Economic Efficiency Strategies In Reducing Pending Jkn Health Insurance Claims During The First Six Months Of 2025

Abstract

The pending status of JKN (National Health Insurance) claims has become a crucial issue as it can affect cash flow, service effectiveness, and the financial stability of healthcare facilities. This study aims to analyze economic efficiency strategies in reducing the number of pending JKN insurance claims during the first six months of 2025. The research employs a descriptive quantitative method using secondary data obtained from JKN claim reports for the period of January to June 2025 at Hospital X in the Greater Bandung area. The findings provide an overview of the pending claim values during the first six months of 2025. The results indicate that increased efficiency through administrative process optimization, the implementation of a digital claim system, and timely claim submissions significantly contributed to reducing the number of pending claims. During this six-month period, pending claim submissions at Hospital X in the Greater Bandung area decreased by 7.88% from a total of 126,471 cases. These results demonstrate that effective claim reduction strategies can help hospitals remain competitive in the JKN era without compromising service quality. This study is expected to contribute to the formulation of economic efficiency policies to improve JKN claim management in the future while maintaining patient satisfaction as a top priority.