ABTRAKAkhir-akhir ini bisnis asuransi kesehatan (askes) tampak meningkat baik yang diselenggarakan oleh BUMN maupun oleh Badan Swasta. Oleh karena itu perkembangan askes mempunyai potensi dalam mempengaruhi pelayanan di rumah sakit. Dalam hal ini pihak rumah sakit sebagai pelaksana pelayanan kesehatan berupaya meningkatkan mutu pelayanan baik langsung atau tidak langsung terhadap peserta asuransi kesehatan.Dilihat dari jenis pelayanan yang diselenggarakan dirumah sakit, maka proses administrasi keuangan sebagai pelayanan tidak langsung mempunyai kaitan erat dengan upaya diatas. Dari data rumah sakit menunjukkan adanya keterlambatan proses administrasi keuangan peserta PT ASKES rawat inap, mempengaruhi proses pembayaran oleh PT ASKES. Sehubungan dengan upaya meningkatkan mutu pelayanan tidak langsung, maka pengadaan formulir monitoring khusus bermaksud untuk mempercepat proses administrasi peserta PT ASKES rawat inap.Sehubungan dengan permasalahan diatas, maka penelitian ini bertujuan untuk mengetahui gambaran proses administrasi keuangan dan perbedaan proses administrasi keuangan antara sebelum dan sesudah pengadaan formulir monitoring khusus (FMK) peserta PT ASKES rawat inap.Penelitian ini memakai gabungan metoda kualitatif dan kuantitatif. Metoda kualitatif dilakukan dengan mengadakan wawancara mendalam (in-depth ilerview) terhadap petugas administrasi yang terlibat dalam proses keuangan peserta PT ASKES rawat inap. Sedang metoda kuantitatif dilakukan dengan mengadakan uji statistik untuk mengetahui apakah ada perbedaan lama proses administrasi antara sebelum dan sesudah pengadaan FMK peserta PT ASKES rawat inap.Dari hasil penelitian dapat disimpulkan bahwa dari ketiga proses administrasi keuangan yaitu proses kelengkapan surat jaminan, proses pengiriman status/FMK dan proses perhitungan biaya, ternyata hanya proses perhitungan biaya ynag menunjukkan perbedaan yang bermakna antara sebelum dan sesudah pengadaan FMK. Hal ini menunjukkan bahwa pengadaan FMK mempunyai manfaat bagi petugas Bagian P2D-Askes dalam membantu mempercepat proses perhitungan biaya.Pada pengamatan tentang pelaksanaan proses administrasi keuangan di ruang perawatan, walaupun telah diberikan petunjuk pelaksanaan cara melengkapi FMK, namun dalam pelaksanaannya perlu ditingkatkan lagi peranan petugas administrasi ruang perawatan dalam proses administrasi keuangan. OIeh karena itu disarankan perlu dilakukan penataran ulang dan evaluasi lebih lanjut tentang peranan petugas administrasi membantu Bagian P2D-Askes dalam proses administrasi keuangan peserta PT ASKES rawat inap.

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ABSTRACT

In recent years, the health insurance business run by both private parties and state-owned companies have been flourishing. Subsequently, health insurance has become an important factor which potentially influences the services-either direct or indirect- offered by hospitals. As provider of health services, hospitals strive to improve the quality of the services extended to participants of health insurance programs.

Financial administration is indirect hospital service, which is closely inter-related to that effort. The records show that any tardiness in this process influences payment extended by PT ASKES to in-patients. To upgrade the quality of the hospital's indirect service, monitoring forms are provided with the purpose of accelerating the administration process.

The study is conducted to obtain a description regarding the process of financial administration, and to find out whether there is a difference in the process after the monitoring forms were distributed among in-patient who were also PT ASKES members.

The study combines qualitative and quantitative methods. In-depth interview were conducted with the administrative staff involved in the financial process of PT ASKES in-patient, while quantitative methods included statistical experiments to determine whether there would be a difference in the length of time spent on administration process before and after the monitoring forms were introduced.

The results came up with the conclusion that of the three financial administration process: completion of letters of guarantee, status/form forwarding and cost calculation, only the process involves in cost calculation showed a significant change. The introduction of the special monitoring forms were apparently effective in assisting the staff in the P21)-Askes Department to speed up the process of calculating hospital costs. While for the process involved in acquiring complete letters of guarantee and the forwarding of status, no significant changes were reported.

Observation on the execution of financial administration process in the care units themselves - where staff were given practical instructions on how to properly fill in the forms - concluded that role of the administrative staff still needs to be improved. It is suggested that an upgrading course and further evaluation on the role of the administrative staff in assisting the P2D-Askes Department be conducted.