Minister Of Health Issues New Rules For Claiming Covid-19 Service Fees

Minister of Health Terawan Agus Putranto (Irfan Meidianto / VOI)

JAKARTA - Minister of Health Terawan Agus Putranto issued a new regulation regarding claims for health care costs for hospitals that handle COVID-19 patients following a new regulation regarding the mention of the term people infected with the new corona virus.

Reporting from Antara, Thursday, July 23, Minister of Health Terawan has issued a Decree of the Minister of Health (KMK) RI number HK.01 / 07 / MENKES / 446/2020 concerning Technical Guidelines for Claims for Reimbursement of Patient Services for Certain Emerging Infectious Diseases for Hospitals Providing Services Corona Virus Disease 2019 (COVID-19).

The Decree of the Minister of Health is an improvement from the previous KMK number HK.01 / 07 / MENKES / 238/2020. The new regulation details the roles and functions of the ministries / agencies and agencies involved, namely details of the roles and functions of the Ministry of Health, BPJS Kesehatan, Provincial / District / City Health Offices, and hospitals.

This new KMK has adjusted to KMK number HK.01.07 / MENKES / 413/2020 concerning Guidelines for Prevention and Control of COVID-19, namely there is a change in the criteria for patients who previously used People Under Monitoring (ODP), Patients Under Supervision (PDP), and COVID-19 confirmations are changed to Suspect Cases, Probable Cases, Confirmation Cases, Comorbid / Complementary Diseases, Complications, and Co-incidence.

Funding for patients treated with Certain Emerging Infectious Diseases (PIE) including COVID-19 infection can be claimed to the Ministry of Health through the Director General of Health Services. This financing claim applies to patients who are admitted to hospitals that provide certain Emerging Infectious Diseases services.

The criteria for patients who can claim service costs include outpatient criteria, namely suspected patients with or without comorbids / comorbidities. The hospital attaches evidence of routine blood laboratory tests and x-ray photos of the thorax, except for pregnant women and patients with nervous and restless mental disorders. Furthermore, patients who confirm COVID-19 with or without comorbid / comorbidities, attach evidence of RT-PCR laboratory examination results from the hospital or from other health service facilities.

Whereas for inpatient criteria, suspected patients over 60 years old with or without comorbid / comorbidities, patients less than 60 years old with comorbid / comorbidities, and patients with severe ARI / severe pneumonia requiring hospitalization and not there are other causes based on a convincing clinical picture.

In addition, what can be claimed for the cost of health services are probable patients, asymptomatic confirmation patients who do not have facilities for independent isolation in residences or public facilities prepared by the government as evidenced by a certificate from the head of the Community Health Center Then, the asymptomatic confirmation patient with comorbid / comorbidities and the confirmation patient with mild, moderate, severe / critical symptoms. Also suspected / probable / confirmed patients with co-incidence

The criteria for outpatient and inpatient care apply to Indonesian citizens and foreign nationals, including health workers and workers who experience COVID-19 due to work, who are treated in hospitals in the territory of the Republic of Indonesia.

The identity of the patient can be proven with a passport, KITAS or UNHCR identity number for foreigners. Meanwhile, for Indonesian citizens this is proven by a National Identity Number (NIK), Family Card, or a certificate from the urban village. Abandoned people as evidenced by a certificate from the social service are also entitled to free services.

If all of these identities cannot be shown, proof of identity can use a patient data certificate signed by the head of the district / city health office and stamped by the district / city health office. A patient data certificate from the district / city health office is submitted by the hospital to the district / city health office.

For this reason, the provincial / district / city health office must prepare a list of Corona Virus Disease 2019 (COVID-19) patients in the work area or check the patient list through the Public Health Emergency Operating Center (PHEOC) from the local district / city health office.

However, if all identities cannot be shown, proof of identity can use a Certificate / Service Guarantee (SJP) from the hospital leadership.

Hospitals that can claim COVID-19 handling costs are referral hospitals for certain emerging infectious diseases, and other hospitals that have facilities for management and patient referral health services (COVID-19) including field hospitals / emergency hospitals.

Services that can be funded in handling COVID-19 patients include service administration, accommodation (rooms and services in emergency rooms, inpatient rooms, intensive care rooms, and isolation rooms), doctor services, action in the room, use of ventilators, supporting examinations. diagnostics (laboratory and radiology in accordance with medical indications), consumable medical materials, medicines, medical devices including the use of PPE in the room, referral ambulances, corpses, and other health services according to medical indications.