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    ba kesepakatan

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    20 views51 pages

    Ba Kesepakatan Pending Klaim 2019

    Uploaded by

    Romi saputra
    ba kesepakatan

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
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    of 51
    SEKRETARIAT JENDERAL ® “sp Jalan H.R Rasuna Said Blok XS Kaviing 4 - 9 Jakarta 12950 — KEMENTERIAN KESEHATAN REPUBLIK INDONESIA TTelp. (021) 5201580 (Hunting) GERMAS Nomor ‘JP.02,03/3/ (693 /2020 (4 Juli 2020 Lampit Satu Berkas Hal ‘Surat Pengantar Penyampaian Berita Acara Kesepakatan Bersama Panduan Penatalaksanaan Solusi Permasalahan Klaim INA CBG Tahun 2019 Yth. 1. Seluruh Direktur/Kepala Fasilitas Kesehatan Rujukan Tingkat Lanjut (FKRTL) yang bekerja sama dengan BPJS Kesehatan 2. Kepala Dinas Kesehatan Prov/Kab/Kota di Seluruh Indonesia 3, Seluruh Ketua Perhimpunan / Asosiasi Rumah Sakit di- Tempat Sehubungan dengan pelaksanaan implementasi Jaminan Kesehatan terdapat masalah-masalah yang mengakibatkan dispute Klaim antara rumah sakit dan BPJS Kesehatan. Menindaklanjuti hal tersebut, telah diadakan pertemuan antera 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 Permasalahan Kiaim INA CBG. Lampiran dalam Berita Acara ini berisi 280 kasus yang digolongkan dalam Aspek Koding sebanyak 210 kasus, Aspek Medis sebanyak 69 kasus, dan Aspek Administrasi sebanyak 11 kasus. Selanjutnya, Berita Acara Kesepakatan Bersama Panduan Penatalaksanaan Solusi Permasalahan Klaim INA CBG ini merupakan acuan untuk penyelesaian kasus-kasus yang dinyatakan sebagai kasus klaim dispute dan pending serta proses verifikasi klaim |NA-CBG. Demikian disampaikan, atas perhatian dan kerjasama Saudara, diucapken terima kasih Tembusan 1. Sekretaris Jenderal 2. Direktur Jenderal Pelayanan Kesehatan 3. Kedeputian Bidang Jaminan Pembiayaan 2 feseuaran £3 BPJSKesehatan > REPUBLIK ‘xsd Badan Penyelenggara Jaminan Social INDONESIA BERITA ACARA KESEPAKATAN BERSAMA PANDUAN PENATALAKSANAAN SOLUS! PERMASALAHAN KLAIM INA-CBG TAHUN 2019 No: JP.02.03/3/1693/2020 No: 41t / A /0?20 Yang bertanda tangan dibawah ini : 1, Nama : dr. Kalsum Komaryani, MPPM Jabatan : Kepala Pusat Pembiayaan dan Jaminan Kesehatan Kementerian Kesehatan RI 2. Nama Jabatan : dr. Beno Herman, MARS, AAK ps. Deputi Direksi Bidang Jaminan Pembiayaan Kesehatan Rujukan BPJS Kesehatan Berdasarkan dari hasil pertemuan kedua belah pihak pada pembahasan Panduan Penatalaksanaan Solusi Permasalahan Klaim INA CBG Tahun 2019, telah disepakati diagnosis dan tindakan prioritas yang terdiri atas aspek koding, medis dan administrasi Hasil kesepakatan dalam lampiran berita acara ini menjadi acuan bersama bagi BPJS Kesehatan dan Rumah Sakit dalam penyelesaian kasus-kasus yang dinyatakan sebagai kasus klaim dispute dan pending serta proses verifikasi klaim INA-CBG. Demikian Berita Acara ini dibuat dan ditandatangani secara bersama-sama oleh para pihak secara sukarela tanpa ada paksaan apapun. Pps.Deputi Direksi Bidang JPK Rujukan “4 BPUS Kesehata eorny BE hg dr. Beno Herff MARS, AAK BoritaAcara Kesepakatan Bersama Panduan Penatalaksangan Solusi Permsalahan Klaim INACBG Tahun 2019 omer: IR02 08/3 1693/2020 omer: U1 /BA/0%20 "praetor [Ecko Sie Samnwtanpn acta ecstawn incr iot ennineemnaaats eect Pseyproatear@ 0°2 Puen sapere Ars Parproatear A013 Jarrod tra eps No.4 bicion det Stroat pen NOB 7 | pha past aan anaTeaNaRT ja ae pea ma pan TAR URS Ta — TRS TR i aca pests saan) jrengieaaniam Cossseanncomresubmacaniese al oscoaa comes |iecsamicorieemcam seu |aesana tant June [stone sce csr cot epctadoreor 2010 fede ate Sosteinan conn conan Jensieae aaron Ta RESTORE RT AT Sica aa TT NS Ga DER ar goa ATI] aa |rotvoonon Cornea ona gasorares etc and uropectnd gi: OD yg eran growers wre lsenove ton ener rreacuroegrimenes Serorte rtobncual perl wr anche tsar tees oars moan asa fe ewes nut seo trp paramos ann) Semgcavane ntact ssearlg pasa ash os pues 01. yg aah ara mos Teta ei werpmgian aa arr nano ro 7 Sem SI aR AAATSES FETT a RR TG RATT ST [pare rowers ps mewn reroraunoze 703. com Impeompowanoargivonevant |sesona Tew jnonnaperananpostsa somone funn svotenatiotnAc0- sc0Ocan 08 e|npavananyssseg anocwsosasra |. 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