The Hospital Cooperation with the Board of Social Security Administrator (BPJS) from the Business Law Perspectives of Indonesia

Siregar, Rospita Adelina (2018) The Hospital Cooperation with the Board of Social Security Administrator (BPJS) from the Business Law Perspectives of Indonesia. In: Conference Proceedings Jakarta Indonesia, ICABE 2018. Universitas Borobudur Jakarta, Indonesia, Jakarta, pp. 459-466. ISBN 2623 3517

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Abstract

Participants of the national social health insurance system (SJSN) receive health services according to BPJS Health regulation number 1 of 2014 on health facilities. The implementation of this BPJS service is based on the laws and regulations, among others: Law number 36 in the year of 2009 on Health, Law 44 of 2009 on hospital, Government Regulation number 101 of 2012 on recipients of health insurance contributions, Presidential Regulation number 12 of 2013 on Health Insurance, Law No. 24 of 2011 on the Social Security Administering Body. Payment of hospital claims refers to the Indonesian Tariff - Case Based Groups hereinafter referred to as INACBG's Tariff in which the amount of the claim payment by BPJS of Health to the Advanced Health Facility for the service package based on the grouping of disease diagnoses or more often is called coding. The results of the survey that assess the satisfaction level of BPJS service are not expected to give hope, the complaints are often delivered, among others: no stock of drugs, low claims of BPJS rates, so hospital has difficulty in operation, the length queue for checking, the service of doctors and paramedic which is somewhat slow. Therefore, it is proposed to the government to immediately review the INA CBG tariff. The topic of discussion is: (1) dynamic and retroactive regulations; (2) health services through the referral system has not gone well; (3) low awareness of hospitals and participants to understand JKN regulations and the high rate of dissatisfaction from the participants.

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