BPJS Affirms Not To Charge Additional Costs For Hospitalization

Responding to the hectic discussion about BPJS Kesehatan which charges additional costs for hospitalizations, Head of Public Relations of BPJS Kesehatan, Rizzky Anugerah emphasized that hospitalization is included in health services guaranteed by BPJS Kesehatan.

It is not true that BPJS Kesehatan charges additional costs for inpatients. As long as the service is in accordance with medical indications and according to the right class, medical costs are guaranteed in full. Except, to advance the treatment class at your own request or there is no medical indication, it cannot be guaranteed," said Rizzky in his statement in Jakarta, Antara, Sunday, December 8.

He added that the hospitalization fee already includes medical costs included in the INA CBGs package tariff. For information, the payment of hospital claims by BPJS Kesehatan to the hospital is carried out at a package rate based on the Indonesia Case Based Groups (INA CBGs).

INA-CBGs is a payment system used by BPJS Kesehatan to pay for health services provided to JKN patients. This system uses a package based on diagnosis and procedures for patients' illness.

With this package tariff, all medical and non-medical service costs (such as inpatient rooms), are included in the calculation of INA-CBGs. Therefore, the hospital is not allowed to withdraw any fees to the patient concerned.

"If there are JKN patients who are asked to pay by the hospital when hospitalized, please report to us through BPJS 1 officer! at the hospital, BPJS Health Care Center 165, Mobile Application JKN, or visit the nearest BPJS Health Office. ," said Rizzky.

However, if there is a desire for participants themselves to advance to higher care classes from the JKN membership class they participated in, these participants may be subject to the provision of paying the difference in costs.

The provisions regarding additional costs to advance to the treatment class are contained in the Regulation of the Minister of Health (Permenkes) Number 3 of 2023 Article 48.

In addition to hospitalization costs, Rizzky also explained about the BPJS Health audit process. For a decade, BPJS Kesehatan has always recorded the title of Unqualified (WTP) or Fair Without Modification (WTM) for its financial statements for 10 consecutive times.

This achievement shows the consistency of BPJS Kesehatan in implementing good governance and always implementing the JKN Program based on the principles of prudence and accountability.

"Every year BPJS Kesehatan is audited by the Public Accountant Office (KAP). It should also be noted that there are many parties who supervise BPJS Kesehatan in carrying out its duties in managing the JKN Program," said Rizzky.

He said the supervision process involved the Internal Supervisory Unit (SPI), the Supervisory Board, the National Social Security Council (DJSN), the Financial Services Authority (OJK), the Financial Supervisory Agency (BPK), the Financial and Development Supervisory Agency (BPKP), to the Corruption Eradication Commission (KPK).

"The multi-layered supervision is a manifestation of the seriousness of BPJS Kesehatan and all parties involved in the JKN ecosystem, to ensure that the JKN Program runs on the right track," said Rizzky.