Teaching medical coders advanced medical coding skills was the focus of workshops run by the World Bank and American Health Information Management Association (AHIMA) in Indonesia this year. Codes are variously used for medical billing, tracking patient treatment, detecting disease trends and estimating future budget needs. The two 5-day train-the-trainer workshops benefitted 25 medical coders from the Ministry of Health and 24 medical coders from the National Health Insurance Agency (BPJS-K), which manages the national health insurance program (JKN).
AHIMA, the global non-profit association of health information professionals, provided on-site training to improve the accuracy and consistency of clinical coding, especially in disputed clinical cases identified by the health ministry. The workshops aim to improve the quality of medical coding and the accuracy of costing data in Indonesia. Medical coding is the process of translating a doctor’s diagnosis, medical procedures and services into universal alphanumeric codes typically used by medical offices to bill patients for treatment or submit claims to insurance companies or government schemes.
The course identifies the source of common coding disputes which would improve coding accuracy and consistency as well as the speed of claims processing. It also reduces variation in interpretation of clinical documentation between, coders and BPJS claim verifiers. Furthermore, medical coding allows for useful data tracking that lets health authorities know how many patients have medical conditions, which conditions they have, and the costs associated with treating them. Accurate clinical coding and associated cost accounting enables fair and equitable tariff setting under JKN's hospital payment system, project budgetary needs, and informs efficiency improving reforms. Advance UHC support for Indonesia’s National Health Insurance (JKN) Reforms and Results Program will continue in 2024.