Professional Documents
Culture Documents
Materi Rujukan RSUD Madising
Materi Rujukan RSUD Madising
KETENTUAN
H110 Pterygium
E119
PELAYANAN RUJUKAN
Non-insulin-depend diabetes mellitus without complication
6
6
19.126.800
907.200
3
Tren Biaya RJTL dan RITL
Bulan
Biaya RJTL Biaya RITL
Pelayanan
Jan-20 35.990.700 67.661.400
Feb-20 38.034.300 89.008.700
Mar-20 43.288.400 60.875.700
Apr-20 22.997.100 32.740.700
Mei-20 27.779.700 39.783.300
Jun-20 35.839.900 63.616.400
Jul-20 34.800.100 48.593.300
Agu-20 47.026.000 64.717.700
Sep-20 54.136.800 43.898.900
Okt-20 53.327.400 76.095.900
Nov-20 51.915.600 61.628.200
Des-20 44.574.700 76.976.100
Total 489.710.700 725.596.300
4
Unit Cost RJTL dan Rate RJTL
5
Unit Cost RITL dan Rate RITL
6
CBGs Terbanyak RJTL
Kode INA CBGs Nama INA CBGs Kasus Biaya Verifikasi Unit Cost
Z-3-25-0 PROSEDUR ULTRASOUND GINEKOLOGIK 1.147 326.665.600 284.800
Q-5-44-0 PENYAKIT KRONIS KECIL LAIN-LAIN 253 45.109.900 178.300
Q-5-42-0 PENYAKIT AKUT KECIL LAIN-LAIN 86 15.093.000 175.500
K-5-18-0 OTHER DIGESTIVE SYSTEM DISORDERS 84 19.538.400 232.600
Z-3-23-0 PROSEDUR ULTRASOUND LAIN-LAIN 70 36.001.000 514.300
Q-5-43-0 PENYAKIT KRONIS BESAR LAIN-LAIN 25 6.295.000 251.800
J-3-13-0 PROSEDUR TERAPI SALURAN PERNAFASAN 25 7.410.000 296.400
Q-5-23-0 PEMERIKSAAN ANTEPARTUM 22 2.618.000 119.000
Q-5-25-0 GASTROINTESTINAL AKUT 17 2.159.000 127.000
Q-5-24-0 PEMERIKSAAN POSTPARTUM 16 1.302.400 81.400
7
Diagnosa Terbanyak RJTL
Kode Diag Primer Nama Diagnosa Primer Kasus Biaya Verifikasi Unit Cost
Z349 Supervision of normal pregnancy, unspecified 789 214.376.700 271.707
Z348 Supervision of other normal pregnancy 266 75.437.300 283.599
Z340 Supervision of normal first pregnancy 106 30.188.800 284.800
K30 Dyspepsia 69 16.113.200 233.525
Z098 Follow-up examination after other treatment for other conditions 60 10.804.500 180.075
R509 Fever, unspecified 41 7.437.300 181.398
N939 Abnormal uterine and vaginal bleeding, unspecified 19 9.435.700 496.616
E119 Non-insulin-dependent diabetes mellitus without complications 18 3.209.400 178.300
A099 Gastroenteritis and colitis of unspecified origin 18 3.279.900 182.217
O069 Unspecified abortion, complete or unspecified, without complication 17 4.507.100 265.124
Kode Diag Primer Nama Diagnosa Primer Kasus Biaya Verifikasi Unit Cost
Z349 Supervision of normal pregnancy, unspecified 692 197.081.600 284.800
Z348 Supervision of other normal pregnancy 263 74.902.400 284.800
Z340 Supervision of normal first pregnancy 106 30.188.800 284.800
O069 Unspecified abortion, complete or unspecified, without complication 14 3.987.200 284.800
O021 Missed abortion 12 3.417.600 284.800
O064 Unspecified abortion, incomplete, without complication 11 3.132.800 284.800
O060 Unspecified abortion, incomplete, complicated by genital tract and pelvic infection 11 3.132.800 284.800
O200 Threatened abortion 6 1.708.800 284.800
N912 Amenorrhoea, unspecified 5 1.424.000 284.800 2
O321 Maternal care for breech presentation 3 854.400 284.800
8
CBGs Terbanyak RITL
Kode INA CBGs Nama INA CBGs Biaya Verifikasi Kasus Unit Cost
O-6-13-I PERSALINAN VAGINAL RINGAN 1.144.894.900 701 1.633.231
K-4-18-I DIAGNOSIS SISTEM PENCERNAAN LAIN-LAIN (RINGAN) 562.740.000 437 1.287.735
O-6-10-I OPERASI PEMBEDAHAN CAESAR RINGAN 1.592.349.500 334 4.767.513
K-4-17-I NYERI ABDOMEN & GASTROENTERITIS LAIN-LAIN (RINGAN) 333.096.000 260 1.281.138
A-4-12-I DEMAM RINGAN 467.693.100 161 2.904.926
I-4-17-I HIPERTENSI RINGAN 188.072.700 93 2.022.287
W-4-16-I GANGGUAN ANTEPARTUM RINGAN 198.428.100 90 2.204.757
G-4-23-I MIGREN DAN SAKIT KEPALA LAIN (RINGAN) 153.546.400 73 2.103.375
W-1-11-I PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK RINGAN 99.757.200 62 1.608.987
O-6-13-II PERSALINAN VAGINAL SEDANG 110.084.600 58 1.898.010
9
Diagnosa Primer Terbanyak RITL
Kode Diag Primer Nama Diagnosa Primer Kasus Biaya Verifikasi Unit Cost
O809 Single spontaneous delivery, unspecified 78 117.330.900 1.504.242
K30 Dyspepsia 63 77.015.700 1.222.471
O800 Spontaneous vertex delivery 55 83.171.400 1.512.207
A099 Gastroenteritis and colitis of unspecified origin 21 26.003.600 1.238.267
I10 Essential (primary) hypertension 14 25.300.100 1.807.150
E119 Non-insulin-dependent diabetes mellitus without complications 11 42.906.800 3.900.618
O210 Mild hyperemesis gravidarum 10 20.764.300 2.076.430
A010 Typhoid fever 10 22.446.700 2.244.670
I500 Congestive heart failure 9 21.736.600 2.415.178
J069 Acute upper respiratory infection, unspecified 8 16.505.200 2.063.150
2
10
Diagnosa Sekunder Terbanyak RITL
2
11
USG Ginekologi Terbanyak RSUD Madising
Kode CBG No Kartu Kasus Biaya Verifikasi
Z-3-25-0 0001071828292 6 1.708.800
Z-3-25-0 0002602772324 6 1.708.800
Z-3-25-0 0001843401622 5 1.424.000
Z-3-25-0 0002071433913 5 1.424.000
Z-3-25-0 0001071835323 5 1.424.000
Z-3-25-0 0001451977749 5 1.424.000
Z-3-25-0 0001559378384 4 1.139.200
Z-3-25-0 0000938634805 4 1.139.200
Z-3-25-0 0002087926233 4 1.139.200
Z-3-25-0 0001797752529 4 1.139.200
Z-3-25-0 0000007676384 4 1.139.200
Z-3-25-0 0000059178586 4 1.139.200
Z-3-25-0 0000042703267 4 1.139.200
Z-3-25-0 0000038556842 4 1.139.200
Z-3-25-0 0000003393191 4 1.139.200
Kode Diag
No Kartu No SEP Tgl Dtg SEP Tgl Plg SEP Nama Diagnosa Primer Diagsekunder Procedure
Primer
209536849 0334R0060720V000089 July 18, 2020 July 19, 2020 Z038 Observation for other 9918 - Injection or infusion of
suspected diseases and electrolytes
conditions
151495176 0334R0060820V000164 August 21, 2020 August 22, 2020 Z038 Observation for other 9059 - Other microscopic examination
suspected diseases and of blood;9396 - Other oxygen
conditions enrichment
151503238 0334R0060820V000157 August 20, 2020 August 24, 2020 R042 Haemoptysis Z038 - Observation for other 9059 - Other microscopic examination
suspected diseases and of blood;9918 - Injection or infusion of
conditions;E119 - Non-insulin- electrolytes;9922 - Injection of other
dependent diabetes mellitus anti-infective
without complications
2
13
KMK 446 Tahun 2020 tentang Juknis
Pelayanan Covid-19
2
14
UTILIZATION REVIEW
keadaan
pasien dalam
darurat
kondisi dapat
pasien telah
dipindahkan
teratasi
- Identitas pasien
- Anamnesis
- Hasil pemeriksaan fisik
- Pemeriksaan penunjang yang telah dilakukan
- Diagnosis kerja
- Terapi dan/atau tindakan yang telah
diberikan
Nama dan
tanda Ringkasa
tangan KDDIAG NMDIAG n medis
KASUS BIAYA
tenaga
kesehatan
I10
H110
Pengantar
Essential (primary) hypertension
Pterygium
pasien
10
6
7.801.400
19.126.800 Alasan (indikasi medis)
Rujukan dan tujuan tindakan
E119
minimal
Non-insulin-depend diabetes mellitus without complication 6 907.200
T140 memuat
Superficial injury of unspecified body region 6 907.200 medis yang diperlukan
D649 Anaemia, unspecified 6 943.200
R402 Coma, unspecified 4 897.500
R060 Dyspnoea 3 723.900
R074 Chest pain, unspecified 3 3.784.600
Z33 Pregnant state, incidental 3 1.477.200
Fasilitas
O342 Maternal care due to uterine scar from previous surgery 3 2.380.200
Penyelenggaraan rujukan di Fasilitas Kesehatan Penerima Rujukan dari Fasilitas Kesehatan yang sama
dapat berupa kontrol ulang ke poli yang sama maupun Rujukan internal ke poli yang berbeda
Kontrol ulang atau rujukan internal dapat diberikan berdasarkan indikasi medis pasien maksimal 3 (tiga)
bulan sejak tanggal rujukan awal dikeluarkan.
anjuran kontrol atau rujukan internal dalam kasus kontrol ulang atau rujukan internal
Fasilitas Kesehatan Penerima Rujukan dari Fasilitas Kesehatan yang sama memasukan informasi pada
kolom keterangan di aplikasi eligibilitas (Vclaim) yang berupa indikasi medis masih diperlukan kembali
serta rencana tindak lanjut yang akan dilakukan
SURAT KETERANGAN KONTROL
Contoh Surat Keterangan Kontrol
Pencapaian RSUD
Indikator Penilaian Target
Madising
Terhubung Aplicares
a. Display Tempat Tidur yang terhubung dengan
Terhubung Aplicares namum belum
Aplicares
KDDIAG NMDIAG KASUS BIAYA production
I10 Essential (primary) hypertension 10 7.801.400
b. Keluhan Peserta TerkaitH110
Iur Biaya
Pterygium tidak ada keluhan
6 19.126.800 tidak ada keluhan
c. Keluhan Peserta Terkait E119
Diskriminasi Pelayanan tidak ada keluhan
Non-insulin-depend diabetes mellitus without complication 6 907.200
tidak ada keluhan
T140 Superficial injury of unspecified body region 6 907.200
d. Keluhan Peserta TerkaitD649
KuotaAnaemia,
Kamar Perawatan
unspecified tidak ada keluhan
6 943.200 tidak ada keluhan
R402 Coma, unspecified 4 897.500
e. Updating Rutin Ketersediaan TT
R060 Dyspnoea update setiap3 hari723.900
R074 Chest pain, unspecified 3 3.784.600
f. Angka Rujuk Balik Z33 Pregnant state, incidental 6 peserta
3 1.477.200 0 peserta (0%)
O342 Maternal care due to uterine scar from previous surgery 3 2.380.200
HASIL SURVEY PESERTA TERHADAP LAYANAN RUMAH SAKIT
DI KEPWIL SULSELBARTRAMAL TAHUN 2020
Prioritas Perbaikan yang perlu ditingkatkan
N
i
l
a
i
C
u
s
t
o
m
e
r
F
e
e
d
b
a
c
k
I
n
d
e
k
s
(
C
F
I
)
m
e
n
s
a
I10 Essential (primary) hypertension 10 7.801.400
l
a
h H110 Pterygium 6 19.126.800
s
a
t
u
E119 Non-insulin-depend diabetes mellitus without complication 6 907.200
i
n
d
k
e
p
a
R402 Coma, unspecified 4 897.500
t
f
a
R074 Chest pain, unspecified 3 3.784.600
s
k
e
s
Z33 Pregnant state, incidental 3 1.477.200
t
e
r
O342 Maternal care due to uterine scar from previous surgery 3 2.380.200
h
a
d
a
p
k
o
n
t
r
a
k
T
a
h
u
n
2
0
2
1
STANDAR WAKTU TUNGGU
LAYANAN DI FKRTL
Persiapan Loket Poliklinik
Pendaftaran Administrasi
• 10 • 50
KDDIAG NMDIAG
menit KASUS BIAYA • 9
menit I10
H110
Essential (primary) hypertension
Pterygium
10
6
7.801.400
19.126.800
m
E119 Non-insulin-depend diabetes mellitus without complication 6 907.200
www.bpjs-kesehatan.go.id