Reporter / Donggala : Zubair
KAILIPOST.COM,- DONGGALA- THE PREMIUM Claim for patients enrolled in BPJS Health of Donggala District each year amounting to Rp303 million. Meanwhile, the premium action should be made as early as possible, no later than 15 days after the claim from the hospital. The patients enrolled in national health insurance must be paid in accordance with the medical data.
This was stated by Head of BPJS of Donggala District, Sudirman when hearing from Commission I of DPRD with several other partners, namely President Director of Kabelota Hospital, Regional Financial Management Agency last Friday (06/04/2018).
Sudirman explained that the BPJS service system embraces the capitation system by making advance payments to those registered with FKTP, doctors and clinics. From the capitation, the payment varies according to the provisions of the legislation. In addition, there is a non-capitation. ” All payment is done within fifteen days of the month after the claim of patient or registered in BPJS, “he said.
In Donggala District, he added, there are participants of National Health Insurance (JKN) who entered got subsidized from APBD. From the data, while there are as many as 13 thousand more patients who become dependent with BPJS premium. He explained, related to the insurance fund in the hospital, constrained because there are Rp303 million monthly arrears of health premiums both BPJS and Regional Health Insurance which becomes the obligation of Donggala Government to be deposited into BPJS.
“However, the new one was paid in October and November 2017.” He further admitted that he could pay this year only for January, while for February and March, there is no clarity. This is a dilemma for us, so it is constrained by financing, ” he said.
However, BPJS still makes premium payments to the patient’s actions until the referral. Although for premium claims, BPJS had to finance up to last March. For January 2018 and then he said, the premium submission from the hospital for the BPJS patient bridge is still in file verification.
In contrast, the executive director of Kabelota Hospital, Ahmadi Arif, who replaced Dr. Annisa Anwar, explains that all basic health services and acts in the hospital admitted to storing various problems.
Alluding to the payment of BPJS by the government, Ahmadi acknowledged that the District Government promised to finalize and recognize if the new dues are paid in October and November to December 2017. For January to March he will be paid to BPJS, according to Donggala Government. He mentioned, for the actions and services, it will invite the hospital verification team to resolve the claims of JKN and BPJS patients.
The most urgency in the hospital is the issue of electricity dues. Arrears of hospital management for the payment of electricity contribution worth Rp91 million more. Surprisingly, there is no cash in hospital for paying electricity. However, it has been communicated to the Regent to find a solution to the settlement.
The second problem mentioned by Ahmadi, is the medical waste that piled up in the hospital, due to incineration (medical waste destruction machine), damaged and estimated cost of Rp700 million needed to fix it. The medical waste is temporarily stacked in one of the patient’s unused action rooms. “The estimate is that about 5 tons of existing medical waste has not been handled yet, this is a huge issue in the future because B3 waste has an impact on the dangerous environment,” Ahmadi said.
Next to the third thing mentioned by Ahmadi, about the accreditation of hospitals that have not been done by the government. If this happens, it is feared to have an impact on the status of the hospital, one of which will not be refinanced by BPJS if this year the accreditation is not done immediately.
The obstacles faced during the absence of a budget for financing the accreditation program of the hospital, “If accreditation is made this year, the local government must prepare the budget which is estimated at one billion.” to be honest.
The newly appointed President Director since March 14 said that he was resigned to the issues faced by Kabelota Hospital. It depends on the government and the competent authorities in organizing basic health services for the community.
A number of parties presented on the hearing are, among others, the head of BPJS of Donggala District, former president of Kabelota Hospital, Dr. Annisa Anwar, Secretary of Regional Financial Management Agency, and not attended by Head of Health Office.**
