lengkap memiliki peluang yang jauh lebih besar untuk diselesaikan dalam waktu singkat. Empat variabel lainnya—sebab dirawat, jenis rumah sakit, nominal klaim, dan riwayat pengajuan sebelumnya—tidak menunjukkan hubungan signifikan namun memiliki kecenderungan praktis yang relevan.
The duration of claim settlement is an important indicator in assessing the efficiency of insurance services, particularly for hospital daily cash benefit products. Delays in the claim process may reduce customer satisfaction and trust in insurance companies. This study aims to analyze the factors associated with the duration of claim settlement for hospital daily cash benefits at PT. X based on 2023–2024 data. A cross-sectional design with a quantitative approach was used, utilizing secondary data from 320 claims. The analysis was conducted using univariate and bivariate methods with ordinal logistic regression. The results showed that most claims were settled within 6–14 days (39.1%) and 0–5 days (37.5%). Two variables showed statistically significant relationships with claim duration: region of origin and completeness of documents. Participants from outside Java Island tended to experience longer claim durations, while claims submitted with complete documents had a significantly higher likelihood of being processed more quickly. The other four variables—reason for hospitalization, hospital type, claim amount, and claim history—were not statistically significant but showed relevant practical trends.
The duration of claim settlement is an important indicator in assessing the efficiency of insurance services, particularly for hospital daily cash benefit products. Delays in the claim process may reduce customer satisfaction and trust in insurance companies. This study aims to analyze the factors associated with the duration of claim settlement for hospital daily cash benefits at PT. X based on 2023–2024 data. A cross-sectional design with a quantitative approach was used, utilizing secondary data from 320 claims. The analysis was conducted using univariate and bivariate methods with ordinal logistic regression. The results showed that most claims were settled within 6–14 days (39.1%) and 0–5 days (37.5%). Two variables showed statistically significant relationships with claim duration: region of origin and completeness of documents. Participants from outside Java Island tended to experience longer claim durations, while claims submitted with complete documents had a significantly higher likelihood of being processed more quickly. The other four variables—reason for hospitalization, hospital type, claim amount, and claim history—were not statistically significant but showed relevant practical trends.
S-12000
Depok : FKM-UI, 2025
S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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S-9001
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S1 - Skripsi Pusat Informasi Kesehatan Masyarakat
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