WORKSHOP POLA PENGELOLAAN KEUANGAN PADA RUMAH SAKIT PUBLIK

RUMAH SAKIT JOGJA

Disampaikan oleh Dra Antik Suharyanti MSi Wadir Umum dan Keuangan

UNDANG-UNDANG NO 44 TAHUN 2009 TENTANG RUMAH SAKIT

Berdasarkan pengelolaannya Rumah Sakit dibagi : Rumah Sakit Publik Rumah Sakit Privat.

Rumah Sakit JOGJA
 Rumah

Sakit Publik dikelola Pemerintah Kota Yogyakarta  Tipe B  Terakreditasi 12 jenis pelayanan

oleh

Sumber Daya Manusia Juni 2011 JENIS TENAGA Tenaga Medis Tenaga Keperawatan Tenaga Kefarmasian Tenaga Kesehatan masyarakat Tenaga Keterapian Fisik Tenaga Gizi Tenaga Keteknisan Medis PNS/PNS 40 210 17 12 4 5 34 NABAN/ PTT 15 9 2 7 JUMLAH 40 225 26 12 4 7 41 Tenaga Umum/ Non Keperawatan TOTAL PEGAWAI 72 394 65 98 137 492 .

PENGELOLAAN KEUANGAN RUMAH SAKIT SEBAGAI BLUD  Pendapatan dapat digunakan langsung untuk menjaga likuiditas dan kelancaran cashflow  Tarif ditetapkan dengan Keputusan Kepala Daerah  Kerjasamasama investasi/KSO dapat dilakukan untuk mendorong pengembangan dan peningkatan skala usaha .

PENDAPATAN BLUD  Seluruh pendapatan RSUD (kecuali yang berasal dari hibah terikat) dapat dikelola langsung untuk membiayai pengeluaran BLUD sesuai RBA  Seluruh pendapatan RSUD (kecuali dari APBD APBN) dilaksanakan melalui rekening kas RSUD  Seluruh pendapatan dilaporkan kepada PPKD setiap triwulan .

SUMBER PENDAPATAN  Jasa Layanan  Hasil Kerjasama  Lain-lain pendapatan BLUD yang sah  Hibah  APBD/APBN .

JASA LAYANAN  Pelayanan IRD/UGD  Pelayanan Rawat Jalan/Poliklinik  Pelayanan Rawat Inap  Pelayanan Farmasi  Pelayanan Radiologi  Pelayanan Laboratorium  Pelayanan IBS/Bedah Sentral  Rehabilitasi Medik  Ambulance .

HASIL KERJASAMA Misalnya :  Pengelolaan Parkir  Sewa Kantin  Sewa Warung  Sewa Ruang  Lainnya .

LAIN-LAIN PENDAPATAN RS  Jasa Giro  Bunga Deposito  Diklat  Incenerator  Lainnya .

PEMBIAYAAN/PENGELUARAN Biaya Operasional Biaya non Operasional Biaya Investasi .

648.632.945.891.577.800.000 % 65.179.374.000 % 65.000 34.63 30.900 .59 7.922.516.256.99 5.900 1.69 2011 32.Anggaran Biaya 2011 (Non Gaji PNS) JENIS BIAYA Biaya Operasional Biaya Non Operasional Pengeluaran Investasi Pengeluaran Pendanaan/Pembiayaan JUMLAH 2010 28.448.000 2.

Biaya Pelayanan .Biaya Umum dan Administrasi .Biaya Operasional Meliputi : .

Biaya kerugian penurunan nilai .Biaya non operasional lain-lain .Biaya bunga .Biaya administrasi bank .Belanja non Operasional Meliputi : .Biaya kerugian penjualan aset tetap .

Biaya untuk Sarana Fisik .Biaya Pembelian Tanah .Biaya untuk Peralatan dan Mesin .Pengeluara Investasi Meliputi : .

BLUD dapat melakukan kerjasama . BLUD dapat melakukan pinjaman pendek atau jangka panjang  Pinjaman jangka panjang persetujuan kepala daerah jangka wajib mendapat jangka  BLUD dapat melakukan investasi pendek maupun jangka panjang  Investasi jangka panjang persetujuan kepala daerah wajib mendapat  Untuk meningkatkan kualitas dan kuantitas pelayanan.

patient’s payment method  Regular/cash  ASKES (PNS)  Jamkesmas (central/national government health insurance)  Jamkesos (province government. DIY)  Jamkesda (yogyakarta (city) government)  Jamsostek (for workers/employee of a certain company)  Other cooperation/colaboration .

Jamkesos.52 38.33 20.40 48.62 0.23 12.48 100 Rawat Inap (%) 36.40 3.13 100 JENIS PASIEN Umum/Kas Askes PNS Jamkesmas.46 3.JUMLAH PASIEN BERDASARKAN CARA BAYAR RSUD KOTA YOGYAKARTA 2010 Rawat Jalan (%) 27. Jamkesda Asuransi Lain Lainnya Jumlah .27 0.60 100 IRD (%) 62.55 21.27 21.11 1.64 2.

083.269.626.230.745.199 592.605.543.69 3.581 % 41.650 9.625 2.79 0.029.381.378 6.12 4.070 1.377.418.440 % 34.882 870.94 27.231.463.039.870 7.505.477.094 33.76 0.077.11 1.622.808.26 6.PENDAPATAN BERDASARKAN CARA BAYAR PASIEN RSUD KOTA YOGYAKARTA CARA BAYAR Umum/Kas Askes PNS Jamkesmas (Pemerintah Pusat) Jamkesos (Propinsi DIY) Jamkesda (Pemerintah Kota ) Jamsostek (Jaminan Tenaga Kerja) Lainnya Jumlah 2010 13.392 448.821 310.892.967.350.841.84 3.567.65 27.42 1.66 28.267 25.27 .212.55 17.101.925.620 5.581 67.94 2011 sd September 8.572 1.

UMUM/TUNAI  Dasar Pembayaran Peraturan Walikota tentang Tarif pelayanan Kesehatan pada RSUD Kota Yogyakarta  Dibayar sebesar tagihan yang dikeluarkan oleh Kasir .

TNI dan Polri  Dasar Klaim Askes adalah MOU antara Rumah Sakit dengan ASKES  Dasar MOU adalah Keputusan Menteri Kesehatan tentang Tarif Pelayanan Kesehatan Peserta PT Askes .ASKES  Peserta PNS.

 Pembayaran atas tagihan klaim RS dilakukan oleh PT. . melalui mekanisme transfer ke rekening RS. Askes selambat-lambatnya 7 hari kerja tertanggal Form Pengajuan Klaim.  Besaran nilai besaran klaim yang diajukan mengacu pada MOU antara PT. selambat-lambatnya tanggal 10 bulan berikutnya. Askes dengan RS.Proses Klaim Pasien Askes  Pengajuan klaim dilakukan secara kolektif oleh RS setiap bulan.

 Verifikator dari PT.  Petugas Entry Data Pelayanan. melaksanakan verifikasi atas kebenaran entry data dari petugas peng-entry data pelayanan. bertugas melakukan proses entry data pelayanan pasien Askes ke dalam software PT Askes sesuai dengan tarif yang tercantum dalam MOU.Petugas Pengelola Askes  Petugas PT. . Askes sebagai penerbit SJP (Surat Jaminan Pelayanan). Askes.

melakukan pengajuan pembayaran atas pelayanan terhadap pasien Askes berdasarkan hasil verifikasi dari verifikator PT. . dimana PT Askes akan menindaklanjuti dengan melakukan pembayaran melalui transfer ke rekening RS sesuai dengan pengajuan pembayaran. Askes. Petugas Administrasi Keuangan.

.JAMKESMAS (health insurance for society)  Participant/member : poor family  Jamkesmas claims are based on the tariff released by the ministry of health suitable with the diagnosis and medical procedures of a certain disease.

they need to report the usage of the fund through software that has been decided (hardcopy and softcopy) .Operation  Source of capital/funds (national/government fund) : APBN  The capital/fund is transferred directly from the department of health to the next PPK (hospital) bank’s account  The next PPK is responsible for the usage of the funds.

 responsibility report is legal after the approval (in the form of news event) that has been signed by the director and independent verificator  Responsibility reports is sent to the Central Jamkesmas Management team. and copy of these are also sent to the Province Jamkesmas Management team and Regency/city Jamkesmas Management team as monitoring materials. .  Central Jamkesmas management team verify and inform the result of final verification as the foundation for responsibility reports on the jamkesmas capital usage.

publish/release SKP Jamkesmas with the guidance of SK Bupati/Walikota (regent/major of town legal letter) about the participant/member who are listed in the Jamkesmas participant quota  Coder officer (medical record).PT Askes.Jamkesmas management officer in the hospital  SKP publisher officer (Surat Keabsahan Peserta) (member validation letter) Jamkesmas . . has a duty to translate diagnosis and procedures which are done by the doctor according to ICD-X and ICD-IX CM. and put those translation in the entry of Jamkesmas software (INA-CBG’s).

 Independent of Ministry authority to whether it is not. Claim administration officer. has a duty to do a research (checking) on the completion of claim files and conduct the next administration procedure. then finally submit the claim files to the Jamkesmas verificator officer. verificators. acceptable to be covered or it is . are the assistant of Health RI that had the verify hospital claim proposal.

JAMKESDA  Type of member KMS. Merapi eruption victims  Services Outpatient services Class III inpatient services . health program. Reccomendation. Yes 118. religion/elderly people. Jamkesda GTT/PTT/ Naban . RT/RW/PT.

and claim the payment to the UPT PJKD afterwards (re-imburse)  Hospital claim’s proposal is based on hospital services tariff.JAMKESDA patient’s claiming method  Inpatient services has to get guarantee proof from UPT Penyelenggara Jaminan Kesehatan Daerah (PJKD) (Local Government Health insurance provider)  re-imburse is acceptable for inpatient service  For outpatient services. the patient need to pay in advance. . and the payment from Jamkesda is suitable with the Jamkesda tariff after being verified by Jamkesda verificator.

JAMKESOS  Member/Participant/target  People with social issues/problems  Poor family that is not covered by Jamkesmas program  Kader Posyandu/ Posyandu officer  Program’s specific target  Services  Outpatient service  Class III inpatient services .

 Claim proposal that has been stated valid and complete will be verified by the Jamkesos verificator  Verification results is given to the hospital together with payment transfer receipt. . for maximum 15 days after the claim stated complete and valid.JAMKESOS patient’s claiming method  Claim is collectively proposed based on hospital service’s tariff for maximum at the 5th date of the next respective month.

JAMSOSTEK  Member participated in the Jamsostek program  Services (suitable with the MoU)  Outpatient services  Inpatient services (class II facilitation service)  The workers/employee and their family  Claims are based on :  The tariff of hospital services .

Jamsostek verifies all of the services fee to decide the amount of service fee covered by PT Jamsostek and the amount of service fee that should be paid by the patients themselves (the fee is not covered by the insurance). .JAMSOSTEK patient’s claiming method  Patient brings the bill from hospital to get the insurance claim from PT Jamsostek  PT.  The patients pay the fee that’s not covered by PT Jamsostek by cash. and service fee that’s covered by PT Jamsostek will be paid collectively by PT Jamsostek to the hospital through transfer method.

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