Disampaikan oleh Dra Antik Suharyanti MSi Wadir Umum dan Keuangan
Berdasarkan pengelolaannya Rumah Sakit dibagi : Rumah Sakit Publik Rumah Sakit Privat.
Sakit Publik dikelola Pemerintah Kota Yogyakarta Tipe B Terakreditasi 12 jenis pelayanan
oleh
PNS/PNS
40 210 17 12 4 5 34
NABAN/
PTT 15 9 2 7
JUMLAH
40 225 26 12 4 7 41
72
394
65
98
137
492
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
30,891,448,000
34,179,577,900
Biaya Operasional
Meliputi : - Biaya Pelayanan - Biaya Umum dan Administrasi
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
insurance) Jamkesos (province government, DIY) Jamkesda (yogyakarta (city) government) Jamsostek (for workers/employee of a certain company) Other cooperation/colaboration
JENIS PASIEN Umum/Kas Askes PNS Jamkesmas, Jamkesos, Jamkesda Asuransi Lain Lainnya Jumlah
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
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.
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.
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.
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.
(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
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
JAMSOSTEK
Member
participated in the Jamsostek program Services (suitable with the MoU) Outpatient services Inpatient services (class II facilitation service)
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.