The purpose of BPJS claimed is the submission of patient treatment expenses of BPJS member from Hospital to BPJS. RSUP Dr. Kariadi Semarang executes inpatient Claim collectively and is claimed to BPJS every month completed with document supporting. On January, RSUP Dr. Kariadi Semarang has submitted BPJS member claimed to BPJS Verifier. Among those who submitted document to BPJS Verifier, there are some documents returned to the center of casmix official because of pending claimed by BPJS Verifier. This research purpose is to know the factors influencing pending of BPJS member claimed in RSUP Dr Kariadi Semarang.This research is carried out on May-June in Center of Casemix RSUP Dr.Kariadi Semarang, this kind of research uses Interview and observation method with cross sectional approaches by descriptive research, while the population of this research is pending claimed documents submitted in January.The result of this research shows the factors influencing pending of BPJS member claimed are 100% coding or because the difference coding given by RS coder with BPJS Verifier code that does not discover an agreement about CA (carcinoma) patient coding, so that the claimed documents are pending until RS coder and BPJS Verifier discover the agreement for giving code, and the claimed document can be claimed again to BPJS.
