Turkish Journal of Physiotherapy and Rehabilitation; 32(3) ISSN 2651-4451 | e-ISSN 2651-446X www.turkjphysiotherrehabil.org 507 THE UTILIZATION OF INPATIENT MEDICAL RECORD DATA IN IMPROVING QUALITY OF CLAIMS TO THE HEALTH BPJS PATIENTS AT B HOSPITAL IN YOGYAKARTA Agung Dwi Saputro¹, Firman Pribadi² 1,2 Universitas Muhammadiyah Yogyakarta, Indonesia Corresponding Author - firmanpribadi@umy.ac.id 2 ABSTRACT Background: In dealing with health services competition, cost containment has an important role appropriate with efficient quality improvement concept. Efficiency refers to the process of minimizing waste, error, and redundancy (Pena Ndiaye, 2003). The private hospital operating costs mostly come from patient income, so that the efficiency of service and the effectiveness of submission claims are very important. This research aimed to determine the efficiency rate through the claim submission results, the completeness number of medical resumes filling, and several pending claims at B Hospital Yogyakarta. Methodology: This study was conducted using a collaborative action research method by monitoring the medical resumes filling and stimulating the patient's INA CBGs (Indonesian Case Base Groups) grouping during the patient was treated in the inpatient room. This research was conducted in two cycles where each cycle consisted of the following steps: (1). Planning (2) Action (3) Observing (4) Reflecting. The population was BPJS dependent inpatients. The samples were 94 first-class patients, 89 second-class patients, and 91 third-class patients. Results and Discussion: The number of positive difference claim files increased in all treatment classes. The number of completed medical resumes increased and the number of claim files returned decreased. The four components in INA CBGs, namely coding, costing, clinical pathways, and information technology have an important role in service efficiency and the effectiveness of claim management. The application of patient- centered care (PCC) by sharing information, participation, and collaboration between medical personnel and patients plays an important role in quality and cost control. Conclusion: Collaborative action of coding officers, nurses, doctors, and other health professionals improve inpatient care efficiency and increases the effectiveness of claims management. Keywords: cost control, medical resume, claims. I. INTRODUCTION In dealing with health care competition, the organization may adopt one of three strategies: 1). Improving the quality of the product and increasing the price; 2). making products with lower quality at lower prices and 3). Improving quality at the same time reduce prices. From that, cost containment plays an important role in the efficient quality improvement concept. Efficiency refers to the process of minimizing waste, error, and redundancy (Pena & Ndiaye, 2003). Cost containment is the practice of minimizing to the possible extent, increases in variable costs periodic and total fixed costs per unit (Kinney & Raiborn 2011). Hospital as an institutions that provides health services has an important role in the successful implementation of the National Health Insurance program, therefore government and private hospitals should collaborate with the Health Social Security Administration (BPJS Kesehatan) to serve patients with BPJS dependents. B Hospital in Yogyakarta is a class B private education hospital with 423 tt beds, 60-70% BOR, and outpatient visits daily average of 700-800 patients who have collaborated with BPJS Kesehatan providers since January 1,