Contents:
- Medical Video: Cara Pengambilan Nomor Antrian BPJS Via SMS & Telegram | SANTOSA HOSPITAL BANDUNG CENTRAL
- Basic procedure using BPJS Health
- Requirements for hospitalization with BPJS Kesehatan
- How to use BPJS Kesehatan for hospitalization at level 2 health facilities
- What if level 2 health facilities can't handle it?
Medical Video: Cara Pengambilan Nomor Antrian BPJS Via SMS & Telegram | SANTOSA HOSPITAL BANDUNG CENTRAL
BPJS Kesehatan is a type of government-owned health insurance. Automatic, there will be many people who use this facility. Included in taking care of hospitalization claims at the hospital. Do you know what is the procedure for filing BPJS for hospitalization? What must be prepared first? Consider the following review.
Basic procedure using BPJS Health
BPJS Kesehatan, which is government-owned insurance, has a variety of services, ranging from covering outpatient treatment, hospitalization, to referring to surgery. The main requirement for being able to use a health BPJS is to be registered as a participant first.
Before you or your family member is sick to need hospitalization, you should indeed have registered first in the BPJS Health system.
Then, premiums or installments per month BPJS Your health must be paid regularly. If you are in arrears when you or your family is sick, then the process of using BPJS Kesehatan will certainly be hampered.
You will be asked to complete arrears first. Whether before outpatient care at a health facility (hereinafter referred to as health facilities) at level 1 or hospitalization, all payments must be completed first.
Requirements for hospitalization with BPJS Kesehatan
For patients who are not emergency, to hospitalize you must go to level 1 health facility first. Level 1 health facilities, for example puskesmas or special clinics that have collaborated with BPJS Kesehatan.
Then, reported from the Health Service Practical Guide, if level 1 health facilities have inpatient facilities, the patient can be hospitalized at the health facility. If not, the doctor in health facility 1 will refer you to the hospital (health facility level 2) for hospitalization. For that there are several files that you need to prepare:
- Copy of family card
- Copy of ID card
- Original health and photocopy BPJS card
- Reference letter made by a level 1 health facility doctor
- Participant Eligibility Letter (SEP)
- Medical card
How to use BPJS Kesehatan for hospitalization at level 2 health facilities
After submitting the file at the hospital referred by the level 1 health facility, you will be re-examined by a doctor at the hospital. The doctor will tell when the patient can start hospitalization or does not need to be hospitalized, but is given treatment for outpatient treatment at home.
If you will be treated at a level 2 health facility, follow the next procedure as an inpatient. Usually after the action is given, or the medication needed as recommended by your doctor, you will be asked to sign a proof of service sheet.
This is where the hospital or health facility will take notes. Recording will be included next to a special system provided by BPJS Kesehatan.
Furthermore, the Health BPJS will pay for your medical expenses according to the records provided by the hospital. In this case, the BPJS is of a nature cashless, that is, you do not need to spend money to pay for hospital fees first. All costs are issued directly by BPJS Kesehatan to the hospital.
However, not all actions or drugs will be borne by the BPJS. If there are some actions or drugs from a doctor who do not enter the BPJS Health service, then the patient pays for the action or the drug itself.
Therefore, discuss as much as possible with doctors and hospital staff about procedures, actions, and all administrative matters related to your treatment.
What if level 2 health facilities can't handle it?
If you are unable to handle your case or illness in a level 2 health facility (for example due to lack of facilities or a specialist), you will be referred to a larger hospital. The procedure is more or less the same when you enter hospital level 2 health facilities. In addition to preparing the prerequisite documents, attach also the reference letter file from health facility 2 to level 3 health facilities.
Furthermore, doctor level 3 health facilities will re-examine the condition of newly referred patients. If you really need hospitalization, then you will be hospitalized at this level 3 health facility.
The next flow is more or less the same as in level 2 facilities, just different places.
In essence, the claim of hospitalization from BPJS Health will be directly carried out by the hospital to BPJS Kesehatan. BPJS users must prepare complete administrative data, then the hospital will confirm to the BPJS.
