) BPJS Kesehatan Badan Penyelenggara Jaminan Sosial 6 Nomor 2 396/VIl-01/0324 Surabaya, 19 Maret 2024 Lampiran —_: Sembilan Lembar Hal Umpan Balik Capaian Kepatuhan FKRTL Februari 2024 Yh, Direktur/Kepala FKRTL Kerjasama BPJS Kesehatan Cabang Surabaya di Surabaya Kami ucapkan terima kasin atas kerjasama yang telah terjalin baik dalam memberikan Pelayanan kesehatan untuk peserta Program Jaminan Kesehatan Nasional-Kartu Indonesia Sehat (JKN-KIS) Dalam rangka upaya kendali mutu pelayanan Kesehatan di Fasilitas Kesehatan Rujukan Tingkat Lanjutan, bersama ini kami sampaikan umpan balik indeks kepatuhan sebagai berikut 1. Display Tempat Tidur Data display ketersediaan tempat tidur agar dilakukan monitoring rutin berkala dan di update secara realtime. Berdasarkan data monitoring, terdapat §9 FKRTL yang sudah rutin update selama bulan Februari, ada 1 FKRTL belum rutin update Data Terlampir. 2. Display Tindakan Medis Operasi Data display jadwal antrian operasi agar dilakukan monitoring rutin berkala an update secara realtime. Berdasarkan data monitoring 58 FKRTL sudah rutin update jadwal antrian operasi. 2 FKRTL belum rutin update. Data Terlampir. 3. Sistem Antrian Online Sistem antrian Online melinat beberapa indikator yaitu : Jumlah antrean online, Jumlah bridging antrean, Jumlah MJKN, dan Jumlah non bridging. Menurut data monitoring, terdapat 59 FKRTL yang sudah memenuhi indikator kepatuhan antrean online. 1 FKRTL yang belum memenuhi indikator kepatuhan antrean online. Data terlampir. 4. Penyelesaian Keluhan Penyelesaian keluhan mengambil data dari pencatatan pemberian informasi dan penanganan pengaduan melalui aplikasi SIP serta laporan pengaduan melalui ‘Cantor CobonBotdgas EBSHS: Terdapat 60 FKRTL yang telah memenuhi nya. Data terlampir J), Raya Ohamnfahus Surabaya 60285 - Jawa Timur ww bojs-kesehatan.go.i5. Survei Pemahaman Faskes Telah dilakukan survei pemahaman faskes yang dilakukan pada tanggal 4 Oktober 2023. Hasil dari survei pemahaman faskes terdapat 60 FKRTL yang telah melaksanakan survei, Data terlampir 6 KESSAN Kesan dan Pesan setelah pelayanan dilakukan oleh peserta dengan memberikan rating kepada Faskes. Monitoring pengisian KESSAN dapat di cek secara realtime melalui aplikasi mobile JKN pada menu info lokasi faskes dan pada aplikasi aplicares https://faskes. bpis-kesehatan go id/aplicares! . Target minimal rating faskes adalah 4 dan minimal pengisian oleh 30 responden setiap bulan. Terdapat 59 FKRTL yang telah memenuhi rating KESSAN. 1 FKRTL yang belum memenuhi rating KESSAN. Data terlampir. Kami lampirkan juga hasil krtik dan saran peserta melalui KESSAN bulan Februari 2024. Mohon dijadikan perhatian juga terkait kritik dan saran tersebut. 7. Capaian Program Rujuk Balik (PRB) Kami ucapkan terima kasih atas upaya Rumah Sakit dalam menggalakkan Program Rujuk Balik (PRB) pada bulan Januari 2024. bersama surat ini kami sampaikan Capaian Rekrutmen Peserta PRB sampai dengan 13 Maret 2024. 8. Indeks Kepatuhan FKRTL ‘Target Indeks Kepatuhan FKRTL adalah minimal skor 88. Berikut merupakan update. data kepatuhan Bulan Maret 2024 : Tabel 1. Indeks Kepatuhan FKRTL Maret 2024 [KRITERIAINDIRATOR PENTAMN KEPATURAN, [Updating splay Terpat Tur trhubung AsRKas Moble JEN. [z-Depiay Tindakan Operasierhuzung Apikasi bie IRN [3 Sst Arran erhubung Apikasi bie JKN I. Tindak Lanjut Gan penyelesaianteadan keuan peserta tera layanan Kesehatan Gi FRRT '5-Survet Pemamaman Faskes pada Reguas)JKN [Rial Kepuasan Peserts ol FKRTL yatu mela KESSAN Rakruimen Pesefa PRB 100% ‘Sebagai upaya peningkatan kualitas pelayanan kepada peserta JKN-KIS di tahun 2023, kami mohon dukungan dari seluruh jajaran manajemen FKRTL sebagaimana indikator mutu layanan dan kepatuhan FKRTL a, Melakukan update data ketersediaan Tempat Tidur secara realtime (tidak lebih dari 24 jam). Minimal 4x setiap bulan b. Melakukan update data Tindakan Medis Operasi. Minimal 1x setiap bulan¢. Mengoptimalkan pemanfaatan Sistem antrean online di FKRTL secara rutin sesuai dengan parameter yang sudah ditentukan. d._ Waktu penyelesaian pengaduan peserta yaitu maksimal 3 hari Demikian kami sampaikan, atas perhatian dan kerja sama yang baik, diucapkan terima kasih. EwravPK.01.01Lampiran Surat Nomor : 3 9 6 /VII-01/0324 ‘Tanggal : 19 Maret 2024 Lampiran 1. Capaian Indikator Kepatuhan FKRTL Februari 2023 [nhater® [nana inant 3nd indtsor india aha] Name Fashion r+ nner et ft tr ae To oral [BETRITT- RS WAVAPADATOSPTTAL SURAERYE a d = oa onl aol aan farrsara- KL WOIKIAASTHA CENTRE 1) ae) a of aol 9) 75.00 farrRare- Rankin Cr. Cerone ‘ol a topo asl raw larrRar? “RS Raye Sasbeve asl of rool a6) ane [nF76007- RL UTAIA30 CONTE ae) ae) “4 al sao] 25] 9040 [GoTROZO- ROMAN GACT MUN RATT ital ag ‘ol aerl 25] — a DETTRODS- Rakin Ewa Pangea ae Sal ie oa are] an] re [SEITACSO- RS Sraere Medea vee isl 16 1) 11 eras wa "TRENT- RBUD OR SCETONO SURAEATA saa onal eal a er a | SOTROTO“ RPA DRRAELAN SURIOAYA ssl a6] 1) 1 ol geal as) {EITRIOT Ratt Soorre Lane OTS 7 ae 7 ase! ——2ol on (aY7S008-ALRIK UT ANA FENGOALSIS 35 tae el a aa asf at (aYTRIGT- RS AT RARELUARCARERIESOR wae aa ol 603) zo] oo [ETTRIOB- RS PRU MURAITMAOW AT SURGE jl eh ll aoe] as] — {EATROEZ. RS WYONG SEIARTERA [aaa gla cal s|__ 00] 26] com LeTATTS-ASUeRe ss) as) el arora 991 [et7avG4- RS GOTONG ROYONG 1s) 15] 1 a al 102) as] oe [BETRTGE- RSALOWBOK DUA DUATORTAR sas 1) 1 al orl 25] e007 (ei7RGaD- RS MANVAR MEDICAL CENTRE asl sel sel 1 oro] se] 00 (eI7ROGS- RS AGTHUBADA RASA sss sel 1 al 00o] asl 29.08 {S002 REUD RAN PROVNSTIARA THUR ass) ela 240] a3] 0020 {soTRGTS-RSALRSYAD ef el aul as] vane [SOTROTT- RSUD DRM SOEVANORE as[ 1] el lz} 26 vas [SoTRODY- RS LANA Ya fs el arf asl vas [oa S01 = Rc DRFRUAATSADAPRENER ssf ss] ell al_2.9) 26] von freraoro-RsioaRus svFA sf ag all sl 720] asl 9020, fSo1R005- RS ISLA EMURSARTSURRENVA ss] as val al azar [er7Rare- RS Unversas Argoe ssl vol sol asl al zal asl ze OTRGO7- RSPR as asf nal al all asl ae lzirRoes- Rs WLAN BOOTH SURABAYA ef sol asl al rz) aslo "30TROTS- RS BHAYANGKARA SURAGAYA 18) 33) ri ul al 72 25) 9023, {ri7Rove-RSUD Ghat Dharma lea isl__a5] ve | 7a] a5] 000 (GaTTROT- RS Wives 18] 5) x mn a] 720 25] 9028 1901RT- RSAD BRAMIAYASURAEATA sss) sel 1 al 2a) 9933 [SOTROTS- RS HATA NASYARAT JANATHOR, = al el — a a east [TRIGT- RSW GRARR DRE ri sel | zl 9998 [SOTROTS- RSA PURARARAROA 1 rT 2s] m9 [PTFRCRS- RS ala Uda sl wal sl 2: soar [set 7ROde- RaW BANTUAN OSS SURG a al al a0] a6] 0 "S07 RORY- RS ORERI WENO SURROAYA Se a a a eal aa [s17A005- RS ROSORUTANA sels x ca ozs] 26 vor {ei7sn05-RLRUK MATADR SIANSU Aa el el alae] 25] v0 [RETRORY-RSAPUTRISURSEAYA ssl as] tel ozs) as) oo (RETRY “RTA Nr Uri arr s!_—as] ie) 1 |__| ao] 008 [SOE KOR EC TARGSURENTE Saltash = al oe las] asl ona (GEITSOGLRLRIR MATATAITYA “se et zal asl 078 (STRITA- RS BHARTI RAT aaa raf asl oar [BTRODS- RS BUNOASURGNTA sf rail a6] 91 [ziTS008- CURIBAYAEYE CUNIC ‘| et eras) as] oe [sarnosa- ASIAPERDANAWEDCA so el aro asl 0087 [aersors- KUNK UTAMK OPTI a aa eae) asl a0 [BETRTIS- RS TERAFUNG NSATRAARUNGEA sal el al soo] ae] 10000 [arr Scc8- FUNK UTAIA RUSOR EUR, i al cal al s|_ 800] 2s] 10900, [BESO FUNK SATIASHUEDRA sss) 90 a] e0o asl 10000 larisars- RUNKUNRUCA ale oes| eh ea a] 800 asl 0000 (BETSUTE-FINKINTOS 7 TT soo! as] 1000 (17S017- RINK UT AA RIPUSURARONGRT ols asl ale Ta Anaers asl 10000Lampiran Surat Nomor : 3.9 6 /VII-01/0324 Tanggal : 19 Maret 2024 Lampiran 2. Update Display Tempat Tidur Name Faskes Flag Taroot|Jumiah Upasie|Capaian |Reterangan (B217ROTT-RS Royal Surabaya awe (0 [beim Tercepa (9217R002- RGR BAWTUAV 05 0805 SURFEAYA [Target 2a 00 [Terenas 217R00s Rumbalnar Ewa Pargaa Hae 700 FTereapal [saT7RGT- Rumkt Soomivo Laud Mayona [Teast a0 100 [Tereapi [n217RO18- RUD Bhat arma Hue Tareet fas 00 [Tereapar (2ITROIO Ruka! Or, Oopome [Taret [ax "0 [rereapa 21 7RU2S - RS BUNDK SURABAYA Tae [as [00 [Tercapt [EITAaD RS Mata Unaean Trane ps 00 [Tereapar (217A - RS Univer AGN [Tae fae [09 |Tercapai (aiTRO7S-RS Wave aoe i ic [ai7RO7E RS BHARTI RANA Tarot [at 00 [Tereapa [i7RO7S- RSIOARUS SYFA [eet fas oo [Tereapal [so17R082- RS WYUNG SELARTERE [Faas [re [5 [rereaps (ga17R0e4=RS WLLIAM BOOTH SURABAVA [Tangata 100 [reveal lbar7Ro6s- RS WANVAR WEDIGAL CENTRE [Targat [as 09 [rereapai [o217ROSt = SLOAM HOSPITALS SURABAYA [Target [as 00 [rereapsi [o217R0s2- RSA PERDANA WEDICA Tas hie 700 [Terape: (22178003 -RS HUSADA UTA Tee [as 100 [Tereapat (2I7R094- RSA PUTRISURABAYR Tee [ra [00 [Tereapai [217005 - RS ADI HUSAOR KAPASART arget [ea 62 [Terenas (EITRDRT “RSA Rox Ur Rare Tenet [a5 Tao [Terapet [BBITROS-RS Suobaya Medical Sane Teme [as 00 Frerepat (7R101- RSA GRAFAWEDIA rar As. 00 [reeapat [aaT7RT02-RSALONBOKDUAOUALONTAR [Target Tas Foo [rercapal [2178104 RS GOTONG ROYONG [Taret___[z0 00 [revs GEIRTOS- RS PRU NUHAUMADIWAH SURABAYA |Tapst zs 100 FTeeapa: (D217RT07= RS WITH KELUARGAKENIERAN [Target 25 [00 [rereapi (G2T7RTIO™RS GIGIOAN MULUT UNAR [Faroe ae a0 [Tercapai (ITRTI1- RS MAVAPADA HOSPITAL SURABAVA [Target Jas o_[Fereapai (O2ITRTIS-RS Vbwra les 700 [Terapal (QET7RTIS- RS TERAPUNG KSATREARUNGGR lo 100 Trereapas (92175002 - KURI JEC-TAVAGSURABAYR ‘oan Taro 00 [Tereapat (178004. KLNKWATATRITYA Bokan Tarat(o [00 |rereapai [2175005 KUNK WATA DR SIAVST Boker Taget/o fee [Tereapar [TTS006- RLNIKUTAAA HEMODALEIS 3 | Sukan Taraao 100 [Tereapei (so178007- KLIK UTAMASD CLNE [Soran Tarot TO TTerapa: (2178008- SURABAYAEYE CLINIC Botan Tareetlo 700 [Tereepa [G2178009~ KLRIRUTAWARIUSADABUANA ——[Bukan Target 25 700 [rereapar 27011 - KLNIK OWARMAHUSADA PREMIER [Bukan Teget/o 05 [Teresi [o21780%2- KLIK JATIASH MEDRA [puta Taret(o 70 [Tere [S2175019-KLNKUTAWAOPTINA [Baan Tarlo 1100 |rereapl (S217S014 -RLNK WDUAIA ASTHMA CENTRE [Buran Target [00 [Tereapai [278016 -KUNKUNALA [Bukan Teo To [Teresi [ei7s016- RINK NTIS (Bukan Taeto ico [b27TS0T7-KLNIKUTARARIPUSURA RUNGRUT [Baran Targa [00 —[Tercepat s01R001 -RSUD OR SOETOWO SURABAVA [Target as [100 revere {G01ROI2- RSUD HAN PROWNSIIAWATMUR [Target [aa [00 |Tereapa TSOTRODE- RSV GAERAA MENU SURABRYR [Target 35 [00 |rercapei [S07R005 RS ISLAM JENURSARI SURMBAYA [Target >a 00 —TTercapar foTADO? -RS PHC Trace las Too [Terps [FRTROTO- RSPAL OR RAVELAN SURABAYA [Target fos 00 [Terepe 1SUTRGTT- RSUD DA M SOEWANDRIE Faget a8 [00 [Tercapai S0TROT2- RSAD BRAMIAYA SURABATR roel 8 00 [rereapi [S01ROI9- RS BRAYANGAARASURABAYA [Target [os 50 [Teresi Hs0iRO%a- RSUO Hua Para Trane fas 100 [Terps ETROTS- RS MATA WASYARARAT JAWA THUR [Taruet Jos 100 [Tereapsi FaOIRGTS- RS AL RSYAD ret 00 [rereapar [900 - ROWAH SART WU RABAT raret far 00 [Tercapat TaDIRGRa “RS BLAMAA VAT Tse a5 [00 lTerapal HSOTRG2S -RSIA PURA RARARTA [Fereet_— fas [62 [rereapsLampiran Surat Nomor : 3 9 6 /VII-01/0324 Tanggal : 19 Maret 2024 Lampiran 3. Capaian Update Tindakan Medis Operasi ‘Nama Faskes [Jumiah Update|Capalan] _Keterangan {EiTROTD Ramil Or ager o [> _ [Boum rercapa [o2}9R117- RS WHAYAPADA HOSPITAL SURABIVA [0 (Jee Teresi [O2T7ROOZ-RSIA BANTUAN 05.08.05 SURABAYA [Buxan Target [100 [rereapar (22178005 - Rarer Ewa Panga i [a0 [rercaper (G217ROOT- Rum SoeniveLanua Mulyors [28 [00 [rercanai Jz7RoT8- RSUD Bhat Dharma Fusada foe [00 |Terepal [e217R0z5- RS BUNOA SURABAYA re 00 Teresps: (217R06- RS ata Urcean free 00 [reeepst {BaITROTA- RS Univers NTRS oo 160 [Teeapat (GaTTROE-RS Ways iG aio U2ITROTT RS Royal Saabaya a [00 lTersapm [D217ROTE- Re BHARTI RANAYU cc 00 Frerapat [a217R076- RSI DARUS SYIFR a6 00 reeepa (o217RO82- RS WIYUNG SEIARTERA [er 00 [Tersapa (9277ROB4- RS WILLIAM BOOTH SURABAYA [212 [> [rereapa (ITROSs “RS MANYAR MEDICAL CENTRE [3 Fo lrercapal [D017R0sT- SILOAM HOSPITALS SURABAYA [16 co frerapar (S217ROSE- ASIA PERDANA MEDICA [Botan Target [100 ereapal (2178005 - RS HUSADA UTANA ie [oo frereaps [2178004 RSAPUTR SURABAYA rt 08 Tersapar 0217008 RS ADT HUSADA RAPASART 9 ico [s2;7ROST-RSIA Nar Unt Nore F [60 [rerapai [SaT7ROSE- RS Surabaya Wedcal Senco ps 00 [Tereapat [0217801 - RSA GRATA NEDA fr 00 renee [7A 102A LOWBOK DUADUALONTAR [7 ico [recapst [2t7R 104 - RS GOTONG ROYONS i ce frersapai [S2T7R105 = RS PAU MURANUADIVAH SURABAYA [7 io [rercaat (217107 -RS WIT KELUARGA KENIERIN [13 100 rerepe: [b217R110-RS GIGIOAN MULUT UNAR i 700 [reeapar ai7Ri70- RS Ubaya ia 00 [rereapal IREITRTI5-RS TERAPUNG KSATRIMARLANGGR Suan Taraat [109 Tercapa oe? S002 RU RA JEC-INRGSURABAYA ra [00 —FTereapai (92178008 KENKWATA TATYA ie 700 [Tereape: (02175008 - KLIK WATADR SIANSU ie 00 frereapa (G217S000- KONK UTAWA REMODAISIS 3 [Buta Target 100 [rereapa [278007 KUINK UTAMAO CUNT [Botan Target [100 —[Tecapal [o2175000- SURABAYAEYE CURE co {00 [Tercapai (02175000-KLNKUTAWARTUSADABUANA [Busan Targat [100 |rereapar (92178011 KEK DRARMAHUSADA PREMIER [Bukan Target [100 —Jrercarar (21780%2- KLNK JATIASTH MEORA Jean Taroet [100 |rereapar {I7S073-RUNK UTANAOPTMA laucan Tapet_[100 —HTecapar [De}7S0T4- KLIK WIOJAIA ASTHWA CENTRE —[Sukan Target [700 |reveapal (o2178018-KENKUNALICA [Bukon Target [100 [rereapar (ea178016- KENRNTIBOS [Boa Target_[100—Tereapa (@a17S017- KLNK UTAMARIPUSURARUNGKUT [Buten Target 100 [recap fS0TRGGT- RSUD OR SOETOWO SURABAYA —_[aT@ [00 |Tercapi [01R002- RSUD HAI PROVNSI AWA TMUR 77 oo [RO1ROO4- RSI DAERAH WENUR SURABAYA | BuKan Target 100 S@IROGS RS ISLAM JEMURSARISURABAYA [2 0 TBOTROGT AS PRC her 0 {207RO10~ REPAL OR RAVELAN SURABAYA [R25 0 {30RO1T-REUD DRM SOEWANOHE ret roo {301RDI2- RSAD BRANIAVA SURAGAYA 7 fo [OTRDTS RS BHAVANGKARA SURAGAYA [2 00 {SOTROT4 - RSUD Husade Prima ia 00 TGOTROTS RS MATAIASYARARRT TANATMAUR [25a 00 freeepat TaUTROTS- RS ALRSYAD fer [00 [Tercapa {307020 - RUMAH SART WUT RARAYU re [00 [rereapa [aOTRO24 RS ISLAMTA VERT is 700 [rereapa [iSD1RODS SIA PURA RARARIA = 00 [rercapLampiran Surat Nomor : 3 9 6 /VII-01/0324 Tanggal : 19 Maret 2024 Lampiran 4. 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AWA TIMUR, 209 o, 08 0 5 [es SLAM JENURSARISURAEAYA, 32 el Zz 7a © IRs Pac 280 210 oa 7 |asuo DR MSOENANOHE 63 7] 506 24] 3 [es shavANGKARA SURABAYAH S SANGOERI 162 4 81 ew 8 [Rs MATA MASYARAKAT SURABAYA 4 ol 1 08 [Rs SLAW A YAN 258 al 2 1.6 71 [RSUO Bhakti Onan sea a | 42 124i [72 [run swat ware UND san . «, 1 20% 13 [ns UNIvERSITAS ARLAWGGA ss s 351 144) “|S ROvAL SURABAYA 118 ale 1 3. 15 [RS MANVAR MEDICAL CENTRE m E ma a8] 78 | sLoAM HOSPITALG SURABAYA 78 7 7 a 17 [as museDA UTAWA, 705. al 7 205] Te [aSA0 BRAMUAVA SURABAYA 107. 2 105, 95 19 [RSD HUSADA PRIMA 720 ri 105 7s 20 Rs at asyAD Ze 28 as 21 |RSIPURARATARIA 4 A 7 ea 72 [ASIA SANTUAN C508 05 SURABAA ri al 1 ao 23 frurtsarar Es Pargalie z Di z err 26 [as sweKTiRAHAYY oe af 7 ay 25 AS) OARUS SYA 205 ale 201 20 [as nvunc seuanreRa 210 | 202 38% 27 [ns wiwuas BOOTH SURABAYA 25 rr 230 rrr 28 ASAPEROANA MEDICA 4 dle 1 oct 70] RSA PUTRI SURABAYA 1 al * 20 30 [ks ADIHUSAOAKAPASARI 0 5 a 20% 3 RAN Ure Num: + | a 05 32 |mSA GRANA MEDKA + Fi 2 30003 33 as GOTONG ROYONG 6. | n. 125 34 [RS MITRA RELUARGA KENIERAN “we rm 7 102%] 35 RUMAH SAAT MU RALAWY 22 1 28 38 38 [muri Sento Land Myon * 2 ol rr 0s 5 [url Cr. 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Kritik dan Saran KESSAN Februari 2024 kritik dan Saran KESSAN Februari 2024 dapat ciakses melalui link : https //shorturl ativwy5