Hospital E-Klaim & Health Insurance Integration
Overview & Architecture
Enterprise hospital claim processing system bridging clinical hospital management (SIMRS) with Ministry of Health (Kemenkes) and BPJS Kesehatan web services. Streamlines patient visit reconciliation, automated grouping, hospital tariff calculations, and secure AES-256 payload encryption.
Architectural Overview
Built with React 19, TypeScript, and Express.js backed by Microsoft SQL Server (SIMRS DB) and high-performance REST APIs. Implements resilient payload encryption and audit-logged claim lifecycles adhering to national healthcare integration specifications.
Key Capabilities & Features
- •SIMRS & BPJS Bridge: Bi-directional synchronization connecting local electronic medical records with national health insurance claim web services.- Automated Claim Grouping: High-speed grouping pipeline for patient diagnoses, procedures, and tariff tier evaluations.- AES-256 Security Architecture: Bank-grade payload encryption ensuring strict patient data confidentiality during external transmissions.- Audit & Reconciliation: Comprehensive transaction logs and discrepancy alerts for hospital billing reconciliation.
Engineering Highlights
Database Modeling & Query Optimization
Structured schemas with relational indexing, connection pooling, and ACID transactional guarantees.
Modern Backend & API Architecture
Structured route handlers with safe input parsing, error boundaries, and scalable service boundaries.
Strict Type Safety & Contract Validation
Compile-time type verification paired with runtime schema validation eliminating edge-case runtime failures.