Contents:
- Medical Video: Varicocele Surgery Procedure | Top Male infertility Treatment Centre Chennai
- What health facilities are covered by the BPJS?
- How to claim treatment using BPJS for outpatient care
- 1. Visit FASKES 1
- 2. Care at a referral hospital
- 3. Pay attention to the validity period of the referral letter for outpatient treatment
- You can use BPJS for treatment without referral only for emergency cases
- Can you complain about a service complaint while using BPJS Health?
Medical Video: Varicocele Surgery Procedure | Top Male infertility Treatment Centre Chennai
Each BPJS Health card holder will get free health services that include outpatient and inpatient care. But even if you have the card, you may not know how to claim treatment using BPJS for outpatient care when it is needed. Quiet. We will explain all the details in this article.
What health facilities are covered by the BPJS?
Citing the official BPJS page, each BPJS card owner, aka Kartu Indonesia Sehat (KIS), will get access to the following health services:
- Service administration.
- Promotive and preventive services.
- Medical examination, treatment and consultation; including outpatient care.
- Non-specialist medical actions, both operative and non-operative.
- Drug services and medical materials are used up.
- Blood transfusion according to medical needs.
- Examination of first-degree laboratory diagnosis.
- First level hospitalization as indicated.
When all administrative requirements are complete, you can seek treatment without having to leave money because all costs are borne by the BPJS, including medicines. But indeed, there are a number of certain drugs that are not covered by the BPJS so you have to buy it yourself.
How to claim treatment using BPJS for outpatient care
As a card owner, you should know the proper procedure for treatment using BPJS so that later on you are not confused when you want to claim it.
Well, you need to follow the steps if you want to use BPJS for outpatient care:
1. Visit FASKES 1
BPJS Health implements a tiered referral system. Then you can't just come to the hospital just by carrying a BPJS card for outpatient care.
First of all you have to seek treatment at FASKES 1 (Health Facility 1), which includes a family doctor or health center and local clinic, according to what you fill in the BPJS registration form. You can see FASKES 1 information on your place directly on your BPJS card.
FASKES 1 is the starting gate for you to get a basic medical examination. If you have been examined at FASKES 1 and it turns out that you can still be treated and treated, you do not need to go to the hospital.
If not, FASKES 1 can give you a referral letter for treatment to the nearest advanced health facility (FKRTL) that has collaborated with BPJS Kesehatan. Referral hospitals are usually equipped with facilities and infrastructures that are better able to support your medical complaints.
2. Care at a referral hospital
After you have been referred to the BPJS partner hospital, all examinations and medical actions will be transferred to this hospital. With notes:Bring a BPJS card, an identity card, and a FASKES 1 referral letter when going to seek treatment.
You can continue to use BPJS for outpatient care until the doctor handling you states that your condition is stable. You will also be given a statement stating that you are still undergoing treatment at the referral hospital.
Remember: Reference letters must not be lost. Without the letter, you will be considered medical treatment using personal money without using BPJS claims. So you must show it every time while still outpatient using BPJS.
If the doctor states that your condition has improved, you will be referred back to the initial FASKES by giving a referral statement.
3. Pay attention to the validity period of the referral letter for outpatient treatment
The reference letter provided by FKTP has a validity period. That is, you cannot use these references at will, whenever you want. Reference letters generally can continue to be used up to three months from the beginning of the issuance of the letter.
As long as it has not expired, you are still required to seek treatment at a referral hospital. If your condition has not improved after 3 months, you can extend the validity period of the same referral letter by repeating the procedure from the beginning. Return to FASKES where you are registered to get a basic medical examination and renew the referral.
You can use BPJS for treatment without referral only for emergency cases
To be able to get free treatment with BPJS, you must follow the steps above. The BPJS will not cover your medical expenses if you only bring yourself to the hospital without an official referral letter.
But for emergency cases that can be fatal if not addressed immediately, you can go directly to the BPJS Health partner hospital without having to have a referral letter.
Can you complain about a service complaint while using BPJS Health?
Each BPJS card holder has the right to report complaints or dissatisfaction regarding health services undertaken by contacting the BPJS Health 24 hour call center (1500400). If you want to be clearer, you can come directly to the nearest BPJS Health office.
