laporan umpan balik update2. 10.05.162.docx

LAPORAN BPJS RAWAT JALANPUMPAN BALIK 21 APRIL 2016

SEPTEMBER

September 2015

TerbayarPendingMasuk RI

Jumlah Kasus 4329Terbayar 4323Pending 2Masuk Rawat Inap 4

Berkas Pending

NOTGL PE

LAYANANNO. REG NAMA PASIEN DPJP TARIF RS KETERANGAN

1. 15/09/2015

00792761 TRI WALUYO, TN ARMAN MUCHTAR, dr SpB 60,000 PROSES VERIFIKASI

2. 22/09/2015

00794838 MULYANIH , NY PRAMONO SIGIT Dr,SpJp 137,000 PROSES VERIFIKASI

197,000

Data Masuk Rawat Inap

NOTGL PE

LAYANANNO. REG NAMA PASIEN

DPJP TARIF RS KETERANGAN

1. 10/09/2015 00791297 SITI ROHMAH . NY FARGIATI, dr 201,019 RJ DAN RI PADA HARI YG SAMA

2. 23/09/2015 00795117 JUNITA AMALIA, AN HENNY K, dr SpA 60,000 RJ DAN RI PADA HARI YG SAMA

3. 26/09/2015 00795752 GILANG RAMADHAN,TN

JEFFERSON MARAMPE, dr SpB 212,000 RJ DAN RI PADA HARI YG SAMA

4. 28/09/2015 00795850 SUSI ANDAYANI,NY I PUTU OKA , dr 140,541 RJ DAN RI PADA HARI YG SAMA

613,560

OKTOBER

Jumlah Kasus 4284Terbayar 4276Pending 4Masuk Rawat Inap 3TL 1

Oktober 2015

TerbayarPendingMasuk RITL

Berkas Pending

NOTGL PE


1. 06/10/2015

00798458 CLARISSA RIANDI, AN HENNY K, dr SpA 175,000 PROSES VERIFIKASI

2. 06/10/2015

00798494 TATI HARYATI. NY DENI KRISCAHOYO, dr SpPD 476,000 PROSES VERIFIKASI

3. 26/10/201 0080387 ARIS NURMALINA, NY TUTIK FAUZIAH, dr SpRM 148,000 PROSES VERIFIKASI

5 04. 28/10/201

50080444

5 ASIAH, NY TEGUH HARJONO, dr SpPD 307,910 PROSES VERIFIKASI

1,106,910


NOTGL PE


1. 15/10/2015

00800857

KARTINA DJAMALUDDIN, NY LIDYA SIMAMORA, dr 136,453 RJ DAN RI PADA HARI YG SAMA

2. 20/10/2015

00802040 MUDAS. TN LUSI NURSILAWATI, Dr SpP 158,294 RJ DAN RI PADA HARI YG SAMA

3. 27/10/2015

00804179 SUMIRTA ADHI. TN ARMAN MUCHTAR, dr SpB 60,000 RJ DAN RI PADA HARI YG SAMA

354,747

Data Tidak Layak (TL) Klaim

NOTGL PE


1. 03/10/2015 00797783 ARIO FERNANDES.

TN HIDAYAT ANWAR, dr SpTHT 90,000 TTD

90,000

NOVEMBER

Jumlah Kasus 4061Terbayar 4051Pending 6

Masuk Rawat Inap 2TL 2

November 2015

TerbayarPendingMasuk RITL

Berkas Pending

NO TGL PE

NO. REG NAMA PASIEN DPJP TARIF RS KETERANGAN

LAYANAN1. 05/11/201

50080681

0 DJAENAB, HJ. NY RIWANTI YULIAMI, dr SpS 134,567 PROSES VERIFIKASI

2. 12/11/2015

00808564 MARGANI KENDA, TN DENI KRISCAHOYO, dr SpPD 151,387 PROSES VERIFIKASI

3. 24/11/2015

00811867 NADIRA IFTITAH. BY HENNY K, dr SpA 129,000 PROSES VERIFIKASI

4. 24/11/2015

00812125 LUTFI SUNGKAR, TN DENI KRISCAHOYO, dr SpPD 113,414 PROSES VERIFIKASI

5. 25/11/2015

00812199 SANTI FITRIAH ARMAN MUCHTAR, dr SpB 245,000 PROSES VERIFIKASI

6. 28/11/2015

00813277 DANIEL , TN GATOT SUDIRO. H. SpP 69,000 PROSES VERIFIKASI

842,368


NOTGL PE


1. 21/11/2015

00811241

ARJUNA QONITAH WIJAYA, BY HENNY K, dr SpA 200,960 RJ DAN RI PADA HARI YG SAMA

2. 30/11/2015

00813620 SURATMAN, TN LUSI NURSILAWATI, dr SpP 170,000 RJ DAN RI PADA HARI YG SAMA

370,960


NO TGL PELAYANAN NO. REG NAMA PASIEN DPJP TARIF RS KETERANGAN

1. 04/11/2015 00806460 NUR'AINI , NY DENI KRISCAHOYO, dr SpPD 113,414 TTD

2. 04/11/2015 00806459 HELMY, TN DENI KRISCAHOYO, dr SpPD 113,001 TTD

226,415

DESEMBER

Jumlah Kasus 3910Terbayar 3990Pending 8Masuk Rawat Inap 2

Desember 2015

Terbayar Pending

Masuk RI

Berkas Pending

NOTGL PE


1. 03/12/2015

00814663 SUKARSIH, NY TUTIK FAUZIAH, dr SpRM 132,000 PROSES VERIFIKASI

2. 04/12/2015

00814964 HERMAWATI, NY TUTIK FAUZIAH, dr SpRM 148,000 PROSES VERIFIKASI

3. 14/12/2015

00817204 ASENIH, TN PRAMONO SIGIT Dr,SpJp 310,000 PROSES VERIFIKASI

4. 16/12/2015

00818048

M. IQBAL ANDRI ANDANI, AN

HENNY K, dr SpA 90,000 PROSES VERIFIKASI

5. 28/12/2015

00820612 AHDIYAT . TN TEGUH HARJONO, dr SpPD 115,000 PROSES VERIFIKASI

6. 03/12/2015

00814582 SRI SARTININGSIH, NY SHANTI ISWARA, dr SpGK 60,000 PROSES VERIFIKASI

7. 10/12/2015

00816426 DANISWAN ANWAR. TN SHANTI ISWARA, dr SpGK 60,000 PROSES VERIFIKASI

8. 30/12/2015

00821302 SAIDAH, NY UNTUNG SUDOMO, dr SpPD 60,000 PROSES VERIFIKASI

975,000


NOTGL PE


1. 25/12/2015

00820185 SODIKIN, TN ARIYO BASKORO, dr 225,753 RJ DAN RI PADA HARI YG SAMA

2. 28/12/2015

00820492 KEMINAH, NY THERESIA MARCIA , Dr 164,325 RJ DAN RI PADA HARI YG SAMA

390,078

JANUARI

Jumlah Kasus 4407Terbayar 4308Pending 99

Januari 2016

TerbayarPending

Berkas Pending

NOTGL PE


1. 04/01/2016

00822152 RUDI HARYANTO. TN LUSI NURSILAWATI, dr SpP 140,688 HASIL SPIROMETRI (-)

2. 04/01/2016

00822207 SUMANTOYO, TN SETO HANGGORO, dr SpU 426,000 PROSES REVISI

3. 04/01/2016

00822216 UMIATI. NY SETO HANGGORO, dr SpU 160,000 PROSES REVISI

4. 04/01/2016

00822221 HERIN HERDIANA. TN DENI KRISCAHOYO, dr SpPD 958,663 PROSES REVISI

5. 04/01/2016

00822226 JAKA SAEPUDIN, TN LUSI NURSILAWATI, dr SpP 144,153 HASIL SPIROMETRI (-)

6. 04/01/2016

00822265 DARMIYATI, NY RIWANTI YULIAMI, dr SpS 884,889 TTD

7. 04/01/2016

00822351 SUTIAH. NY UNTUNG SUDOMO, dr SpPD 60,000 PROSES REVISI

8. 04/01/2016

00822384 YANUAR S, TN UNTUNG SUDOMO, dr SpPD 476,000 TTD

9. 04/01/2016

00822406 LISNAWATI BY,NY HENNY K, dr SpA 60,000 PROSES REVISI

10. 05/01/2016

00822608 EDDY KRISNO. TN

HERLY PERMADI AGOENG dr Sp THT 113,000

TTD

11. 05/01/2016

00822744 SATRIANA, TN DENI KRISCAHOYO, dr SpPD 950,000 PROSES REVISI

12. 05/01/2016

00822762 NOER INSAN. NY SAMSON CANDRA, dr SpOG 179,000 TTD

13. 07/01/2016

00823256 KUSMIYATI, NN FARGIATI, dr 186,695 PROSES REVISI

14. 07/01/2016

00823307 SUNARTO. TN HERMAN NUR, dr SpM 60,000 TTD

15. 07/01/2016

00823314 SUKRANTINI, NY SETO HANGGORO, dr SpU 426,000 PROSES REVISI

16. 07/01/2016

00823430 ACIH, NY DENI KRISCAHOYO, dr SpPD 235,167 PROSES REVISI

17. 07/01/2016

00823554 YENNY ALAWIYAH, BY. NY HARMON MAWARDI, dr SpA 161,000 PROSES REVISI

18. 08/01/2016

00823768 HOTMA NAINGGOLAN, NY LUSI NURSILAWATI, dr SpP 142,232 HASIL SPIROMETRI (-)

19. 11/01/201 0082446 NUNUNG HASANAH. NY UNTUNG SUDOMO, dr SpPD 476,000 TTD

6 720. 11/01/201

60082455

2 PUJIANI, NY RUDY, dr SpOG 60,000 PROSES REVISI

21. 11/01/2016

00824624 SONI RIDWAN, TN SUKANDI MULYA, dr 2,045,37

8PROSES REVISI

22. 12/01/2016

00824752 SAJUM MENAH, TN PRAMONO SIGIT Dr,SpJp 139,072 PROSES REVISI

23. 12/01/2016

00824915 MOELYONO KASIO, TN UNTUNG SUDOMO, dr SpPD 140,000 TTD

24. 13/01/2016

00825192 ZAINI HASAN. TN SETO HANGGORO, dr SpU 476,000 TTD

25. 13/01/2016

00825366 ERNI SUGITA SINAGA. NN NAZAR H, dr SpB 60,000 PROSES REVISI

26. 13/01/2016

00825367 NUR'AINI , NY DENI KRISCAHOYO, dr SpPD 113,415 PROSES REVISI

27. 13/01/2016

00825369 SRI SISNAWATI.NY DENI KRISCAHOYO, dr SpPD 113,415 PROSES REVISI

28. 14/01/2016

00825495 ROBIKA, TN LUSI NURSILAWATI, dr SpP 126,336 HASIL SPIROMETRI (-)

29. 14/01/2016

00825517 MUNAWARSIH. NY ARMAN MUCHTAR, dr SpB 60,000 TTD

30. 14/01/2016

00825528 OSMANDOVA, TN RIWANTI YULIAMI, dr SpS 79,796 PROSES REVISI

31. 14/01/2016

00825584 SODIKIN, TN LUSI NURSILAWATI, dr SpP 128,828 HASIL SPIROMETRI (-)

32. 14/01/2016

00825591 JAKA SAEPUDIN, TN LUSI NURSILAWATI, dr SpP 128,828 HASIL SPIROMETRI (-)

33. 14/01/2016

00825614 ROSYATI, NY UNTUNG SUDOMO, dr SpPD 476,000 TTD

34. 14/01/2016

00825670 M. YUSUF FIRDAUS, AN SETO HANGGORO, dr SpU 426,000 PROSES REVISI

35. 14/01/2016

00825771

OK NURMALI DJULMATAND, NY

PRAMONO SIGIT Dr,SpJp 360,000 HASILECHO (-)

36. 15/01/2016

00825840

WIWIK TRIWAHYUNINGSIH, NY

PRAMONO SIGIT Dr,SpJp 132,735 PROSES REVISI

37. 15/01/2016

00826068 FERIALDO KHALISH P, AN HARMON MAWARDI, dr SpA 172,690 PROSES REVISI

38. 15/01/2016

00826788 ERNI SUGITA SINAGA. NN NAZAR H, dr SpB 60,000 PROSES REVISI

39. 16/01/2016

00826170 SALEH ISA , TN SETO HANGGORO, dr SpU 114,000 PROSES REVISI

40. 18/01/2016

00826735 NURHAYA, NY UNTUNG SUDOMO, dr SpPD 159,000 TTD

41. 19/01/2016

00826940 HERIN HERDIANA. TN PRAMONO SIGIT Dr,SpJp 360,000 HASIL ECHO (-)

42. 19/01/2016

00827029 DOLLY SONDAKH. NY HERMAN NUR, dr SpM 123,000 TTD

43. 19/01/2016 828827 TJHIO ENY NIO YOGI DWIRIYANTO, Dr SpB 129,000 PROSES REVISI

44. 20/01/2016

00827299 SAALIH , TN SUKANDI MULYA, dr 231,179 PROSES REVISI

45. 20/01/2016

00827363 SARIPUDIN TN SETO HANGGORO, dr SpU 1,366,00

0PROSES REVISI

46. 20/01/2016

00827377 DURAHMAN , TN DENI KRISCAHOYO, dr SpPD 1,015,00

0PROSES REVISI

47. 20/01/2016

00827395 SHOPA MARWAH, NY

HENRY SIMON SARAGIH, Dr.SpPD 426,000

TTD

48. 21/01/2016

00827853 SITI MARNI. NY DENI KRISCAHOYO, dr SpPD 254,388 PROSES REVISI

49. 22/01/2016

00828006

MALEM UKUR SURBAKTI, NY

IBNUL AMIN , Dr 141,000 PROSES REVISI

50. 22/01/2016

00828047 SUTORO. TN


PROSES REVISI

51. 22/01/2016

00828138 NURLAILI F H, NN HIDAYAT ANWAR, dr SpTHT 196,230 PROSES REVISI

52. 22/01/2016

00828169 SAIR.TN IBNUL AMIN , Dr 550,526 PROSES REVISI

53. 22/01/2016

00828205 M. SOLEH SANTASRIP, TN SETO HANGGORO, dr SpU 476,000 TTD

54. 22/01/2016

00828284 WAIN ABDUL MANAP, TN HERMAN NUR, dr SpM 178,000 TTD

55. 23/01/2016

00828415 ADUNG SALIH, TN LUSI NURSILAWATI, dr SpP 113,000 HASIL SPIROMETRI (-)

56. 23/01/2016

00828442 JAJAH HARJANAH , NY SETO HANGGORO, dr SpU 476,000 TTD

57. 23/01/2016

00828451 NUR SADJI, TN LUSI NURSILAWATI, dr SpP 113,000 HASIL SPIROMETRI (-)

58. 23/01/2016

00828465 NUR SRI RAHAYU,NY ARMAN MUCHTAR, dr SpB 60,000 PROSES VERIFIKASI

59. 23/01/2016

00828470 M YUNUS. TN SETO HANGGORO, dr SpU 426,000 TTD

60. 23/01/2016

00828612 SARWI . NY I PUTU OKA , dr 314,856 PROSES REVISI

61. 25/01/2016

00828715 L. MUSILA, NY ARMAN MUCHTAR, dr SpB 212,000 TTD

62. 25/01/2016

00828802

PARONDINGAN ARITONANG, TN

SETO HANGGORO, dr SpU 169,000 TTD

63. 25/01/2016

00828820 KREMESMI, NY TEGUH HARJONO, dr SpPD 234,000 TTD

64. 25/01/2016

00828832 ROSNIA, NY PRAMONO SIGIT Dr,SpJp 286,292 PROSES REVISI

65. 25/01/2016

00828901

RISMA ANITA BR PERANGIN ANGIN. NY

IWAN HERRYAWAN, dr SpOG 60,000 PROSES REVISI

66. 25/01/2016

00828917

EGA GHIFARI PRATOMO, TN


67. 26/01/2016

00829093 SUHARTINI, NY PRAMONO SIGIT Dr,SpJp 192,351 PROSES REVISI

68. 26/01/2016

00829144 DAFNA LENA ISMAIL, NY UNTUNG SUDOMO, dr SpPD 97,684 PROSES REVISI

69. 26/01/2016

00829185 ENSWIROHMANI, NY SETO HANGGORO, dr SpU 426,000 TTD

70. 26/01/2016

00829195 WANGSIT SETIADI, TN SETO HANGGORO, dr SpU 426,000 TTD

71. 26/01/2016

00829199

PARONDINGAN ARITONANG, TN


72. 26/01/2016

00829270 KIKI HERWANTI LUSI NURSILAWATI, dr SpP 60,000 PROSES REVISI

73. 26/01/2016

00829341 C. D RISWANTIATY, NY SAIFUL IKHWAN, dr SpBS 60,000 PROSES REVISI

74. 26/01/2016

00829407

BY.NY KRESNA MEGANANDA

INDRA SUGIARNO, dr SpA 60,000 PROSES REVISI

75. 26/01/2016

00829128 PARTIN. NY PRAMONO SIGIT Dr,SpJp 95,228 PROSES REVISI

76. 27/01/201 0082950 NURAINI.B.SANUSI.NY TEGUH HARJONO, dr SpPD 104,343 PROSES REVISI

6 877. 27/01/201

60082953

6 ANANG SUTISNA. TN UNTUNG SUDOMO, dr SpPD 64,000 TTD

78. 27/01/2016

00829587 YANTI KUMALA. NY


TTD

79. 27/01/2016

00829608 EDDY SJAMSUARDY, TN SETO HANGGORO, dr SpU 163,000 TTD

80. 27/01/2016

00829683 ANNISA PUTRI I, NN YOGI DWIRIYANTO, Dr SpB 60,000 PROSES REVISI

81. 27/01/2016

00829758 ASEPUDIN, TN FARGIATI, dr 200,658 PROSES REVISI

82. 28/01/2016

00829790 RUSMIATIN, NY PRAMONO SIGIT Dr,SpJp 207,998 TTD

83. 28/01/2016

00829800 HERMAWAN, TN PRAMONO SIGIT Dr,SpJp 212,959 TTD

84. 28/01/2016

00829845 SUNARTO. TN HERMAN NUR, dr SpM 159,310 TTD

85. 28/01/2016

00829851 DEWI SORAYA. NY PRAMONO SIGIT Dr,SpJp 167,027 TTD

86. 28/01/2016

00829965 KARYADI , TN SETO HANGGORO, dr SpU 60,000 PROSES REVISI

87. 28/01/2016

00830013 ENIH T , NY SETO HANGGORO, dr SpU 60,000 PROSES REVISI

88. 28/01/2016

00830023 JUNAER TANIWATI.NY LUSI NURSILAWATI, dr SpP 155,000 TTD

89. 28/01/2016

00830030 NUR AMASE. NY ALIF, Sp.OT 60,000 PROSES REVISI

90. 29/01/2016

00830187 MUDJO SAPUTRO. TN PRAMONO SIGIT Dr,SpJp 173,653 TTD

91. 29/01/2016

00830287 MUSLIM. TN SETO HANGGORO, dr SpU 426,000 TTD

92. 29/01/2016

00830313 SRI RAHAYU, NN SETO HANGGORO, dr SpU 426,000 TTD

93. 29/01/2016

00830392 HARIONO HASUGIAN, TN NURYADI DEWANTO, dr 175,947 PROSES REVISI

94. 29/01/2016

00830396 EDDY SJAMSUARDY, TN SETO HANGGORO, dr SpU 79,000 PROSES REVISI

95. 30/01/2016

00830535 SARIPUDIN TN SETO HANGGORO, dr SpU 55,000 PROSES REVISI

96. 30/01/2016

00830552 WAHYUDIN, TN TEDDY JUNAEDY, dr SpB 179,105 TTD

97. 30/01/2016

00830557 MUTMAINAH. NY SETO HANGGORO, dr SpU 159,000 TTD

98. 30/01/2016

00830674 HELIYANTI. NY SETO HANGGORO, dr SpU 426,000 TTD

99. 31/01/2016

00830801 SOSANA . NY GERRY RUUD RISWANDI , Dr 256,879 PROSES VERIFIKASI

26,293,088

FEBRUARI

Jumlah Kasus 4743Terbayar 4518Pending 223 (Proses Verifikasi, Revisi, Hasil Penunjang, dan TTD)Masuk Rawat Inap 2

Februari2016

TerbayarPendingMasuk Rawat Inap

Masuk Rawat Inap


1. 28/02/2016 00840376 ASRI NURAENI I PUTU OKA , dr 25,000 RJ DAN RI PADA HARI YG SAMA

2 16/02/2016 00836048 FAHMY RAMADHAN HENNY K, dr SpA 79,000 RJ DAN RI PADA HARI YG SAMA

104,000

MARET 2016

Jumlah Kasus 5237Terbayar 2745Pending 2492 (Proses Verifikasi, Revisi, Hasil Penunjang, dan TTD)TL 1

Maret2016

TerbayarPendingTL



1. 18/03/2016 00847073 SRI SISNAWATI DENI KRISCAHOYO, dr SpPD 113,001 RJ DAN RI PADA HARI YG SAMA

113,001

APRIL 2016

Jumlah Kasus 5206Total Inputan 1 s/d 28 April 2016 4250Belum Terinput 956Proses Verifikasi 1 s/d 16 April 2016 2442

laporan umpan balik update2. 10.05.162.docx

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