Claim Module Overview
The Claim module in Ksatria eHospital acts as an electronic repository for all health insurance data used in the hospital. It supports both:
Private insurance (from general health insurance companies)
Government insurance (such as BPJS or other government-funded health plans)
This module manages insurance provider and plan information used for patient claims and billing processes.
Provider Types
There are two main provider types that can be configured:
1. Insurance
Refers to general health insurance from a licensed health insurance company.
2. Company
Refers to corporate-sponsored medical coverage, typically given by employers.
*Note: This is not a medical insurance company, but a benefit provider.
Insurance Ownership Categories
Insurance providers are also classified based on ownership:
Government-Owned
Indicates that the insurer is owned or operated by a government agency or institution.Private
Indicates that the insurer is operated by a non-governmental or private organization.
Insurance Master Data Fields
The following information can be defined in the Insurance Master setup:
Insurance Name
Insurance Type (Insurance / Company)
Ownership Type (Government-Owned / Private)
Contact Person
Insurance Plan Name
Maximum Coverage Limit per plan
Supported Processes
Insurance Provider Management
Create Insurance Provider
Search Insurance Provider
Edit Insurance Provider
Insurance Plan Management
Create Insurance Plan
Search Insurance Plan
Edit Insurance Plan
Related Articles
Bed Management Module Overview
The Bed Management Module in Ksatria eHospital functions as an electronic repository of hospital rooms and bed facilities. It allows hospitals to configure, monitor, and update bed-related information efficiently. Room and Bed Structure Room: A ...Journal Module - Overview and How to Use
The Journal Module in Ksatria eHospital is used to generate accounting journals for transactions such as inventory movements and invoicing. These journals can then be exported and integrated with external financial applications. Journal Generation ...Dashboard Module and How to Generate Dashboard
The Dashboard module provides visual insights into hospital performance. It displays statistical information using graphs and charts, including comparisons with previous periods. Supported features in Analytics and Dashboard modules include: Creating ...How to Register Patient
The Registration module is used by administrative staff to manage patient registrations and appointment scheduling. This module ensures that patient data is securely saved and distributed to the relevant departments. Note: Make sure the patient ...Analytic Module and How to Generate Reports
The Analytics module allows users to create and export various reports. Reports can be generated in two formats: PDF – for viewing and sharing. Excel (MS Excel) – for further data modification and analysis. Users can define several parameters to ...