COVID-19 has had many negative impacts on society. One of them is the impact on the economy in the healthcare sector, namely hospitals. Transmission through direct contact with a sprinkling of phlegm from infected people (through coughing and sneezing) and touching a surface contaminated with the virus made the Indonesian government enforce the Stay at Home policy. This led to reducing the number of BPJS patient visits at the hospital at the beginning of the COVID-19 pandemic. The reduced number of BPJS patient visits had the effect of decreasing hospital income. This is in line with the decrease in outpatient and inpatient income at the Muhammadiyah University General Hospital of Malang from 2019 to 2020 by 14% and 13%, respectively. This study uses Chaos Theory, where hospital revenues from patient visits are reduced unpredictably due to the ongoing COVID-19 pandemic. The method used in this research is a qualitative descriptive method. The results of the data analysis showed that the number of patient visits at UMM Hospital increased in the second year of the COVID-19 pandemic in 2021. Keywords: COVID-19, hospital, risk management, financial, BPJS
Muhammadiyah University General Hospital of Malang is a COVID-19 referral hospital for Malang. Between April 2020 and June 2021, the hospital submitted 62 outpatient and 1364 inpatient cases for COVID-19 claims to the Ministry of Health of the Republic of Indonesia. The percentage of outpatient dispute claims was 25% and of inpatient dispute claims was 39%. These disputed claims disturbed the cash flow of the health facilities. The aim of our study was to describe the causes of outpatient and inpatient COVID-19 dispute claims. Our methodology was descriptive, and the secondary data were taken from claim submission documents. There were ten criteria that caused dispute claims based on KMK Number HK. 01.07/MENKES/4718/2021. This was related to administrative and medical issues. The most common cause of inpatient dispute claims (35%) was that the criteria for discharge from the hospital were not in accordance with the guarantee limit. Additionally, the most common cause of outpatient dispute claims (60%) was the management of isolation that was not related to the guidelines for management and prevention of COVID-19. Keywords: claim dispute criteria, hospital, COVID-19
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