[01]
VClaim
Member verification, SEP (eligibility letter) issuance, referrals, and claim submission — the core of BPJS bridging for outpatient & inpatient care.
[Integration] BPJS Kesehatan
BPJS Kesehatan Integration.
Five BPJS services bridged directly — VClaim, Queue, Pharmacy, i-Care, PCare — with HMAC-SHA256 authentication per the BPJS specification. Automatic SEP, with no duplicate entry.
A real problem
Duplicate entry and failed claims drain staff time.
Without bridging, staff retype member data into the BPJS portal — slow, error-prone, and a source of rejected claims. Proper bridging makes member verification, SEP, and queuing run from a single shared data flow.
Adievia bridges the five BPJS services directly at the core of the system, not as a bolt-on — so registration, clinical, pharmacy, and claims data stay consistent.
5 BPJS services
What is bridged.
Full coverage of the BPJS Kesehatan services relevant to hospital operations — explained one by one.
[02]
Online Queue
Hospital queues connected to Mobile JKN, reducing crowding and complying with BPJS electronic queue requirements.
[03]
Pharmacy
BPJS-related pharmacy services connected to the Pharmacy module for dispensing medication to members.
[04]
i-Care JKN
Access to a member's service history to support physicians' clinical decisions.
[05]
PCare
A service for the primary care scheme, completing BPJS bridging coverage within the Adievia ecosystem.
Bridging flow
From member verification to claims.
[01]
Member verification
The system checks a BPJS member's eligibility directly from the patient registration data.
[02]
Automatic SEP
The SEP (patient eligibility letter) is issued automatically in outpatient care — with no duplicate entry by staff.
[03]
Queue to Mobile JKN
The queue number is sent to the member's Mobile JKN app in line with online queue requirements.
[04]
Care & claims
Service data flows into claim preparation; continuing on to the E-Klaim INA-CBG grouper.
An honest limit: every service depends on the availability of the official BPJS endpoints and the hospital's active PKS. Adievia does not replace the hospital–BPJS relationship; we provide the technical module that connects them.
FAQ
Questions about BPJS bridging.
The hospital needs an active Cooperation Agreement (PKS) with BPJS Kesehatan (the national health insurance body) as well as API access (credentials) from the BPJS portal. Adievia provides the bridging module; the PKS legality and API credentials are owned by and are the responsibility of the hospital.
Data exchange follows the BPJS specification, including signing requests with HMAC-SHA256. This ensures request integrity and authentication in accordance with the standards set by BPJS.
In outpatient care, SEP issuance is designed to be automatic from the member verification data — reducing duplicate entry and the risk of errors. Availability still depends on the official BPJS endpoints being up and running.
Yes. Recorded service data flows into the E-Klaim INA-CBG module (grouper + outbox queue) for claim submission that is resilient to network disruptions. See the E-Klaim INA-CBG integration page.
Next step