@article {2312,
	title = {Analysis of Fraud Potential Control Based on Input and Process in Dadi Regional Hospital, Makassar City},
	journal = {Pharmacognosy Journal},
	volume = {16},
	year = {2024},
	month = {June 2024},
	pages = {668-670},
	type = {Research Article},
	chapter = {668},
	abstract = {<p class="rtejustify">The risk of large losses arising from acts of fraud (fraud) requires the government to issue Permenkes No. 16 of 2019 concerning the prevention and handling of fraud (fraud) and the imposition of administrative sanctions against fraud (fraud) in the implementation of the health insurance program. It{\textquoteright}s just that in its implementation, there are still a number of problems related to the inefficiency of Health BPJS services which ultimately indicate the occurrence of fraud. For this reason, efforts to prevent fraud are needed. This study aims to look at the input and process of fraud control at the Dadi Regional Special Hospital (RSKD) Makassar City. This study uses a qualitative approach with descriptive analysis method by selecting informants by purposive sampling. This research is seen from the input components and process components in the implementation of the National Health Insurance. The research results show that input components include policies, personnel and facilities. The process component includes driving factors and inhibiting factors for potential fraud. Factors driving the potential for fraud are differences in understanding between the verifier and the doctor in charge of the patient regarding the diagnosis, the lack of outreach about fraud prevention and the absence of a JKN anti-fraud team. Factors inhibiting potential fraud are the Implementation of Standard Operations, code of ethics, coordination between parties involved, Clinical Pathway and supervision from the SPI team (Internal Supervisory Team).</p>
},
	keywords = {Financing system, JKN, Prevention of potential fraud},
	doi = {10.5530/pj.2024.16.106},
	author = {Muhammad Alwy Arifin and Amaliah Amriani AS and Darmawansyah, Amran Razak and Muh. Yusri Abadi and Muhammad Al- Fajrin}
}
@article {2178,
	title = {Evaluation of the Economic Impact of Implementing National  Health Insurance (JKN) on Hospitals at RSUD Tenriawaru Kab. bone},
	journal = {Pharmacognosy Journal},
	volume = {15},
	year = {2023},
	month = {December 2023},
	pages = {1156-1162},
	type = {Research Article},
	chapter = {1156},
	abstract = {<p class="rtejustify">The National Health Insurance Program (JKN) through the Social Security Administering Body has been running since January 1 2014, the Tenriawaru Regional General Hospital in Bone Regency is one of the hospitals under the auspices of the local government that works closely with BPJS Kesehatan. The Bone Regency Government has registered 237,381 people into the National Health Insurance (JKN) program. In general, this study aims to analyze the economic impact of the implementation of the National Health Insurance (JKN) on hospital income, hospital financing and financial compensation for hospital employees at Tenriawaru Hospital, Kab, Bone. This study uses a qualitative descriptive research method that aims to obtain an in-depth evaluation study on evaluating the economic impact of the implementation of the National Health Insurance (JKN) program on hospitals. The informants in this study totaled 5 people consisting of the Head of Finance Subdivision, the JKN case mix officer, the Head of Service Subdivision, the Head of HR Subdivision and the Head of Public Relations Subsection. The results of the study show that the implementation of the National Health Insurance (JKN) program has an impact on hospital income. The implementation of JKN provides great benefits for the hospital. the implementation of the National Health Insurance (JKN) program also has an impact on hospital financing, JKN covers hospital operational costs, JKN claims have their respective portions for hospital human resources, drug resources and BHP in hospitals. The implementation of the National Health Insurance (JKN) program has no impact on the financial compensation of employees in hospitals, salaries, bonuses and semi-annual incentives that employees get have no effect on the implementation of JKN in service hospitals that get a portion each for the operational needs of the hospital not for employee financial compensation.</p>
},
	keywords = {Compensation, Financial, Financing, Income, JKN},
	doi = {10.5530/pj.2023.15.210},
	author = {Karmilasari and Sukri Palutturi and Darmawansyah and Muh. Syafar and Indar and Citrakesumasari and Anwar Mallongi}
}
