Ministry Of Health Admits Rp2.42 Trillion Claims For Treatment For COVID-19 Hospitals In 2021 Cannot Be Paid, Why?

Minister of Health Budi Sadikin/Photo: Antara

JAKARTA - Director of Referral Health Services of the Ministry of Health (Kemenkes) Siti Khalimah said the government could not pay claims for treating COVID-19 patients in 2021 at referral hospitals amounting to Rp2.42 trillion.

In 2021, COVID-19 hospital claims are known to be IDR 90.2 trillion. As of February 9 last, as much as Rp2.42 trillion could not be paid with details of Rp680 billion expired and Rp1.74 trillion disputed.

Meanwhile, currently the claims that can be paid are Rp. 62.68 trillion and the remaining claims to be paid by the Ministry of Health are Rp. 25.1 trillion.

Not that you can't pay. Halimah said that the Rp2.42 trillion hospital claim cost was included in expired claims and disputes.

"Claims that cannot be paid are IDR 2.42 trillion. Those that are included in the expiration and are not appropriate are IDR 680 billion, then the dispute that cannot be paid is IDR 1.74 trillion," said Siti in a virtual discussion, quoted on Monday, February 14.

As is known, a dispute claim is a claim submitted that there is a discrepancy or disagreement between BPJS Kesehatan and the hospital over claims relating to services or clinical actions that have an impact on payment of claims for services for COVID-19 patients.

Meanwhile, expired claims are claims that have passed the submission period. Claims for services for COVID-19 patients in 2021 are until October 2021. The expiration period for claims for services for COVID-19 patients in 2021 is 2 months from the end of the service.

Siti said that the number of expired claims and disputes that could not be paid was lower than in 2020.

"The percentage is less because hospitals also understand how they submit claims, so that more are not declared disputed and expired," said Siti.

Furthermore, Siti revealed that the Ministry of Health's claim settlement and claim dispute (TPKD) team is still accelerating the disbursement of unpaid claims. Siti admitted that this process takes more time because it has passed the payment period.

"Since this is an overdue claim over the years, it must be reviewed by BPKP first. We are targeting that next week we will start verification. If they (RS) are fast, we can quickly process this," said Siti.

Siti also asked the OVID-19 referral hospital which has not submitted a claim to the government for services in December 2021, to immediately take care of it no later than February 28, 2022 or the last day before it expires.

This is because the Ministry of Health still needs to submit an additional budget to the Ministry of Finance. "Indeed, there must be a proposal from us with a fixed value. Therefore, we really need this reconciliation with the hospital, so that we can submit the real need to the Ministry of Finance because this uses a special budget, not the regular budget of the Ministry of Health," explained Siti.

"It's fast, our payment process will be done in stages. God willing, starting in March, when the BPKP review is done, we can make payments," he added.