CASEMIX MANAGEMENT SYSTEM
Integrasi Data • Efisiensi Klaim • Optimalisasi Revenue
3
Admin CasemixCasemix Officer
Selesai
Pasien
Agus Handayani
00045766 · 58 tahun · L
Tanggal Masuk
10-09-2026 16:00
Tanggal Keluar
19-09-2026 16:00
LOS
9 hari
Ruang
Kenanga 3
DPJP Yang Merawat
dr. Dimas Haryanto, Sp.P
Penjamin
BPJS Kesehatan
Jenis Pelayanan
Rawat Inap
Diagnosis
| Jenis | ICD-10 | Diagnosis | POA | Sumber |
|---|---|---|---|---|
| Utama | E11.9 | Diabetes mellitus tipe 2 | Y | Khanza |
| Sekunder | N18.9 | Gagal ginjal kronik | Y | Khanza |
Prosedur ICD-9-CM
| Kode | Prosedur | Tanggal | Sumber |
|---|---|---|---|
| 87.03 | Computerized axial tomography of head | 10-09-2026 | CASEMIX |
| 88.72 | Ekokardiografi | 10-09-2026 | Khanza |
| 87.03 | Computerized axial tomography of head | 09-09-2026 | CASEMIX |
| 88.09 | Other soft tissue x-ray of abdominal wall | 08-09-2026 | CASEMIX |
Monitoring Dokumen
| Dokumen | Status | Tanggal | Keterangan |
|---|---|---|---|
| Resume Medis | Belum Lengkap | 10-09-2026 16:00 | - |
| Bukti Pelayanan | Lengkap | 10-09-2026 16:00 | - |
| CPPT | Lengkap | 10-09-2026 16:00 | - |
| Hasil Laboratorium | Lengkap | 10-09-2026 16:00 | - |
| Hasil Radiologi | Lengkap | 10-09-2026 16:00 | - |
| Informed Consent | Lengkap | 10-09-2026 16:00 | - |
| Lembar Operasi | Lengkap | 10-09-2026 16:00 | - |
| SEP | Lengkap | 10-09-2026 16:00 | - |
Coding Review
Coder 01Review
Diagnosis utama: E11.9 · Severity: I
Tidak ada catatan.
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Grouping INA-CBG
| Kode | Deskripsi | Severity | Tarif Dummy | Status |
|---|---|---|---|---|
| I-4-17-III | HIPERTENSI (SEDANG) | III | Rp 2.663.700 | Grouped |
| I-3-17-I | Grouping RSASM | I | Rp 0 | Grouped No Tariff |
| I-3-17-I | Grouping RSASM | I | Rp 0 | Grouped No Tariff |
| I-3-17-I | Grouping RSASM | I | Rp 0 | Grouped No Tariff |
| I-3-17-I | Hipertensi | I | Rp 0 | Grouped No Tariff |
Pembiayaan
Biaya Aktual
Rp 17.320.258
Estimasi Casemix
Rp 14.373.881
Estimasi Klaim
Rp 18.811.144
Margin
Rp 1.490.886
Klaim & Issue
| Nomor Klaim | Pengajuan | Disetujui | Status |
|---|---|---|---|
| CLM-2026-000089 | Rp 18.811.144 | Rp 18.811.144 | Dibayar |