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WORKSHOP POLA PENGELOLAAN KEUANGAN PADA RUMAH SAKIT PUBLIK

RUMAH SAKIT JOGJA

Disampaikan oleh Dra Antik Suharyanti MSi Wadir Umum dan Keuangan

UNDANG-UNDANG NO 44 TAHUN 2009 TENTANG RUMAH SAKIT

Berdasarkan pengelolaannya Rumah Sakit dibagi : Rumah Sakit Publik Rumah Sakit Privat.

Rumah Sakit JOGJA


Rumah

Sakit Publik dikelola Pemerintah Kota Yogyakarta Tipe B Terakreditasi 12 jenis pelayanan

oleh

Sumber Daya Manusia Juni 2011


JENIS TENAGA
Tenaga Medis Tenaga Keperawatan Tenaga Kefarmasian Tenaga Kesehatan masyarakat Tenaga Keterapian Fisik Tenaga Gizi Tenaga Keteknisan Medis

PNS/PNS
40 210 17 12 4 5 34

NABAN/
PTT 15 9 2 7

JUMLAH
40 225 26 12 4 7 41

Tenaga Umum/ Non Keperawatan


TOTAL PEGAWAI

72
394

65
98

137
492

PENGELOLAAN KEUANGAN RUMAH SAKIT SEBAGAI BLUD


Pendapatan dapat digunakan langsung untuk menjaga

likuiditas dan kelancaran cashflow Tarif ditetapkan dengan Keputusan Kepala Daerah Kerjasamasama investasi/KSO dapat dilakukan untuk mendorong pengembangan dan peningkatan skala usaha

PENDAPATAN BLUD
Seluruh pendapatan RSUD (kecuali yang berasal dari

hibah terikat) dapat dikelola langsung untuk membiayai pengeluaran BLUD sesuai RBA Seluruh pendapatan RSUD (kecuali dari APBD APBN) dilaksanakan melalui rekening kas RSUD Seluruh pendapatan dilaporkan kepada PPKD setiap triwulan

SUMBER PENDAPATAN
Jasa Layanan
Hasil Kerjasama Lain-lain pendapatan BLUD yang sah

Hibah
APBD/APBN

JASA LAYANAN
Pelayanan IRD/UGD Pelayanan Rawat Jalan/Poliklinik Pelayanan Rawat Inap Pelayanan Farmasi Pelayanan Radiologi Pelayanan Laboratorium Pelayanan IBS/Bedah Sentral Rehabilitasi Medik Ambulance

HASIL KERJASAMA
Misalnya : Pengelolaan Parkir Sewa Kantin Sewa Warung Sewa Ruang Lainnya

LAIN-LAIN PENDAPATAN RS
Jasa Giro Bunga Deposito

Diklat
Incenerator Lainnya

PEMBIAYAAN/PENGELUARAN
Biaya Operasional Biaya non Operasional Biaya Investasi

Anggaran Biaya 2011 (Non Gaji PNS)


JENIS BIAYA Biaya Operasional Biaya Non Operasional Pengeluaran Investasi Pengeluaran Pendanaan/Pembiayaan JUMLAH 2010 28,516,648,000 2,374,800,000 % 65.59 7.69 2011 32,256,632,900 1,922,945,000 % 65.99 5.63

30,891,448,000

34,179,577,900

Biaya Operasional
Meliputi : - Biaya Pelayanan - Biaya Umum dan Administrasi

Belanja non Operasional


Meliputi : - Biaya bunga - Biaya administrasi bank - Biaya kerugian penjualan aset tetap - Biaya kerugian penurunan nilai - Biaya non operasional lain-lain

Pengeluara Investasi
Meliputi : - Biaya Pembelian Tanah - Biaya untuk Sarana Fisik - Biaya untuk Peralatan dan Mesin

BLUD dapat melakukan pinjaman pendek atau jangka panjang Pinjaman jangka panjang persetujuan kepala daerah

jangka

wajib

mendapat jangka

BLUD dapat melakukan investasi pendek maupun jangka panjang Investasi jangka panjang persetujuan kepala daerah

wajib

mendapat

Untuk meningkatkan kualitas dan kuantitas pelayanan, BLUD dapat melakukan kerjasama

patients payment method


Regular/cash
ASKES (PNS) Jamkesmas (central/national government health

insurance) Jamkesos (province government, DIY) Jamkesda (yogyakarta (city) government) Jamsostek (for workers/employee of a certain company) Other cooperation/colaboration

JUMLAH PASIEN BERDASARKAN CARA BAYAR RSUD KOTA YOGYAKARTA 2010


Rawat Jalan (%) 27.40 48.33 20.40 3.27 0.60 100 IRD (%) 62.23 12.55 21.64 2.11 1.48 100 Rawat Inap (%) 36.27 21.52 38.46 3.62 0.13 100

JENIS PASIEN Umum/Kas Askes PNS Jamkesmas, Jamkesos, Jamkesda Asuransi Lain Lainnya Jumlah

PENDAPATAN BERDASARKAN CARA BAYAR PASIEN RSUD KOTA YOGYAKARTA


CARA BAYAR Umum/Kas Askes PNS Jamkesmas (Pemerintah Pusat) Jamkesos (Propinsi DIY) Jamkesda (Pemerintah Kota ) Jamsostek (Jaminan Tenaga Kerja) Lainnya Jumlah 2010 13,745,967,620 5,841,925,650 9,350,231,625 2,212,626,572 1,029,605,199 592,543,821 310,477,094 33,083,377,581 % 41.55 17.66 28.26 6.69 3.11 1.79 0.94 2011 sd September 8,808,567,870 7,101,269,378 6,892,381,070 1,230,622,882 870,077,392 448,039,581 67,505,267 25,418,463,440 % 34.65 27.94 27.12 4.84 3.42 1.76 0.27

UMUM/TUNAI
Dasar Pembayaran

Peraturan Walikota tentang Tarif pelayanan Kesehatan pada RSUD Kota Yogyakarta Dibayar sebesar tagihan yang dikeluarkan oleh Kasir

ASKES
Peserta PNS, TNI dan Polri
Dasar Klaim Askes adalah MOU antara Rumah

Sakit dengan ASKES Dasar MOU adalah Keputusan Menteri Kesehatan tentang Tarif Pelayanan Kesehatan Peserta PT Askes

Proses Klaim Pasien Askes


Pengajuan klaim dilakukan secara kolektif oleh RS

setiap bulan, selambat-lambatnya tanggal 10 bulan berikutnya. Besaran nilai besaran klaim yang diajukan mengacu pada MOU antara PT. Askes dengan RS. Pembayaran atas tagihan klaim RS dilakukan oleh PT. Askes selambat-lambatnya 7 hari kerja tertanggal Form Pengajuan Klaim, melalui mekanisme transfer ke rekening RS.

Petugas Pengelola Askes


Petugas PT. Askes sebagai penerbit SJP (Surat

Jaminan Pelayanan), Petugas Entry Data Pelayanan, bertugas melakukan proses entry data pelayanan pasien Askes ke dalam software PT Askes sesuai dengan tarif yang tercantum dalam MOU, Verifikator dari PT. Askes, melaksanakan verifikasi atas kebenaran entry data dari petugas peng-entry data pelayanan.

Petugas Administrasi Keuangan, melakukan

pengajuan pembayaran atas pelayanan terhadap pasien Askes berdasarkan hasil verifikasi dari verifikator PT. Askes, dimana PT Askes akan menindaklanjuti dengan melakukan pembayaran melalui transfer ke rekening RS sesuai dengan pengajuan pembayaran.

JAMKESMAS (health insurance for society)


Participant/member : poor family
Jamkesmas claims are based on the tariff

released by the ministry of health suitable with the diagnosis and medical procedures of a certain disease.

Operation
Source of capital/funds (national/government fund)

APBN

The capital/fund is transferred directly from the department of health to the next PPK (hospital) banks account The next PPK is responsible for the usage of the funds, they need to report the usage of the fund through software that has been decided (hardcopy and softcopy)

responsibility report is legal after the approval (in the form of news event) that has been signed by the director and independent verificator Responsibility reports is sent to the Central Jamkesmas Management team, and copy of these are also sent to the Province Jamkesmas Management team and Regency/city Jamkesmas Management team as monitoring materials. Central Jamkesmas management team verify and inform the result of final verification as the foundation for responsibility reports on the jamkesmas capital usage.

Jamkesmas management officer in the hospital


SKP publisher officer (Surat Keabsahan Peserta)

(member validation letter) Jamkesmas - PT Askes, publish/release SKP Jamkesmas with the guidance of SK Bupati/Walikota (regent/major of town legal letter) about the participant/member who are listed in the Jamkesmas participant quota Coder officer (medical record), has a duty to translate diagnosis and procedures which are done by the doctor according to ICD-X and ICD-IX CM, and put those translation in the entry of Jamkesmas software (INA-CBGs).

Claim administration officer, has a duty to do a research (checking) on the completion of claim files and conduct the next administration procedure, then finally submit the claim files to the Jamkesmas verificator officer. Independent of Ministry authority to whether it is not.

verificators, are the assistant of Health RI that had the verify hospital claim proposal, acceptable to be covered or it is

JAMKESDA
Type of member

KMS, Reccomendation, Jamkesda GTT/PTT/ Naban , RT/RW/PT, religion/elderly people, health program, Yes 118, Merapi eruption victims Services Outpatient services Class III inpatient services

JAMKESDA patients claiming method


Inpatient services has to get guarantee proof

from UPT Penyelenggara Jaminan Kesehatan Daerah (PJKD) (Local Government Health insurance provider) re-imburse is acceptable for inpatient service For outpatient services, the patient need to pay in advance, and claim the payment to the UPT PJKD afterwards (re-imburse) Hospital claims proposal is based on hospital services tariff, and the payment from Jamkesda is suitable with the Jamkesda tariff after being verified by Jamkesda verificator.

JAMKESOS
Member/Participant/target
People with social issues/problems
Poor family that is not covered by

Jamkesmas program Kader Posyandu/ Posyandu officer Programs specific target Services Outpatient service Class III inpatient services

JAMKESOS patients claiming method


Claim is collectively proposed based on hospital services tariff for maximum at the 5th date of the next respective month. Claim proposal that has been stated valid and complete will be verified by the Jamkesos verificator
Verification results is given to the hospital together with payment transfer receipt, for maximum 15 days after the claim stated complete and valid.

JAMSOSTEK
Member

participated in the Jamsostek program Services (suitable with the MoU) Outpatient services Inpatient services (class II facilitation service)

The workers/employee and their family

Claims are based on : The tariff of hospital services

JAMSOSTEK patients claiming method


Patient brings the bill from hospital to get the

insurance claim from PT Jamsostek PT. Jamsostek verifies all of the services fee to decide the amount of service fee covered by PT Jamsostek and the amount of service fee that should be paid by the patients themselves (the fee is not covered by the insurance). The patients pay the fee thats not covered by PT Jamsostek by cash, and service fee thats covered by PT Jamsostek will be paid collectively by PT Jamsostek to the hospital through transfer method.