Cases of Dispute and Pending Claims in Hospitals in the Era of National Health Insurance

Background: Indonesia began to implement a National Health Insurance System based on the National Social Security System in 2014 with the support of government regulations which states that Indonesia requires every citizen to have access to comprehensive and quality health services so that can continue their life through the National Health Insurance. Pending and dispute claims are problems that often occur in the era of national health insurance that can affect hospital budget allocation and planning policies, increasing the high cost burden for hospitals which will affect the quality of health services provided. The purpose of this study was to determine pending cases and dispute claims in hospitals in the Era of National Health Insurance.Methods: The study used a descriptive method with a qualitative approach. The data collection technique used is the observation method, namely directly to the e-claim file at several hospitals. 15 e-claim files taken in total from April – July 2021.Results: Obtained 13 cases of pending claims and 2 cases of dispute claims. Cases pending claims are caused by not complying with the code with evidence or resources, not in accordance with medical clinical practice guidelines and the rules of the health insurance provider.Conclusions: In coding, it is necessary to match the theory on the ICD-10, update the ICD-10. It is necessary to understand the rules and provisions made by the insurer and the related guidelines and rules. Please be aware of every latest code update.

Analysis and Impact Evaluation of Entrepreneurs’ Improvisational Behavior Trigger Patterns

How entrepreneurial firms can enhance the level of exploratory and exploitative improvisation in a balanced manner to enhance organizational dynamics has become an important research topic. Current research on the triggers of duality entrepreneurial improvisation has just started, exploring mainly abstract characteristic variables, and has not paid attention to the impact of entrepreneurs’ daily behaviors. In order to make up for the shortcomings of current research, the research goal of this paper is to construct a triggering model of entrepreneurs’ improvisation based on the research of entrepreneurs’ daily behaviors and then to evaluate the influence of the improvisational behavior trigger patterns. Based on the paradoxical and theoretical perspective of duality, a structured observation method is used to explore which behavioral patterns of entrepreneurs tend to trigger dual improvisational behaviors in themselves, their teams, and their organizations. After observing and recording the creators and collecting phenomenal data, six entrepreneurial behavior patterns containing 39 specific operational behaviors have been extracted from the phenomenal data by drawing on the rooted theory approach. In addition, the influence of entrepreneurial patterns is evaluated and ranked using the pairwise hesitant fuzzy set evaluation method. This study reveals the relationship between entrepreneurs’ daily behaviors and dyadic entrepreneurial improvisation at the operational level and provides guiding plans for entrepreneurs to improve their own and their organizations’ improvisation levels.

Application of Quick Response Code Indonesian as a Payment Tool in Digitizing MSMEs

The purpose of the research is to contribute to the development of technology in the financial sector, to give influence to the community in terms of cashless, then also to provide insight into financial technology on financial literacy by using QRIS (Quick Response Code Indonesian). MSME use facilitate their business activities by implementing fintech in terms of transaction management and the role of financial technology, is the QRIS (Quick Response Code Indonesian) application as a means of payment. The research method used in the research on the application of QRIS (Quick Response Code Indonesian) as a Payment Tool in digitizing MSMEs is a qualitative descriptive study using field research methods. This study uses interviews with 10 traders and 10 UMKM consumers who use QRIS. The research location is in BSD Modern Market, using non-probability techniques. Primary data taken directly from the object of research. With the direct observation method at the BSD modern market, South Tangerang with interview techniques for both consumers and traders who use QRIS as well as secondary data also obtained through various literatures. The result of the research is that QRIS as a digital payment tool for MSMEs is non-cash digital payment using Gopay, Ovo and others. QRIS has the potential to expand MSME sales, with QRIS an increase in digital sales traffic and a decrease in cash, minimizing the risk of paying counterfeit money, automatically recording transactions, building credit profiles for banks, making it easier to get working capital, payment of retribution, bills, purchasing goods in cash easily.

Implementation of Hand Washing Dance Method to Knowledge of Hand Washing Techniques of Preschool Age Children During the Covid 19 Pandemic

Positive habits need to be instilled from an early age, so that children get used to it, including the habit of washing hands with soap. Instilling hand washing techniques in children must be carried out with something unique, for example by playing, so that children feel happy. Hands Washing Dance is packaged expressively according to the character of PAUD (Early Childhood Education) students who prioritize learning while playing, which is expected to foster a sense of enthusiasm for children in washing hands after activities. The purpose of this community service is to provide care for preschool-aged children so that they can practice good hand washing techniques with the handwashing dance method during the Covid-19 Pandemic Period”. The method used is an observation method. Results: from the results of the pretest, 60% of respondents got bad criteria, and 40% of other respondents got very bad criteria. After applying the Hand Washing Dance and doing the post test the results were 10% of respondents with sufficient results, and 90% of respondents with good results. Conclusion: The ability of the respondent to wash hands after using the Handwashing dance method increased.

The human-elephant conflict: mapping the elephant area and the level of conflict vulnerability in the Mila Landscape, Pidie District, Aceh, Indonesia

Elephants are designated as endangered animals because their population in the wild continues to decline. One of the causes of its extinction is the threat of conflict between elephants and humans. The conflict between Sumatran elephants and humans in Aceh continues to increase every year, but there is no resolution to this conflict. This study was aimed to analyse the level of risk of elephant-human conflict in the Mila area and map the conflict areas. The method used was the observation method with the purposive sampling technique. The data was analysed using the disaster risk formula. The results of the analysis of the risk level of elephant-human conflict in Mila District showed that the high-risk level was in Tuha Lala Village (35.24%), Babah Jurong Village (35.22%) and Kumbang Village (35.04%). The level of risk was moderate in Krueng Lala Village (27.64%), Andeue Mosque Village (30.38%) and Dayah Andeue Village (33.38%). Meanwhile, areas with a low-risk level were Kulu Village (21.65%) and Dayah Sinthop Village (20.32%). The mapping of conflict risk areas was coloured red for high risk, yellow for medium risk and green for low risk. The conclusion in this study is that Tula Lala Village, Babah Jurong Village and Kumbang Village are areas with high conflict marked in red. Krueng Lala Village, Andeu Mosque Village and Andeue Dayah Village are areas with moderate conflict which are marked in yellow. Meanwhile, Kulu Village and Dayah Sinthop Village are areas with low conflict marked in green.

Teachers’ Perceptions toward using Geography Textbooks: A Study in Secondary Schools in Nepal

This paper is an attempt to examine the teacher’s perception on use of geography textbooks at the secondary school level in the Kathmandu district of Bagmati Province, Nepal. Eight geography teachers who teach geography in community secondary schools were selected purposively. The semi-structured interview and class observation method were used to obtain on the teacher’s perceptions regarding the usages of secondary level geography textbooks. The classroom observation was used to see how teachers used geography textbooks in the classrooms by observation protocol. The interviews were recorded on audio recorder and transcribed it. The data obtained from interviews provided more profound answers and crossed check accuracy of the observational data. After collecting necessary data, analysis of the data acquired from semi-structured interviews and classroom observations were made through the interpretative method by combining different sources of data. The results reveal that geography teachers who had pro-textbook views believed that their teaching could be conducted effectively using the textbooks. By contrast, teachers who had anti-textbook views believe that geography textbook was inadequate and ineffective. Secondary level geography textbooks contain both potential and limitations. The teacher should supplement geography textbooks with other authentic teaching materials to give learners more learning.

Sacred groves – an ancient tradition of nature conservation of sthalavrikshas in coimbatore, tamil nadu, india

In India sthalavrikshas worship in temples was a religrous practice. In Tamil Nadu almost every temple is associated with a plant or tree connected to the history and mythology of the temple and or deity. The worshipper who comes to the temple attains a healty spiritua; enlighten. Sthalavrikshas is a natural tree found in the temple site brfore construction of the temple. The present investigation was carried out in coimbatore district to enumerate the sthalavrikshas associate with temple by field observation method. During the field visit temples were frequently visited and surveyed for the sthalavrikshas from the month of December 2019 - February 2020. The survey was conduced at 46 ancient temples of the coimbatore district and revelated the occurrence of 19 sthalavrikshas species were observed in different area of coimbatore district. These sacred plants are worshiped by the local people for getting the blessing of health and wealth by positive powers of nature. Sthalavrikshas are germplasm reservers and an indicator of socio-cultural conservation strategy. It is concluded that the Sthalavriksha worship is an age old practice, myths, beliefs and floklore play a major role in the exsistance of Sthalavrikshas worship and this customms help in plant conservation.

THE EFFECT of PROMOTION on IMPULSIVE BUYING with LIFESTYLE as a MODERATION VARIABLE on FASHION PRODUCTS in ONLINE SHOP SHOPEE

The purpose of this study was to explain the effect of promotion on impulsive buyers and to explain that people with high lifestyles often make impulse purchases. Sampling using incidental sampling technique, the number of respondents as many as 100 respondents. The data collection method used is the observation method and the questionnaire method. Analysis of the data used is a multiple linear regression analysis with moderating variables using the SPSS program. The results of the study prove that promotion has a direct effect on impulse buying and it is not proven that people with a high lifestyle are more likely to make impulsive purchases.

Interpreting Dante's code in art

The purpose of the article is to study the interpretational possibilities of Dante's code in artistic samples of various types of art. Methodology. Methods of observation, modeling, comparison, analysis, and synthesis were used in the methodology of the work. The scientific novelty of the work lies in the fact that the analysis of interpretations of Dante's code on the example of fine art, computer games, cartoons, musical arrangement in a ballet performance is carried out. Conclusions. Dante's code is a kind of cultural code that contains common information. The observation method was applied to fix the perception of works of art in order to study Dante's code. Modeling and comparison methods allowed us to determine the features of Dante's code in different genres and types of art. In the history of the visual arts, Dante's code is interpreted both in the works of artists and becomes a creative process with a generalized content of D. Alighieri's works, but with the exact use of the code name (S. Dali). Comparing the use of Dante's code in computer games, cartoons, we state that in the visual arts and modern video series, Dante's code is reproduced in accordance with the content of D. Alighieri's works. In the history of music, in the musical design of a ballet performance, Dante's code is reproduced in a generalized form, where the reference to the name and title of D. Alighieri's works dominates. In the libretto of the Kyiv ballet of the same name, Dante's code is embodied in two appeals: to a love story and fragmentarily and generally to the work "The Divine Comedy". The musical series of the ballet "Dante" is not directly related to Dante's code, but there are attempts by the authors to find allusions, reminiscences in the music of composers (A. Dvořák, R. Wagner, Ezio Bosso). Keywords: Dante's code, interpretation, ballet, fine arts, musical arrangement of a ballet performance, computer game, cartoon.