Hospital must have a component of hospital service quality and healthy financial, so that hospital will be able to become of good service and financial performance will not get losses. This study was a case study to analyze service performance and financial performance at At-Turots Al-Islamy Hospital in Yogyakarta in the era of National Health Insurance. The informants in the study were the head of the finance department, health workers and BPJS patients. Data collection techniques used interview guidelines, questionnaires and documentation. Research shows that 1) service performance in the era of National Health Insurance as many as 5 (50.0%) respondents stated in good category. Services that need to be improved are the duration of waiting time and timeliness in implementing the schedule, as well as the readiness of doctors to serve patients. 2) Financial performance in the era of National Health Insurance was quite good in 2016, but in 2017 had a decrease in financial ratios. This condition is due to claims/payments of BPJS patients being disbursed in the following month so that financial performance becomes disrupted, the hospital’s tariff is sometimes not in accordance with the tariffs determined by BPJS.