IMPLEMENTASI KNOWLEDGE DISCOVERY IN DATABASE (KDD) DALAM SERVICE LEVEL AGREEMENT (SLA) KLAIM PADA ASURANSI KESEHATAN

Fahrul Nurzaman

Abstract


Service Level Agreement (SLA) is a very important thing to consider in improving quality of care in Health Insurance. One quality of service is the settlement of claims in accordance with Service Level Agreement (SLA). Settlement of claims in accordance with Service Level Agreement provides a guarantee of customer satisfaction, thereby affecting the profitability of the Company. This paper describes the implementation of Data Mining to gain knowledge about SLA claims in Health Insurance using the method of Knowledge Discovery in Databases (KDD). Purpose of extracting the data present the knowledge to see the performance claims settlement. It is intended for management in reaching a decision on whether the claims of performance improvement claims settlement has been positive or negative effect on service to customers. Claims Services consists of two types of service as a Cashless claims and reimbursement services. Presentation of data both cashless settlement of claims and reimbursements are classified into three parts, namely good, average and poor, where data is taken through the process of Data warehouse query. The data presented are the data settling claims last 6 years. From the presentation of the data shows that the settlement of claims in accordance with Service Level Agreement (SLA) so that the performance claims settlement a positive effect on service to customers.

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References


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