KEMENTERIAN KESEHATAN REPUBLIK INDONESIA iB SEKRETARIAT JENDERAL ® Jalan H.R Rasuna Said Blok XS Kaviing 4 - 9 Jakarta 12950 By “Telp. (021) 5201580 (Hunting) GERMAS Nomor _-JP.02.09/9/40/2018 8 Januari 2018 Lampiran Satu Berkas Hal Surat Pengantar Berita Acara Kesepakatan Bersama Panduan Penatalaksanaan Solusi Permasalahan Klaim INA CBG Yth, 1. Para Direktur/Kepala Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) yang bekerja sama dengan BPJS Kesehatan 2. Kepala Dinas Kesehatan di Seluruh Indonesia 3. Ketua Perhimpunan Rumah Sakit Indonesia (PERS!) di- Tempat Sehubungan dengan pelaksanaan implementasi Jaminan Kesehatan tordapat masalah-masalah yang mengakibatkan dispute Klaim antara rumah sakit dan BPJS Kesehatan. Menindaklanjuti hal tersebut, telah diadakan pertemuan antara PPJK Kementerian Kesehatan, BPJS Kesehatan dan Perhimpunan Profesi Kedokteran untuk membahas penyelesaian kasus-kasus yang menjadi dispute. Hasil kesepakatan penyelesaian ini dituangkan dalam Berita Acara Kesepakatan Bersama Panduan Penatalaksanaan Solusi Peimaselahan Klain INA CBG. Lampiran dalam Berita Acara ini berisi 182 kasus yang digolongkan dalam Aspek Koding sebanyak 165 kasus, Aspek Medis sebanyak 10 kasus, dan Aspek Administrasi sebanyak 7 kasus. Selanjutnya, Berita Acara Kesepakatan Bersama Panduan Penatalaksanaan Solusi Permasalahan Kiaim INA CBG ini merupakan acuan untuk penyelesaian kasus-kasus yang dinyatakan sebagai kasus pending klaim. Demikian disampaikan, atas perhatian dan kerjasama Saudara, diucapkan terima kasih. Tembusan 1. Sekretars Jenderal 2. Direktur Jenderal Pelayanan KesehatanKESENATAN £3 BPJS Kesehatan REPUBLIK a2 Badan Penyerenggara Jaminan Sosil INDONESIA BERITA ACARA KESEPAKATAN BERSAMA PANDUAN PENATALAKSANAAN SOLUSI PERMASALAHAN KLAIM INA CBG No: IP.02.08/3/1906/ 2017 No 780 18A/ 217 Yang bertanda tangan dibawah ini 1. Nama : dr. Kalsum Komaryani, MPPM Jabatan : Kepala Pusat Pembiayaan dan Jaminan Kesehatan Kementerian Kesehatan RI 2. Nama :dr. Andi Afdal Abdullah, MBA, AK Jabatan : Deputi Direksi Bidang Jaminan Pembiayaan Kesehatan Rujukan BPJS Kesehatan Berdasarkan dari hasil pertemuan kedua belah pihak pada pembahasen Panduan Penatalaksanaan Solusi Permasalahan Klaim INA CBG, telah disepakati diagnosis dan tindakan prioritas yang terdiri atas aspek koding, medis dan administrasi. Hasil kesepakatan dalam lampiran berita acara ini menjadi referensi bersama bagi BPJS Kesehatan dan Rumah Sakit dalam melaksanakan proses verifikasi klaim INA CBG. Demikian Berita Acara ini dibuat dan ditandatangani secara bersama-sama oleh para pihak secara sukarela tanpa ada paksaan apapun. 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