Increasing number of Indonesia Health Insurance Program participants has greatly impacted on the increasing utilization of service and the number of claim reimbursement of BPJS Health. This change required a large number of additional resources and staff for claim administration processing. BPJS Health then launched an initiative to simplify claim processing and management so that less resources are needed. The initiative was named VEDIKA which is short for Digital Claim Verification, a digital application for the claim verification process for secondary health facility reimbursement. The objectives of VEDIKA are to improve financial performance and BPJS Health reputation, so that BPJS Health can meet service level agreement on claim processing time and that claim verification staff can be optimized. After the implementation of VEDIKA, BPJS Health has reduced the length of claim processing from 45 days to 15 days. Another result upon implementation of VEDIKA is that the total number of verification staff needed has fallen from 1345 to 961. The key takeaways from the successful implementation of VEDIKA are provider support and digital system.
Cempaka Putih
P.O. Box 1391/JKT
ID- Jakarta Pusat 10510
Indonesia