BPJScan reads the standard claim TXT file your hospital already submits and runs 78 analysis filters over every single claim. Trusted by 60+ hospitals across 10+ provinces.
INA-CBG & iDRG ready · results in 2–5 minutes · no change to your existing hospital information system
Claim Analysis · 1,247 claims
Rp 4.2 B
Total BPJS tariff
Rp 847 M
Hospital vs BPJS gap
1.24
Casemix index
47 opportunities identified
Illustrative figures. Results vary with each hospital's claim volume and case mix. “M” = million IDR, “B” = billion IDR.
60+
Hospitals
10+
Provinces
Rp 3 B+
Optimized at one hospital
~4 mo
Estimated payback
Actual result from one partner hospital. Payback estimates and results vary with claim volume and case mix.
Under Indonesia's JKN scheme, hospitals are paid a fixed INA-CBG tariff per case. Without systematic analysis, part of the legitimate optimization potential in each month's claims is simply hard to see.
Claims are returned or held because the coding does not match the payer's rules. Appealing them costs the casemix team time and effort that could go elsewhere.
Diagnoses and procedures are not coded to the full complexity that was actually delivered and documented, so the resulting INA-CBG tariff sits below the care provided.
Manual review realistically covers a sample or the highest-value claims. Everything else goes out unexamined, month after month.
Three steps. Insight within minutes, from the same file you already send to the payer.
The standard claim TXT export from E-Klaim or INA-CBG. No conversion, no reformatting — the exact file you submit to BPJS. A ZIP of several months can be uploaded at once for trend analysis.
78 filters run over every claim — financial metrics, length of stay, ICD-10 coding rules, and 33 condition-specific audits. Hundreds of claims complete in 2–5 minutes.
An interactive dashboard shows optimization potential, ICD-10 audit findings, and prioritised recommendations your casemix team can act on before submission.
From AI-driven insight to ICD-10 audit and 33 condition-specific checks — all derived from a single TXT file.
13
Highlight claims worth optimizing and cases at risk of being held, benchmark efficiency and length of stay across attending physicians and specialties, and attach a concrete recommendation to every finding.
3
Coding is validated automatically against official ICD-10 rules. Each claim comes back either clean or flagged for coder review, so potential issues are corrected before the file leaves the hospital — fewer revisions, less risk of a hold, and more consistency between coders.
18
Detect the visit anomalies and inpatient patterns verifiers tend to flag. The casemix team reviews the cases that genuinely carry risk instead of working through hundreds of files one by one.
7
Revenue per attending physician, top-up potential, cost components (drugs, devices, consumables, professional fees), tariff gaps by diagnosis / INA-CBG / procedure, and extreme-cost outliers.
33
From surgical cases to internal medicine, obstetrics to critical care. Each condition carries its own audit logic matched to its claim rules, helping coders confirm the coding reflects the complexity actually delivered.
5
Upload several months at once and watch performance move over time: revenue and growth, case volume, emerging diagnoses and procedure adoption, length of stay and bed occupancy, plus recaps for devices, ambulance, blood, chronic medication and chemotherapy.
Results vary with each hospital's claim volume and case mix.
Manual review depends on the care and the available hours of a small team. BPJScan applies the same checks to every claim, every time.
| Aspect | Manual review | With BPJScan |
|---|---|---|
| Speed | Hours for a single batch of claims | Hundreds of claims in 2–5 minutes |
| Coverage | A sample, or only the high-value claims | 78 filters over every claim |
| Consistency | Varies with workload and reviewer | Identical rules applied to all claims |
| Pattern detection | Cross-month and per-physician trends are hard to see | Multi-month analysis and per-physician contribution |
| Outcome | Some optimization potential goes unseen | Potential surfaced, claims more audit-ready |
Indonesia's national tariff system is moving from INA-CBG to iDRG. BPJScan now ships with 8 iDRG analysis submenus so the casemix team can understand the tariff impact well before full implementation — no surprises on go-live day.
Estimated tariff impact (illustrative)
The iDRG menu activates automatically once iDRG data is present in the e-Klaim TXT file. Illustrative figures only.
BPJScan is strongest alongside two companion products that guard the claim before and after submission.
Before the claim
Strengthens coding at the source: supports pre-coding from the start of care, keeps documentation complete, and checks the diagnosis matches the reason for admission — while the patient is still on the ward.
At claim time — you are here
Audits and optimizes every claim before it is submitted: undercoding, top-up potential, and the patterns that commonly trigger a hold.
After the claim
Reconciles the payer's verification results against the hospital information system automatically, tracks which claims have been paid, then distributes physician fees per attending doctor transparently.
BPJScan is an AI platform that analyses the BPJS claim TXT file produced by Indonesia's E-Klaim and INA-CBG systems. It surfaces the optimization potential in each claim, audits ICD-10 coding, and reports on claim performance automatically.
The standard TXT file from E-Klaim and INA-CBG, plus ZIP archives containing several months of TXT data for trend analysis. The Professional tier also accepts PDF claim submission recaps (FPK). Upload the same file you send to the payer — no conversion needed.
Yes. Claim data is processed on a secure cloud server, is not stored permanently, and is never shared with third parties. BPJScan is registered with PSE Komdigi, the Indonesian electronic system operator registry. Only non-identifying metadata (claim counts, timestamps) is retained for analytics. An on-premise option is available for hospitals that require it.
Yes. BPJScan runs standalone — there is no need to replace the system you already run. Upload the claim TXT file and BPJScan handles the analysis. MedMinutes also provides a full EMR and hospital information system if you want the wider platform, but BPJScan does not require it.
No. BPJScan helps ensure the coding reflects the care that was actually delivered and documented, in line with ICD-10 rules and INA-CBG regulations — it does not inflate claims without basis. The goal is claims that are tidier and more audit-ready, so legitimate optimization potential is not missed and the risk of correction during verification goes down.
A BPJScan subscription starts at IDR 2 million per month and is scaled to the size and needs of the hospital. Schedule a demo for a quote that fits your case volume.
Yes — a 30-minute demo can be scheduled at any time. We run it on your hospital's own claim data, so what you see is your actual optimization potential rather than simulated numbers.
A 30-minute demo on your hospital's real claim file. No simulated numbers, no obligation.
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