Analysis Of The Causes Of Delay In Private Insurance Claims Payment And Its Impact On JIH Hospital's Cash Flow

Yulizar Abdi Jabbar; Nurfauziah

doi:10.63922/ijebir.v4i06.2476

Yulizar Abdi Jabbar Universitas Islam Indonesia
Nurfauziah Universitas Islam Indonesia

DOI: https://doi.org/10.63922/ijebir.v4i06.2476

Keywords: Hospital, insurance, delayed claim payments, cash flow, insurance claims.

Abstract

Delayed insurance claim payments represent a common financial challenge faced by private hospitals. This study aims to identify the factors causing delays in private insurance claim payments at JIH Hospital and analyze their impact on the hospital’s cash flow. Using a qualitative approach involving interviews and observations over four months, data were collected from the hospital’s Billing Unit Head and Financial Manager. The findings revealed that delayed claim payments stem from internal factors, such as incomplete supporting documents, manual administrative processes, and slow document sign-offs by physicians, as well as external factors, including insurers’ demands for additional documentation and unstable financial conditions of insurance companies. Despite insurance receivables contributing 47-48% of total revenue, JIH Hospital successfully mitigated the cash flow impact of delayed claims through comprehensive financial management strategies. These included adjusting the schedule of non-routine liability payments to align with claim receipt patterns and maintaining a minimum cash reserve equivalent to one month’s revenue. This study recommends strengthening legal aspects in insurance partnership agreements, accelerating digital transformation for billing workflows, and developing comprehensive training programs for relevant staff.

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