Healthcare and Social Security Agency (BPJS) is a government program, that started on January 1, 2014. at the Early Implementation is not yet completed. and has shortcomings, among others payment of claims insurance JKN to Government’s Partner hospitals (BPJS). The aims of this research was to describe Healthcare and Social Security Agency (BPJS) accountability in claims insurance handling and factors that influence, This study used descriptive and qualitative data, While the research analysis using the data analysis process based on the result of in depth interview and documents.. the result showed that accountability in claims insurance handling generally the result has been accountable (80,5 %) although several indicators to measure showed any discrepancy / not accountable. when measured with indicator refers to a predetermined scheduler that is not accountable. The presence indicator adherence to rules and procedures have not been fully accountable. while ability indicator for do performance evaluation and Transparency Indicator in decision-making and to implement effectiveness and cost-efficiency performance of its duties has been accountable. Then, to determine the factors that the effect of accountability in claims insurance handling used a variable factor of service rules, factor of bureaucratic apparatus and factors of priority interests and service users. Application and implementation of the third factor have relevance and has a causal impact that influence the Healthcare and Social Security Agency (BPJS) in claims insurance handling