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UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI

JANUARI 2017

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG
1 RJTL 2,713 451,166,661 536,600,800 (68,070,842)
Echokardiografi 164 144,173,200 54,251,200 (89,922,000)

USG Kandungan
& Kebidanan
13 2,924,700 4,046,900 1,603,500
Katarak 9 46,604,450 32,744,700 (20,354,750)
Fisioteraphy 1,217 147,416,200 145,079,700 (20,438,899)
HD 167 155,867,780 137,858,500 (17,959,640)
4,283 948,152,991 910,581,800 (37,571,191)

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG
2 RITL:
-kls 1 83 382,232,300 334,670,700 (67,161,142)
-kls 2
135 544,994,525 470,112,100 (36,532,060)
-kls 3 92 338,418,277 278,867,300 (25,362,740)
subtotal 310 1,265,645,102 1,083,650,100 (129,055,942)
Iur Naik Kelas 42,018,375
Grand Total 310 1,223,626,727 1,083,650,100 (139,976,627)

Jenis Pelayanan Jumlah Klaim Rawat I


Kelas 1 83 Januari 201
Kelas 2 135
1,400,000,000 1,
Kelas 3 92
Rata - rata LOS 4 1,200,000,000

Iur Naik Kelas 42,018,375 1,000,000,000


Tarif RS 1,265,645,102 800,000,000
Tarif Inacbg 1,083,650,100
600,000,000
400,000,000
200,000,000
83 135 92 4
-
42,018,3
Jumlah
Klaim terbayar

Bulan Rawat Jalan Rawat Inap Total Klaim


Januari 902,843,300 1,072,147,100 1,974,990,400

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI JANUA

JUMLAH TARIF

GRAND TOTAL
NO BULAN KLAIM
RS INACBG SELISIH TARIF
TERBAYAR

JANUARI

1 RAJAL 948,152,991 910,581,800 (37,571,191)


RANAP 1,223,626,727 1,083,650,100 (139,976,627) 1,974,990,400
TOTAL 2,171,779,718 1,994,231,900 (177,547,818)
S RS MEKAR SARI

RATA -RATA RATA - RATA RATA-RATA


LOS JENIS PELAYANAN
TARIF RS TARIF INACBG LOS

166,298 197,789 Rawat Jalan


879,105 330,800 Echokardiografi

USG Kandungan &


224,977 311,300
Kebidanan

5,178,272 3,638,300 Katarak


121,131 119,211 Fisioteraphy
933,340 825,500 HD
221,376 212,604 Total

RATA -RATA RATA - RATA RATA-RATA


LOS JENIS PELAYANAN
TARIF RS TARIF INACBG LOS

Rawat Jalan
303 3,678,460 3,637,725 3.65 Echokardiografi
USG Kandungan &
534 4,036,996 3,482,312 3.96
Kebidanan
352 3,678,460 3,031,166 3.83 Katarak
1,189 4,082,726 3,495,645 3.84 Fisioteraphy
HD
1,189 3,947,182.99 3,495,645 3.84 Total

Klaim Rawat Inap


Januari 2017 Kelas 1

1,265,645,102 Kelas 2
1,083,650,100
Kelas 3

Rata - rata LOS

Iur Naik Kelas

Tarif RS

3 135 92 4 Tarif Inacbg


42,018,375
Jumlah
Tagihan BPJS Terbayar
Januari 2017
2,500,000,000
1,974,990,400
2,000,000,000 Rawat Jalan
Rawat Inap
1,500,000,000 Total Klaim
1,072,147,100
1,000,000,000 902,843,300

500,000,000

-
Januari

H SAKIT MEKAR SARI JANUARI 2017

SELISIH JUMLAH PERSENTASE


PERSENTASE
KLAIM KLAIM
KLAIM
TERBAYAR TERBAYAR DARI
TERBAYAR DARI
DENGAN JUMLAH TARIF
TARIF RS
TARIF INA INA/KODING

(19,241,500) 99% 91%


Rawat Jalan
TARIF GROUPING Januari 2017
TARIF RS 1,000,000,000
INACBG
900,000,000 Rawat Jalan
451,166,661 536,600,800 800,000,000
Echokardiograf
144,173,200 54,251,200 700,000,000
600,000,000 USG Kandungan
& Kebidanan
500,000,000
2,924,700 4,046,900
400,000,000 Katarak
46,604,450 32,744,700
147,416,200 145,079,700 300,000,000 Fisioteraphy
155,867,780 137,858,500 200,000,000
HD
948,152,991 910,581,800 100,000,000
0 Total
TARIF RS TARIF GROUPING INACBG

JUMLAH
KASUS

2,713
164 Jumlah Kasus
4,500
Jenis Pelayanan
13 4,000 Rawat Jalan
9 3,500
2,713 Echokardiog
3,000
1,217 2,500
4,283 USG Kandun
167 2,000 Kebidanan
4,283 1,500
1,000 Katarak
500 1,217
0 164 13 9 167 Fisioteraph
JUMLAH KASUS HD
Total
an
17
Rawat Jalan

Echokardiograf

USG Kandungan
& Kebidanan

Katarak

Fisioteraphy

HD

Total
NG INACBG

sus
anan
Rawat Jalan
Echokardiograf

4,283 USG Kandungan &


Kebidanan
Katarak

167 Fisioteraphy
HD
Total
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI
FEBUARI 2017

JENIS TARIF
JUMLAH
NO PELAYANA TARIF RS GROUPING SELISIH
KASUS
N INACBG

1 RJTL 2,564 452,714,880 545,949,100 (68,070,842)


Echokardiograf 179 126,831,300 59,213,200 (67,618,100)
USG
Kandungan &
Kebidanan 13 3,240,200 4,843,700 1,603,500
Katarak 11 60,376,050 40,021,300 (20,354,750)
Fisioteraphy 1,180 159,057,099 138,618,200 (20,438,899)
HD 173 154,420,140 136,460,500 (17,959,640)
4,120 956,639,669 925,106,000 (31,533,669)

JENIS TARIF
JUMLAH
NO PELAYANA TARIF RS GROUPING SELISIH
KASUS
N INACBG

2 RITL:
-kls 1 83 462,135,430 363,503,600 (67,161,142)
-kls 2 126 539,799,085 479,265,300 (36,532,060)
-kls 3 92 424,839,764 306,554,500 (25,362,740)
subtotal 301 1,426,774,279 1,149,323,400 (129,055,942)
Iur Naik Kelas 70,603,770
Grand Total 301 1,356,170,509 1,149,323,400 (206,847,109)

Jenis Pelayanan Jumlah


Kelas 1 83 Klaim Rawat Inap
Kelas 2 126 Febuari 2017
Kelas 3 92 1600000000
1,426,774,279
Rata - rata LOS 4 1400000000
Iur Naik Kelas 70,603,770 1200000000 1,149,323,4
Tarif RS 1,426,774,279 1000000000
Tarif Inacbg 1,149,323,400
800000000
600000000
400000000
200000000 70,603,770
83 126 92 4
0
Jumlah
400000000
200000000 70,603,770
83 126 92 4
0
Jumlah

Klaim terbayar

Bulan Rawat Jalan Rawat Inap Total Klaim Tag


Febuari 882,271,100 1,159,110,300 2,041,381,400

2,500,000,000

2,000,000,000

1,500,000,000

1,000,000,000 882

500,000,000

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI FEBRUARI

JUMLAH TARIF

GRAND TOTAL
NO BULAN
RS INACBG SELISIH TARIF KLAIM TERBAYAR

FEBRUARI
RAJAL 956,639,669 925,106,000 (31,533,669)
1
RANAP 1,356,170,509 1,149,323,400 (206,847,109) 2,041,381,400
TOTAL 2,312,810,178 2,074,429,400 (238,380,778)
JS RS MEKAR SARI

RATA - RATA
RATA -RATA RATA-RATA
LOS TARIF
TARIF RS LOS
INACBG

176,566 212,929
708,555 330,800

249,246 372,592

5,488,732 3,638,300
134,794 117,473
892,602 788,789
232,194 224,540

RATA - RATA
RATA -RATA RATA-RATA
LOS TARIF
TARIF RS LOS
INACBG

338 4,617,824 3,951,126 4.07


471 4,284,120 3,803,693 3.74
339 4,617,824 3,332,114 3.68
1,148 4,740,114 3,818,350 3.81

1,148 4,505,549.86 3,818,350 3.81

Klaim Rawat Inap


Febuari 2017
1,426,774,279
Kelas 1
1,149,323,400 Kelas 2
Kelas 3
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

70,603,770
92 4

Jumlah
Tarif Inacbg

70,603,770
92 4

Jumlah

Tagihan BPJS Terbayar


Febuari 2017
2,500,000,000
2,041,381,400
2,000,000,000 Rawat Jalan
Rawat Inap
1,500,000,000
1,159,110,300 Total Klaim

1,000,000,000 882,271,100

500,000,000

-
Febuari

H SAKIT MEKAR SARI FEBRUARI 2017

SELISIH KLAIM
PERSENTASE PERSENTASE
TERBAYAR
KLAIM TERBAYAR KLAIM
DENGAN
DARI TARIF TERBAYAR
JUMLAH TARIF
INA/KODING DARI TARIF RS
INACBG

(33,048,000) 98% 88%


JENIS PELAYANAN TARIF RS
TARIF GROUPING
INACBG
Raw
Feb
Rawat Jalan 452,714,880 545,949,100 1,200,000,000
Echokardiografi 126,831,300 59,213,200
1,000,000,000
USG Kandungan & Kebidanan
3,240,200 4,843,700
800,000,000
Katarak 60,376,050 40,021,300
Fisioteraphy 159,057,099 138,618,200
600,000,000
HD 154,420,140 136,460,500
Total 956,639,669 925,106,000
400,000,000

200,000,000

JENIS PELAYANAN JUMLAH KASUS


0
TARIF RS T
Rawat Jalan 2,564
Echokardiografi 179
USG Kandungan & Kebidanan 13
Katarak 11
Fisioteraphy 1,180
HD 173 Jum
Total 4,120 Jenis
4,500

4,000

3,500

3,000
2,564
2,500

2,000

1,500

1,000

500
179
13 11
0
1,500

1,000

500
179
13 11
0
JUMLAH K
Rawat Jalan
Febuari 2017
200,000,000

000,000,000 Rawat Jalan


Echokardiograf
USG Kandungan &
800,000,000 Kebidanan
Katarak
600,000,000 Fisioteraphy
HD
Total
400,000,000

200,000,000

0
TARIF RS TARIF GROUPING INACBG

Jumlah Kasus
Jenis Pelayanan
,500
4,120
,000

,500 Rawat Jalan


Echokardiograf
,000 USG Kandungan &
Kebidanan
2,564
,500 Katarak
Fisioteraphy
,000 HD
Total
,500
1,180
,000

500
179 173
13 11
0
,500
1,180
,000

500
179 173
13 11
0
JUMLAH KASUS
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI
MARET 2017

JENIS JUMLAH TARIF GROUPING


NO TARIF RS SELISIH LOS
PELAYANAN KASUS INACBG

1 RJTL 3,174 567,582,484 623,787,800 (68,070,842)


Echokardiografi 161 113,601,200 53,258,800 (60,342,400)
USG
Kandungan &
Kebidanan 10 2,006,000 3,113,000 1,107,000
Katarak 7 37,621,075 25,468,100 (12,152,975)
Fisioteraphy 1,450 194,342,299 172,120,800 (22,221,499)
HD 214 208,405,312 176,657,000 (31,748,312)
5,016 1,123,558,370 1,054,405,500 (69,152,870)

JENIS JUMLAH TARIF GROUPING


NO TARIF RS SELISIH LOS
PELAYANAN KASUS INACBG

2 RITL:
-kls 1 94 523,707,142 456,546,000 (67,161,142) 404
-kls 2 658
180 730,688,560 694,156,500 (36,532,060)
-kls 3 134 458,672,740 433,310,000 (25,362,740) 512
subtotal 408 1,713,068,442 1,584,012,500 (129,055,942) 1,574
Iur Naik Kelas 60,288,085
Grand Total 408 1,652,780,357 1,584,012,500 (68,767,857) 1,574

Jenis Pelayanan Jumlah


Kelas 1
Kelas 2
94
180
Klaim Rawat Inap
Kelas 3 134 Maret 2017
Rata - rata LOS 4 1800000000 1,652,780,357
1,584,012,500
Iur Naik Kelas 60,288,085 1600000000
Tarif RS 1,652,780,357 1400000000
Tarif Inacbg 1,584,012,500 1200000000
1000000000
800000000
600000000
400000000
200000000
94 180 134 4 60,288,085
0
Jumlah

Klaim terbayar
Tagihan B
Mare
3,000,000,000
2,500,000,000
2,000,000,000
Bulan Rawat Jalan Rawat Inap Total Klaim
Tagihan B
Maret 1,049,761,600 1,588,870,100 2,638,631,700 Mare
3,000,000,000
2,500,000,000
2,000,000,000 1,588
1,500,000,000
1,049,761,600
1,000,000,000
500,000,000
-
M

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI MARET 2017

JUMLAH TARIF

SELISIH JUMLAH
GRAND TOTAL
KLAIM TERBAYAR
NO BULAN KLAIM
RS INACBG SELISIH TARIF DENGAN JUMLAH
TERBAYAR
TARIF INACBG

MARET
RAJAL 1,123,558,370 1,054,405,500 (69,152,870)
1
RANAP 1,652,780,357 1,584,012,500 (68,767,857) 2,638,631,700 213,700
TOTAL 2,776,338,727 2,638,418,000 (137,920,727)
R SARI

RATA -RATA TARIF RATA - RATA RATA-RATA


JENIS PELAYANAN
RS TARIF INACBG LOS

178,822 196,530 Rawat Jalan


705,598 330,800 Echokardiografi

USG Kandungan &


200,600 311,300
Kebidanan

5,374,439 3,638,300 Katarak


134,029 118,704 Fisioteraphy
973,857 825,500 HD
223,995 210,208 Total

RATA -RATA TARIF RATA - RATA RATA-RATA


JENIS PELAYANAN
RS TARIF INACBG LOS

Rawat Jalan
3,422,931 3,407,060 4.30 Echokardiografi
USG Kandungan &
4,059,381 3,856,425 3.66
Kebidanan
3,422,931 3,233,657 3.82 Katarak
4,198,697 3,882,384 3.86 Fisioteraphy
HD
4,050,932.25 3,882,384 3.86 Total

m Rawat Inap
aret 2017
1,652,780,357
1,584,012,500 Kelas 1
Kelas 2
Kelas 3
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

4 60,288,085

umlah

Tagihan BPJS Terbayar


Maret 2017
2,638,631,700

Rawat Jalan
Tagihan BPJS Terbayar
Maret 2017
2,638,631,700

Rawat Jalan
1,588,870,100 Rawat Inap
1,049,761,600 Total Klaim

Maret

EKAR SARI MARET 2017

PERSENTASE KLAIM PERSENTASE


TERBAYAR DARI KLAIM TERBAYAR
TARIF INA/KODING DARI TARIF RS

100% 95%
TARIF GROUPING
TARIF RS
INACBG Rawat Jalan
567,582,484 623,787,800
Maret 2017
1,200,000,000
113,601,200 53,258,800 1,000,000,000
800,000,000 Rawat Jal
600,000,000
400,000,000
2,006,000 3,113,000 200,000,000 Echokard
0 Fisiotera
37,621,075 25,468,100 G
F RS CB Total
194,342,299 172,120,800 RI IN
A
TA
208,405,312 176,657,000 NG
UPI
1,123,558,370 1,054,405,500 RO
FG
RI
TA

JUMLAH KASUS

3,174
161
Jumlah Kasus
10
7 6,000 Jenis Pelayanan
1,450 5,016
5,000
214
5,016 4,000
3,174
3,000

2,000 1,450
1,000
161 10 7 214
0
JUMLAH KASUS
Rawat Jalan
Maret 2017
Rawat Jalan USG Kandungan &
Kebidanan
Echokardiograf Katarak
Fisioteraphy HD
RS G Total
ACB
IN
NG
UPI
RO
FG
RI

Jumlah Kasus
Jenis Pelayanan
5,016 Rawat Jalan
Echokardiograf
USG Kandungan &
Kebidanan
Katarak
1,450 Fisioteraphy
HD
1 10 7 214
Total
JUMLAH KASUS
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI
Apr-17

JENIS TARIF
JUMLAH
NO PELAYANA TARIF RS GROUPING SELISIH LOS
KASUS
N INACBG
1 RJTL 2,690 485,284,740 525,731,200 40,446,460
Echokardiogr 169 120,709,800 55,905,200 (64,804,600)
USG
Kandungan
1,029,000
&
Kebidanan 9 1,782,600 2,811,600
Katarak 15 42,273,750 27,958,500 (14,315,250)
Fisioteraphy 1,358 182,062,400 160,430,200 (21,632,200)
HD 214 211,071,440 176,657,000 (34,414,440)
4,455 ### 949,493,700 (93,691,030)

JENIS TARIF
JUMLAH
NO PELAYANA TARIF RS GROUPING SELISIH LOS
KASUS
N INACBG
2 RITL:
-kls 1 82 409,830,389 326,593,800 (83,236,589) 320
-kls 2 475
123 540,254,510 468,956,500 (71,298,010)
-kls 3 116 531,460,313 389,217,100 ### 444
subtotal 321 ### 1,184,767,400 ### 1,239
Iur Naik Kelas 15,516,630
Grand Total 321 ### 1,184,767,400 ### 1,239

Jenis PelayanaJumlah
Kelas 1 82
Kelas 2 123
Kelas 3 116 Klaim Rawat Inap
Rata - rata LOS 4 April 2017
Iur Naik Kelas 15,516,630
Tarif RS 1,481,545,212 1600000000 1,481,545,212
Tarif Inacbg 1,184,767,400 1400000000
1,184,767,4
1200000000
1000000000
800000000
600000000
400000000
200000000
82 123 116 4 15,516,630
0
Jumlah
600000000
400000000
200000000
82 123 116 4 15,516,630
0
Jumlah

Klaim terbayar
Tagihan B
Bulan Rawat Jalan Rawat Inap Total Klaim Apr
April 942,677,100 ### 2,130,263,100
2,500,000,000

2,000,000,000

1,500,000,000
1,18
942,677,100
1,000,000,000

500,000,000

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI APRIL 2017

JUMLAH TARIF

SELISIH JUMLAH
GRAND TOTAL
KLAIM TERBAYAR
NO BULAN KLAIM
RS INACBG SELISIH TARIF DENGAN JUMLAH
TERBAYAR
TARIF INACBG

APRIL
RAJAL 1,043,184,730 949,493,700 (93,691,030)
1
RANAP 1,466,028,582 1,184,767,400 (281,261,182) 2,130,263,100 (3,998,000)
TOTAL 2,509,213,312 2,134,261,100 (374,952,212)
R SARI

RATA -RATA RATA - RATA RATA-RATA


JENIS PELAYANAN
TARIF RS TARIF INACBG LOS

180,403 195,439 Rawat Jalan


714,259 330,800 Echokardiografi

USG Kandungan &


198,067 312,400
Kebidanan

2,818,250 1,863,900 Katarak


134,067 118,137 Fisioteraphy
986,315 825,500 HD
234,160 213,130 Total

RATA -RATA RATA - RATA RATA-RATA


JENIS PELAYANAN
TARIF RS TARIF INACBG LOS

Rawat Jalan
4,997,932 3,982,851 3.90 Echokardiografi
USG Kandungan &
4,392,313 3,812,654 3.86
Kebidanan
4,581,554 3,355,320 3.83 Katarak
4,615,406 3,690,864 3.86 Fisioteraphy
HD
4,567,067.23 3,690,864 3.86 Total

m Rawat Inap
pril 2017
1,481,545,212
Kelas 1
Kelas 2
1,184,767,400
Kelas 3
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

4 15,516,630

mlah
Tarif Inacbg

4 15,516,630

mlah

Tagihan BPJS Terbayar


April 2017
2,130,263,100
Rawat Jalan
Rawat Inap
1,187,586,000 Total Klaim
942,677,100

April

EKAR SARI APRIL 2017

PERSENTASE
KLAIM PERSENTASE KLAIM
TERBAYAR DARI TERBAYAR DARI
TARIF TARIF RS
INA/KODING

100% 85%
TARIF GROUPING
TARIF RS
INACBG
Rawat Jalan
April 2017
485,284,740 525,731,200
1,200,000,000
120,709,800 55,905,200
1,000,000,000

800,000,000
1,782,600 2,811,600
42,273,750 27,958,500 600,000,000
182,062,400 160,430,200
211,071,440 176,657,000 400,000,000
1,043,184,730 949,493,700
200,000,000

0
TARIF RS TARIF GROUPING INA
JUMLAH KASUS

2,690
169
Jumlah Kasus
9 Jenis Pelayanan
15 5,000
1,358 4,455
4,500
214
4,000
4,455
3,500
3,000 2,690
2,500
2,000
1,500 1,358

1,000
500 169 214
9 15
0
JUMLAH KASUS
Rawat Jalan
April 2017
Rawat Jalan
Echokardiograf
USG
Kandungan &
Kebidanan
Katarak
Fisioteraphy
HD
Total

RIF RS TARIF GROUPING INACBG

Jumlah Kasus
Jenis Pelayanan
4,455
Rawat Jalan

Echokardiograf

USG Kandungan &


Kebidanan

Katarak
1,358 Fisioteraphy

HD
214
9 15 Total
UMLAH KASUS
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI
MEI 2017

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG

1 RJTL 3,083 469,236,763 607,891,300 138,654,537


Echokardiografi 216 147,051,600 71,452,800 (75,598,800)
USG Kandungan
1,021,400
& Kebidanan 10 1,810,000 2,831,400
Katarak 4 21,578,000 14,553,200 (7,024,800)
Fisioteraphy 1,252 173,856,540 156,621,300 (17,235,240)
HD 235 222,237,700 193,992,500 (28,245,200)
4,800 ### 1,047,342,500 11,571,897

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG

2 RITL:
-kls 1 99 482,122,005 378,345,400 ###
-kls 2
158 755,940,508 593,388,300 ###
-kls 3 122 514,779,498 369,751,400 ###
subtotal 379 ### 1,341,485,100 (411,356,911)
Iur Naik Kelas 59,086,160
Grand Total 379 ### 1,341,485,100 (411,356,911)

Jenis Pelayanan Jumlah


Kelas 1 99
Kelas 2 158 Klaim Rawat Inap
Kelas 3 122 Mei 2017
Rata - rata LOS 4
1800000000 1,693,755,851
Iur Naik Kelas 59,086,160
Tarif RS 1,693,755,851 1600000000
1400000000 1,341,485
Tarif Inacbg 1,341,485,100
1200000000
1000000000
800000000
600000000
400000000
200000000
99 158 122 4 59,086,160
0
Jumlah
600000000
400000000
200000000
99 158 122 4 59,086,160
0
Jumlah

Klaim terbayar
Tagiha
Bulan Rawat Jalan Rawat Inap Total Klaim
Mei 1,036,690,000 ### 2,364,798,600
2,500,000,000

2,000,000,000

1,500,000,000
1,036,690,
1,000,000,000

500,000,000

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI MEI 2017

JUMLAH TARIF

GRAND TOTAL
BULAN KLAIM
RS INACBG SELISIH TARIF TERBAYAR

MEI
RAJAL 1,035,770,603 1,047,342,500 11,571,897
1
RANAP 1,693,755,851 1,341,485,100 (352,270,751) 2,364,798,600
TOTAL 2,729,526,454 2,388,827,600 (340,698,854)
PJS RS MEKAR SARI

RATA -
RATA -RATA RATA RATA-RATA
LOS JENIS PELAYANAN
TARIF RS TARIF LOS
INACBG
152,201 197,175 Rawat Jalan
680,794 330,800 Echokardiografi
USG Kandungan &
181,000 283,140
Kebidanan
5,394,500 3,638,300 Katarak
138,863 125,097 Fisioteraphy
945,692 825,500 HD
215,786 218,196 Total

RATA -
RATA -RATA RATA RATA-RATA
LOS JENIS PELAYANAN
TARIF RS TARIF LOS
INACBG
Rawat Jalan
382 4,869,919.24 ### 3.86 Echokardiografi
USG Kandungan &
4,784,433.59 ### 3.94
622 Kebidanan
491 4,219,504.08 ### 4.02 Katarak
1495 4,624,912.96 ### 3.94 Fisioteraphy
HD
1495 4,469,012.80 3,539,539 3.94 Total

Klaim Rawat Inap


Mei 2017
1,693,755,851
Kelas 1
1,341,485,100 Kelas 2
Kelas 3
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

158 122 4 59,086,160

Jumlah
158 122 4 59,086,160

Jumlah

Tagihan BPJS Terbayar


Mei 2017
2,500,000,000 2,364,798,600

2,000,000,000
Rawat Jalan
Rawat Inap
1,500,000,000 1,328,108,600 Total Klaim
1,036,690,000
1,000,000,000

500,000,000

-
Mei

MAH SAKIT MEKAR SARI MEI 2017

SELISIH JUMLAH PERSENTASE PERSENTASE


KLAIM TERBAYAR KLAIM TERBAYAR KLAIM
DENGAN JUMLAH DARI TARIF TERBAYAR
TARIF INACBG INA/KODING DARI TARIF RS

(24,029,000) 99% 87%


TARIF GROUPING Rawat Jalan
TARIF RS
INACBG Mei
2017
469,236,763 607,891,300
147051600 71,452,800 1,200,000,000

1,000,000,000
1,810,000 2,831,400
800,000,000
21,578,000 14,553,200
173,856,540 156,621,300 600,000,000
222,237,700 193,992,500
400,000,000
1,035,770,603 1,047,342,500
200,000,000

-
TARIF RS TARIF GROUPING INACBG

JUMLAH KASUS

3,083
216
Jumlah Kasus
10 Jenis Pelayanan
4 6,000
1,252
235 5,000 4,800
4,800
4,000
3,083
3,000

2,000
1,252
1,000
216 235
10 4
0
JUMLAH KASUS
wat Jalan
Mei
2017
Rawat Jalan
Echokardiograf
USG Kandungan
& Kebidanan
Katarak
Fisioteraphy
HD
Total

TARIF GROUPING INACBG

mlah Kasus
nis Pelayanan

4,800 Rawat Jalan

Echokardiograf

USG Kandungan &


Kebidanan

Katarak

Fisioteraphy
1,252
HD
235
Total
KASUS
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI
JUNI 2017

TARIF
JUMLAH
NO JENIS PELAYANAN TARIF RS GROUPING
KASUS
INACBG
1 RJTL 2,080 330,784,640 352,900,030
Echokardiografi 118 79,649,400 39,034,400
USG Kandungan &
Kebidanan 5 928,800 1,566,400
Katarak 1 5,372,250 3,638,300
Fisioteraphy 948 131,461,080 122,361,700
HD 223 207,361,630 184,086,500
3,375 755,557,800 703,587,330

TARIF
JUMLAH
NO JENIS PELAYANAN TARIF RS GROUPING
KASUS
INACBG
2 RITL:
-kls 1 77 445,525,782 319,552,500
-kls 2
137 718,292,977 546,827,300
-kls 3 117 481,755,090 352,008,100
subtotal 331 1,645,573,849 1,218,387,900
Iur Naik Kelas 63,984,595
Grand Total 331 1,581,589,254 1,218,387,900

Jenis Pelayanan Jumlah


Kelas 1 77
Kelas 2 137 Klaim
Kelas 3 117 Jun
Rata - rata LOS 4
Iur Naik Kelas 63,984,595 1,800,000,000
Tarif RS 1,645,573,849 1,600,000,000
Tarif Inacbg 1,218,387,900 1,400,000,000
1,200,000,000
1,000,000,000
800,000,000
600,000,000
400,000,000
200,000,000
77 137 117 4
-
Juml
Klaim terbayar

Bulan Rawat Jalan Rawat Inap Total Klaim


Juni 752,383,700 1,185,716,800 1,938,100,500

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SAR

JUMLAH TARIF

NO BULAN
RS INACBG SELISIH TARIF

JUNI
RAJAL 755,557,800 703,587,330 (51,970,470)
1
RANAP 1,581,589,254 1,218,387,900 (363,201,354)
TOTAL 2,337,147,054 1,921,975,230 (415,171,824)
IEW PASIEN BPJS RS MEKAR SARI
JUNI 2017

RATA -RATA RATA - RATA RATA-RATA


SELISIH LOS
TARIF RS TARIF INACBG LOS

22,115,390 159,031 169,663


(40,615,000) 674,995 330,800
637,600 185,760 313,280
(1,733,950) 5,372,250 3,638,300
(9,099,380) 138,672 129,074
(23,275,130) 929,873 825,500
(51,970,470) 223,869 208,470

RATA -RATA RATA - RATA RATA-RATA


SELISIH LOS
TARIF RS TARIF INACBG LOS

(125,973,282) 317 5,786,049 4,150,032 4.12


548 5,243,014 3,991,440 4.00
(171,465,677)
(129,746,990) 462 4,117,565 3,008,616 3.95
(427,185,949) 1327 4,971,522 3,680,930 4.01

(363,201,354) 1327 4,778,215.27 3,680,930.21 4.01

Klaim Rawat Inap


Juni 2017
00,000
1,645,573,849
00,000 Kelas 1
Kelas 2
00,000
1,218,387,900 Kelas 3
00,000 Rata - rata LOS
00,000 Iur Naik Kelas
Tarif RS
00,000
Tarif Inacbg
00,000
00,000
00,000 63,984,595
77 137 117 4
-
Jumlah
Tagihan BPJS Terbayar
Juni 2017
2,500,000,000

2,000,000,000 1,938,100,500
Rawat Jalan
Rawat Inap
1,500,000,000
1,185,716,800 Total Klaim

1,000,000,000 752,383,700

500,000,000

-
Juni

T JKN-BPJS RUMAH SAKIT MEKAR SARI JUNI 2017

SELISIH JUMLAH
PERSENTASE KLAIM PERSENTASE KLAIM
GRAND TOTAL KLAIM KLAIM TERBAYAR
TERBAYAR DARI TERBAYAR DARI
TERBAYAR DENGAN JUMLAH
TARIF INA/KODING TARIF RS
TARIF INACBG

1,938,100,500 16,125,270 101% 83%


JENIS PELAYANAN TARIF RS
TARIF GROUPING
INACBG
Rawat Jal
Juni
Rawat Jalan 330,784,640 352,900,030 2017
Echokardiografi 79,649,400 39,034,400 800,000,000
700,000,000
USG Kandungan & 600,000,000
500,000,000
Kebidanan 400,000,000
928,800 1,566,400 300,000,000
200,000,000
Katarak 5,372,250 3,638,300 100,000,000
-
Fisioteraphy 131,461,080 122,361,700 RS G
F CB
HD 207,361,630 184,086,500 RI IN
A
TA
Total 755,557,800 703,587,330 I NG
O UP
R
FG
RI
TA

JUMLAH
JENIS PELAYANAN
KASUS

Rawat Jalan 2,080


Echokardiografi 118 Jumlah K
USG Kandungan & Jenis Pelay
Kebidanan 5 4,000
Katarak 1
3,500
Fisioteraphy 948
HD 223 3,000
Total 3,375 2,500
2,080
2,000

1,500
948
1,000

500 223
118 5 1
-
JUMLAH KASUS
Rawat Jalan
Juni
2017 Rawat Jalan
,000 Echokardiograf
,000
,000 USG Kandungan &
,000
,000 Kebidanan
,000
,000
,000 Katarak
-
RS G Fisioteraphy
F CB
RI IN
A
HD
TA
NG
UPI Total
GRO
F
RI
TA

Jumlah Kasus
Jenis Pelayanan
3,375 Rawat Jalan

Echokardiograf

USG Kandungan &


2,080 Kebidanan

Katarak

948 Fisioteraphy

HD
118 223
5 1 Total
JUMLAH KASUS
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI
Jul-17

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG

1 RJTL 3,022 417,500,760 581,374,200 163,873,440


Echokardiografi 211 142,838,800 69,798,800 (73,040,000)
USG
Kandungan &
Kebidanan 11 2,143,400 3,424,300 1,280,900
Katarak 8 44,176,400 29,106,400 (15,070,000)
Fisioteraphy 1,079 147,504,800 135,385,000 (12,119,800)
HD 217 203,882,960 179,133,500 (24,749,460)
4,548 958,047,120 998,222,200 40,175,080

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG

2 RITL:
-kls 1 111 626,451,384 461,126,600 (165,324,784)
-kls 2
141 605,914,071 479,847,100 (126,066,971)
-kls 3 123 633,210,878 433,450,600 (199,760,278)
subtotal 375 1,865,576,333 1,374,424,300 (491,152,033)
Iur Naik Kelas 57,383,600
Grand Total 375 1,808,192,733 1,374,424,300 (433,768,433)

Jenis Pelayanan Jumlah


Kelas 1 111 Klaim Rawat Ina
Kelas 2 141 Juli 2017
Kelas 3 123
2,000,000,000 1,865,57
Rata - rata LOS 4
1,800,000,000
Iur Naik Kelas 57,383,600
1,600,000,000
Tarif RS 1,865,576,333 1
1,400,000,000
Tarif Inacbg 1,374,424,300
1,200,000,000
1,000,000,000
800,000,000
600,000,000
400,000,000
200,000,000
111 141 123 4 57,383,600
-
Jumlah
1,200,000,000
1,000,000,000
800,000,000
600,000,000
400,000,000
200,000,000
111 141 123 4 57,383,600
-
Jumlah

Klaim terbayar
Tagi
Bulan Rawat Jalan Rawat Inap Total Klaim
Juli 993,106,300 1,333,308,100 2,326,414,400
2,500,000,000

2,000,000,000

1,500,000,000

993,10
1,000,000,000

500,000,000

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI JULI 201

JUMLAH TARIF

GRAND TOTAL
NO BULAN
RS INACBG SELISIH TARIF KLAIM TERBAYAR

JULI
RAJAL 958,047,120 998,222,200 40,175,080
1
RANAP 1,808,192,733 1,374,424,300 (433,768,433) 2,326,414,400
TOTAL 2,766,239,853 2,372,646,500 (393,593,353)
RS MEKAR SARI

RATA -
RATA -RATA RATA RATA-RATA
LOS JENIS PELAYANAN
TARIF RS TARIF LOS
INACBG
138,154 192,381 Rawat Jalan
676,961 330,800 Echokardiografi

USG Kandungan &


194,855 311,300
Kebidanan

5,522,050 3,638,300 Katarak


136,705 125,473 Fisioteraphy
939,553 825,500 HD
210,652 219,486 Total

RATA -
RATA -RATA RATA RATA-RATA
LOS JENIS PELAYANAN
TARIF RS TARIF LOS
INACBG
Rawat Jalan
464 5,643,706 4,154,294 4.18 Echokardiografi
USG Kandungan &
558 4,297,263 3,403,171 3.96
Kebidanan
518 5,148,056 3,523,989 4.21 Katarak
1,540 4,974,870 3,665,131 4.11 Fisioteraphy
HD
1,540 4,821,847.29 3,665,131 4.11 Total

Klaim Rawat Inap


Juli 2017
1,865,576,333
Kelas 1
Kelas 2
1,374,424,300 Kelas 3
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

141 123 4 57,383,600

Jumlah
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

141 123 4 57,383,600

Jumlah

Tagihan BPJS Terbayar


Juli 2017
2,500,000,000 2,326,414,400

2,000,000,000
Rawat Jalan
Rawat Inap
1,500,000,000 1,333,308,100 Total Klaim
993,106,300
1,000,000,000

500,000,000

-
Juli

SAKIT MEKAR SARI JULI 2017

SELISIH JUMLAH
PERSENTASE
KLAIM PERSENTASE KLAIM
KLAIM
TERBAYAR TERBAYAR DARI
TERBAYAR DARI
DENGAN JUMLAH TARIF INA/KODING
TARIF RS
TARIF INACBG

(46,232,100) 98% 84%


TARIF RS
TARIF GROUPING Rawat Jalan
INACBG Juli
2017 Rawat Jala
417,500,760 581,374,200
142,838,800 69,798,800 1,200,000,000 Echokardi
USG Kand
1,000,000,000
Kebidanan
800,000,000 Katarak
2,143,400 3,424,300
Fisioterap
44,176,400 29,106,400 600,000,000
HD
147,504,800 135,385,000
400,000,000 Total
203,882,960 179,133,500
958,047,120 998,222,200 200,000,000

-
TARIF RS TARIF GROUPING INACBG

JUMLAH
KASUS

3,022
211 Jumlah Kasus
Jenis Pelayanan
11 5,000
4,548
8 4,500
1,079 Rawat Jala
4,000
217 3,500 Echokardio
4,548 3,022
3,000
USG Kandu
2,500 Kebidanan
2,000
Katarak
1,500
1,079
1,000 Fisioterap
500 211 217
11 8 HD
-
JUMLAH KASUS
Total
lan

Rawat Jalan
Echokardiograf
USG Kandungan &
Kebidanan
Katarak
Fisioteraphy
HD
Total

NG INACBG

Kasus
yanan
4,548
Rawat Jalan

Echokardiograf

USG Kandungan &


Kebidanan

Katarak

Fisioteraphy
7
HD

Total
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI
Aug-17

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG

1 RJTL 3,313 451,851,660 643,425,600 191,573,940


Echokardiografi 142 94,281,900 46,973,600 (47,308,300)
USG Kandungan
2,135,900
& Kebidanan 21 4,401,400 6,537,300
Katarak 7 39,280,620 25,468,100 (13,812,520)
Fisioteraphy 1,273 176,716,140 161,425,200 (15,290,940)
HD 241 227,657,960 198,945,500 (28,712,460)
4,997 994,189,680 1,082,775,300 88,585,620

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG

2 RITL:
-kls 1 104 563,858,022 398,522,900 (165,335,122)
-kls 2
151 774,765,137 565,923,100 (208,842,037)
-kls 3 125 526,174,290 380,399,200 (145,775,090)
subtotal 380 1,864,797,449 1,344,845,200 (519,952,249)
Iur Naik Kelas 39,464,275
Grand Total 380 1,825,333,174 1,344,845,200 480,487,974

Jenis Pelayanan Jumlah


Kelas 1 104 Klaim Ra
Kelas 2 151 Agustu
Kelas 3 125
2,000,000,000
Rata - rata LOS 4
1,800,000,000
Iur Naik Kelas 39,464,275
1,600,000,000
Tarif RS 1,825,333,174
1,400,000,000
Tarif Inacbg 1,344,845,200
1,200,000,000
1,000,000,000
800,000,000
600,000,000
400,000,000
200,000,000
104 151 125 4 3
-
Jumlah
1,000,000,000
800,000,000
600,000,000
400,000,000
200,000,000
104 151 125 4 3
-
Jumlah

Klaim terbayar
T
Bulan Rawat Jalan Rawat Inap Total Klaim
Agustus 1,077,914,300 1,333,784,900 2,411,699,200
3,000,000,000

2,500,000,000

2,000,000,000

1,500,000,000
1,
1,000,000,000

500,000,000

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI AGUS

JUMLAH TARIF

GRAND TOTAL
NO BULAN
RS INACBG SELISIH TARIF KLAIM TERBAYAR

AGUSTUS
RAJAL 994,189,680 1,082,775,300 88,585,620
1
RANAP 1,825,333,174 1,344,845,200 (480,487,974) 2,411,699,200
TOTAL 2,819,522,854 2,427,620,500 (391,902,354)
RS MEKAR SARI

RATA - RATA RATA-


RATA -RATA JENIS
LOS TARIF RATA
TARIF RS PELAYANAN
INACBG LOS

136,387 194,212 Rawat Jalan


663,957 330,800 Echokardiografi
USG Kandungan
209,590 311,300
& Kebidanan
5,611,517 3,638,300 Katarak
138,819 126,807 Fisioteraphy
944,639 825,500 HD
Total

RATA - RATA RATA-


RATA -RATA JENIS
LOS TARIF RATA
TARIF RS PELAYANAN
INACBG LOS

Rawat Jalan
413 5,421,712 3,831,951 3.97 Echokardiografi
USG Kandungan
609 5,130,895 3,747,835 4.03
& Kebidanan
498 4,209,394 3,043,194 3.98 Katarak
1,520 4,907,362 3,539,066 4.00 Fisioteraphy
HD
1,520 4,803,508.35 3,539,066 4.00 Total

Klaim Rawat Inap


Agustus 2017
1,825,333,174
Kelas 1
Kelas 2
1,344,845,200 Kelas 3
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

151 125 4 39,464,275

Jumlah
Iur Naik Kelas
Tarif RS
Tarif Inacbg

151 125 4 39,464,275

Jumlah

Tagihan BPJS Terbayar


Agustus 2017
3,000,000,000

2,500,000,000 2,411,699,200
Rawat Jalan
2,000,000,000 Rawat Inap
Total Klaim
1,500,000,000 1,333,784,900
1,077,914,300
1,000,000,000

500,000,000

-
Agustus

AKIT MEKAR SARI AGUSTUS 2017

SELISIH JUMLAH PERSENTASE


PERSENTASE KLAIM
KLAIM TERBAYAR KLAIM
TERBAYAR DARI TARIF
DENGAN JUMLAH TERBAYAR DARI
INA/KODING
TARIF INACBG TARIF RS

(15,921,300) 99% 86%


TARIF Rawat Jalan
TARIF RS GROUPING
INACBG
Agustus
2017 Rawat Jalan
451,851,660 643,425,600 Echokardiograf
1,200,000,000
94,281,900 46,973,600 USG Kandungan &
1,000,000,000 Kebidanan
Katarak
800,000,000
4,401,400 6,537,300 Fisioteraphy
39,280,620 25,468,100 600,000,000
HD
176,716,140 161,425,200 400,000,000 Total
227,657,960 198,945,500 200,000,000
994,189,680 1,082,775,300 -
TARIF RS TARIF GROUPING INACBG

JUMLAH
KASUS

3,313
142 Jumlah Kasus
Jenis Pelayanan
21 6,000
7
4,997
1,273 5,000 Rawat Jalan
241
Echokardiograf
4,997 4,000
3,313
USG Kandungan &
3,000 Kebidanan

2,000 Katarak
1,273
1,000 Fisioteraphy
142 241
21 7 HD
0
JUMLAH KASUS
Total
an
Rawat Jalan
Echokardiograf
USG Kandungan &
Kebidanan
Katarak
Fisioteraphy
HD
Total

G INACBG

Kasus
yanan
4,997
Rawat Jalan

Echokardiograf

USG Kandungan &


Kebidanan

Katarak

Fisioteraphy

HD

Total
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SAR
Sep-17

JUMLAH TARIF GROUPING


NO JENIS PELAYANAN TARIF RS
KASUS INACBG

1 RJTL 2,808 393,738,681 560,649,300


Echokardiografi 202 138,208,900 66,821,600
USG Kandungan &
Kebidanan 17 3,354,100 5,292,100
Katarak 6 32,227,100 29,106,400
Fisioteraphy 1,191 151,755,000 135,839,800
HD 231 220,269,560 190,690,500
4,455 939,553,341 988,399,700

JUMLAH TARIF GROUPING


NO JENIS PELAYANAN TARIF RS
KASUS INACBG
2 RITL:
-kls 1 108 553,762,662 515,812,900
-kls 2
122 628,800,389 513,379,200
-kls 3 135 550,978,457 503,594,800
subtotal 365 1,733,541,508 1,532,786,900
Iur Naik Kelas 55,442,500
Grand Total 365 1,678,099,008 1,532,786,900

Jenis Pelayanan Jumlah


Kelas 1 108 Klaim
Kelas 2 122 Septe
Kelas 3 135
1,800,000,000
Rata - rata LOS 4
Iur Naik Kelas 55,442,500 1,600,000,000
Tarif RS 1,678,099,008 1,400,000,000
Tarif Inacbg 1,532,786,900 1,200,000,000
1,000,000,000
800,000,000
600,000,000
400,000,000
200,000,000
108 122 135
-
Ju
400,000,000
200,000,000
108 122 135
-
Ju

Klaim terbayar

Bulan Rawat Jalan Rawat Inap Total Klaim


September 978,357,300 1,292,400,400 2,270,757,700

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI S

JUMLAH TARIF

NO BULAN
RS INACBG SELISIH TARIF

SEPTEMBER
RAJAL 939,553,341 988,399,700 48,846,359
1
RANAP 1,678,099,008 1,532,786,900 (145,312,108)
TOTAL 2,617,652,349 2,521,186,600 (96,465,749)
ASIEN BPJS RS MEKAR SARI
ep-17

RATA -RATA RATA - RATA RATA-RATA


SELISIH LOS
TARIF RS TARIF INACBG LOS

166,910,619 140,220.33 199,661.43


(71,387,300) 684,202.48 330,800.00
1,938,000 197,300.00 311,300.00
(3,120,700) 5,371,183.33 4,851,066.67
(15,915,200) 127,418.14 114,055.25
(29,579,060) 953,547.88 825,500.00
48,846,359 210,898.62 221,863.01

RATA -RATA RATA - RATA RATA-RATA


SELISIH LOS
TARIF RS TARIF INACBG LOS

(37,949,762) 402 5,127,432 4,776,045 3.72


5,154,102 4,208,026 4.43
(115,421,189) 541
(47,383,657) 523 4,081,322 3,730,332 3.87
(200,754,608) 1,466 4,749,429 4,199,416 4.02

(145,312,108) 1,466 4,597,532 4,199,416 4.02

Klaim Rawat Inap


September 2017
1,678,099,008
1,532,786,900 Kelas 1
Kelas 2
Kelas 3
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

108 122 135 4 55,442,500

Jumlah
108 122 135 4 55,442,500

Jumlah

Tagihan BPJS Terbayar


September 2017
2,500,000,000 2,270,757,700

2,000,000,000
Rawat Jalan
Rawat Inap
1,500,000,000 1,292,400,400 Total Klaim
978,357,300
1,000,000,000

500,000,000

-
September

S RUMAH SAKIT MEKAR SARI SEPTEMBER 2017

SELISIH JUMLAH
KLAIM
PERSENTASE KLAIM PERSENTASE KLAIM
GRAND TOTAL TERBAYAR
TERBAYAR DARI TERBAYAR DARI TARIF
KLAIM TERBAYAR DENGAN
TARIF INA/KODING RS
JUMLAH TARIF
INACBG

2,270,757,700 (250,428,900) 90% 87%


TARIF
JENIS
PELAYANAN
TARIF RS GROUPING Rawat Jalan
INACBG September
Rawat Jalan 393,738,681 560,649,300 2017
Echokardiografi 138,208,900 66,821,600
1,200,000,000
USG Kandungan
1,000,000,000
& Kebidanan 3,354,100 5,292,100
800,000,000
Katarak 32,227,100 29,106,400
600,000,000
Fisioteraphy 151,755,000 135,839,800
400,000,000
HD 220,269,560 190,690,500
200,000,000
Total 939,553,341 988,399,700
-
TARIF RS TARIF GROUPING INACBG

JENIS JUMLAH
PELAYANAN KASUS
Rawat Jalan 2,808
Echokardiografi 202 Jumlah Kasus
USG Kandungan Jenis Pelayanan
& Kebidanan 17 5,000
Katarak 6 4,455
4,500
Fisioteraphy 1,191 4,000
HD 231 3,500
Total 4,455 2,808
3,000
2,500
2,000
1,500 1,191
1,000
500 202 231
17 6
0
JUMLAH KASUS
awat Jalan
eptember
2017 Rawat Jalan
Echokardiograf
USG Kandungan &
Kebidanan
Katarak
Fisioteraphy
HD
Total

ARIF GROUPING INACBG

mlah Kasus
nis Pelayanan
4,455
Rawat Jalan

Echokardiograf

USG Kandungan &


Kebidanan

Katarak
1,191
Fisioteraphy
231
HD
KASUS
Total
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI
Oct-17

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG

1 RJTL 3,368 523,247,120 667,036,800 143,789,680


Echokardiografi 181 123,602,100 59,874,800 (63,727,300)
USG Kandungan
2,189,000
& Kebidanan 23 4,970,900 7,159,900
Katarak 12 66,042,910 43,659,600 (22,383,310)
Fisioteraphy 1,280 160,354,999 150,732,500 (9,622,499)
HD 232 220,584,723 191,516,000 (29,068,723)
5,096 1,098,802,752 1,119,979,600 21,176,848

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG

2 RITL:
-kls 1 123 722,531,351 525,995,200 (196,536,151)
-kls 2
156 706,164,635 589,372,300 (116,792,335)
-kls 3 134 659,021,747 510,689,300 (148,332,447)
subtotal 413 2,087,717,733 1,626,056,800 (461,660,933)
Iur Naik Kelas 74,766,092
Grand Total 413 2,012,951,641 1,626,056,800 386,894,841

Jenis Pelayanan Jumlah


Kelas 1 123 Klaim Ra
Kelas 2 156 Oktob
Kelas 3 134
2,500,000,000
Rata - rata LOS 4
Iur Naik Kelas 74,766,092
2,000,000,000
Tarif RS 2,012,951,641
Tarif Inacbg 1,626,056,800
1,500,000,000

1,000,000,000

500,000,000

123 156 134 4 7


-
Jumlah
1,000,000,000

500,000,000

123 156 134 4 7


-
Jumlah

Klaim terbayar
T
Bulan Rawat Jalan Rawat Inap Total Klaim
Oktober 1,120,253,600 1,543,091,800 2,663,345,400

3,000,000,000
2,500,000,000
2,000,000,000
1,500,000,000
1,
1,000,000,000
500,000,000
-

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI OKTO

JUMLAH TARIF

GRAND TOTAL
NO BULAN
RS INACBG SELISIH TARIF KLAIM TERBAYAR

OKTOBER
RAJAL 1,098,802,752 1,119,979,600 21,176,848
1
RANAP 2,012,951,641 1,626,056,800 (386,894,841) 2,663,345,400
TOTAL 3,111,754,393 2,746,036,400 (365,717,993)
RS MEKAR SARI

RATA - RATA RATA-


RATA -RATA JENIS
LOS TARIF RATA
TARIF RS PELAYANAN
INACBG LOS

155,358 198,051 Rawat Jalan


682,885 330,800 Echokardiografi
USG Kandungan
216,126 311,300
& Kebidanan
5,503,576 3,638,300 Katarak
125,277 117,760 Fisioteraphy
950,796 825,500 HD
215,621 219,776 Total

RATA - RATA RATA-


RATA -RATA JENIS
LOS TARIF RATA
TARIF RS PELAYANAN
INACBG LOS

Rawat Jalan
496 5,874,239 4,276,384 4.03 Echokardiografi
USG Kandungan
640 4,526,696 3,778,028 4.10
& Kebidanan
565 4,918,073 3,811,114 4.22 Katarak
1,701 5,055,007 3,937,184 4.12 Fisioteraphy
HD
1,701 4,873,974.92 3,937,184 4.12 Total

Klaim Rawat Inap


Oktober 2017

Kelas 1
2,012,951,641
Kelas 2
1,626,056,800 Kelas 3
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

156 134 4 74,766,092

Jumlah
Iur Naik Kelas
Tarif RS
Tarif Inacbg

156 134 4 74,766,092

Jumlah

Tagihan BPJS Terbayar


Oktober
2017
3,000,000,000 2,663,345,400
Rawat Jalan
2,500,000,000
Rawat Inap
2,000,000,000 Total Klaim
1,543,091,800
1,500,000,000
1,120,253,600
1,000,000,000
500,000,000
-
Oktober

KIT MEKAR SARI OKTOBER 2017

SELISIH JUMLAH PERSENTASE


PERSENTASE KLAIM
KLAIM TERBAYAR KLAIM
TERBAYAR DARI TARIF
DENGAN JUMLAH TERBAYAR DARI
INA/KODING
TARIF INACBG TARIF RS

(82,691,000) 97% 86%


TARIF RS
TARIF
GROUPING
Rawat Jalan
INACBG Oktober
2017 Rawat Jalan
523,247,120 667,036,800 Echokardiograf
1,200,000,000
123,602,100 59,874,800 USG Kandungan
1,000,000,000 Kebidanan
Katarak
4,970,900 7,159,900 800,000,000
Fisioteraphy
66,042,910 43,659,600 600,000,000
HD
160,354,999 150,732,500 400,000,000 Total
220,584,723 191,516,000 200,000,000
1,098,802,752 1,119,979,600
-
TARIF RS TARIF GROUPING INACBG

JUMLAH
KASUS

3,368
181 Jumlah Kasus
Jenis Pelayanan
23 6,000
12 5,096
5,000 Rawat Jalan
1,280
232 Echokardiograf
4,000
5,096 3,368
USG Kandungan
3,000 Kebidanan

2,000 Katarak
1,280
1,000 Fisioteraphy
181 232
23 12 HD
0
JUMLAH KASUS
Total
lan
er
Rawat Jalan
Echokardiograf
USG Kandungan &
Kebidanan
Katarak
Fisioteraphy
HD
Total

NG INACBG

asus
yanan
5,096
Rawat Jalan

Echokardiograf

USG Kandungan &


Kebidanan

Katarak

Fisioteraphy

HD

Total
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI
Nov-17

TARIF GROUPING
NO JENIS PELAYANAN JUMLAH KASUS TARIF RS SELISIH
INACBG

1 RJTL 3,339 467,239,958 659,017,800 191,777,842


Echokardiografi 203 136,656,800 67,152,400 (69,504,400)
USG Kandungan &
666,400
Kebidanan 7 1,512,700 2,179,100
Katarak 18 109,893,500 87,319,200 (22,574,300)
Fisioteraphy 1,177 148,975,000 137,415,700 (11,559,300)
HD 228 216,258,780 188,214,000 (28,044,780)
4,972 1,080,536,738 1,141,298,200 60,761,462

TARIF GROUPING
NO JENIS PELAYANAN JUMLAH KASUS TARIF RS SELISIH
INACBG
2 RITL:
-kls 1 104 631,361,895 487,056,800 (144,305,095)
-kls 2
133 546,088,824 475,807,700 (70,281,124)
-kls 3 135 547,582,008 464,896,200 (82,685,808)
subtotal 372 1,725,032,727 1,427,760,700 (297,272,027)
Iur Naik Kelas 38,732,050
Grand Total 372 1,686,300,677 1,427,760,700 258,539,977

Jenis Pelayanan Jumlah


Kelas 1
Kelas 2
104
134
Klaim
Kelas 3 133 Nov
Rata - rata LOS 4 1,800,000,000
Iur Naik Kelas 38,732,050 1,600,000,000
Tarif RS 1,682,979,977 1,400,000,000
Tarif Inacbg 1,421,788,500 1,200,000,000
1,000,000,000
800,000,000
600,000,000
400,000,000
200,000,000
104 134 133
-
Ju

Klaim terbayar

Bulan Rawat Jalan Rawat Inap Total Klaim


November 1,138,285,400 1,009,542,500 2,147,827,900

2,500,000,000
2,000,000,000
1,500,000,000
MASIH ADA BERKAS PENDING SEJUMLAH 400jt an 2,500,000,000
2,000,000,000
1,500,000,000
1,000,000,000
500,000,000
-

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI NO

JUMLAH TARIF

GRAND TOTAL
NO BULAN KLAIM
RS INACBG SELISIH TARIF TERBAYAR

NOVEMBER
RAJAL 1,080,536,738 1,141,298,200 60,761,462
1
RANAP 1,686,300,677 1,427,760,700 (258,539,977) 2,147,827,900
TOTAL 2,766,837,415 2,569,058,900 (197,778,515)
JS RS MEKAR SARI

RATA -RATA TARIF RATA - RATA TARIF RATA-RATA JENIS


LOS
RS INACBG LOS PELAYANAN

139,934 197,370 Rawat Jalan


673,186 330,800 Echokardiografi
USG Kandungan &
216,100 311,300
Kebidanan
6,105,194 4,851,067 Katarak
126,572 116,751 Fisioteraphy
948,503 825,500 HD
217,324 229,545 Total

RATA -RATA TARIF RATA - RATA TARIF RATA-RATA JENIS


LOS
RS INACBG LOS PELAYANAN
Rawat Jalan
446 6,070,787 4,683,238 4.29 Echokardiografi
USG Kandungan &
515 4,105,931 3,577,502 3.87
Kebidanan
531 4,056,163 3,443,676 3.93 Katarak
1,492 4,637,185 3,838,066 4.01 Fisioteraphy
HD
1,492 4,533,066.34 3,838,066 4.01 Total

Klaim Rawat Inap


November 2017
1,682,979,977
Kelas 1
1,421,788,500 Kelas 2
Kelas 3
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

104 134 133 4 38,732,050

Jumlah

Tagihan BPJS Terbayar


November
2017
2,500,000,000 Rawat Jalan
2,147,827,900
Rawat Inap
2,000,000,000
Total Klaim
1,500,000,000 1,138,285,400 1,009,542,500
Tagihan BPJS Terbayar
November
2017
2,500,000,000 Rawat Jalan
2,147,827,900
Rawat Inap
2,000,000,000
Total Klaim
1,500,000,000 1,138,285,400 1,009,542,500
1,000,000,000
500,000,000
-
November

SAKIT MEKAR SARI NOVEMBER 2017

SELISIH
JUMLAH KLAIM PERSENTASE
PERSENTASE KLAIM
TERBAYAR KLAIM TERBAYAR
TERBAYAR DARI
DENGAN DARI TARIF
TARIF RS
JUMLAH TARIF INA/KODING
INACBG

(421,231,000) 84% 78%


TARIF RS
TARIF GROUPING
INACBG Rawat Jalan
467,239,958 659,017,800
November Rawat Jalan
136,656,800 67,152,400 2017 Echokardiograf
USG Kandungan
1,200,000,000 Kebidanan
1,512,700 2,179,100 Katarak
1,000,000,000
109,893,500 87,319,200 800,000,000 Fisioteraphy
148,975,000 137,415,700 600,000,000 HD
216,258,780 188,214,000 400,000,000 Total
1,080,536,738 1,141,298,200 200,000,000
-
TARIF RS TARIF GROUPING INACBG

JUMLAH KASUS
3,339
203

7
18 Jumlah Kasus
1,177 6,000 Jenis Pelayanan
228 4,972 Rawat Jalan
5,000
4,972
Echokardiograf
4,000
3,339
USG Kandungan
3,000 Kebidanan
2,000 Katarak
1,177
1,000 Fisioteraphy
203 7 18 228
0 HD
JUMLAH KASUS Total
lan
ber Rawat Jalan
Echokardiograf
USG Kandungan &
Kebidanan
Katarak
Fisioteraphy
HD
Total

NG INACBG

asus
yanan
4,972 Rawat Jalan
Echokardiograf
USG Kandungan &
Kebidanan
Katarak
Fisioteraphy
HD
Total
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI
Dec-17

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG

1 RJTL 2,838 415,405,604 559,968,100 144,562,496


Echokardiografi 218 147,659,000 72,114,400 (75,544,600)
USG Kandungan
535,600
& Kebidanan 6 1,332,200 1,867,800
Katarak 11 59,107,200 50,936,200 (8,171,000)
Fisioteraphy 1,008 128,775,999 115,359,600 (13,416,399)
HD 226 215,443,079 186,563,000 (28,880,079)
4,307 967,723,082 986,809,100 19,086,018

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG

2 RITL:
-kls 1 117 625,417,170 534,390,500 (91,026,670)
-kls 2
144 682,436,630 547,602,700 (134,833,930)
-kls 3 104 402,653,750 317,375,100 (85,278,650)
subtotal 365 1,710,507,550 1,399,368,300 (311,139,250)
Iur Naik Kelas 50,591,147
Grand Total 365 1,659,916,403 1,399,368,300 260,548,103

Jenis Pelayanan Jumlah


Kelas 1 117 Klaim R
Kelas 2 144 Desem
Kelas 3 104
1,800,000,000
Rata - rata LOS 4
Iur Naik Kelas 50,591,147 1,600,000,000
Tarif RS 1,659,916,403 1,400,000,000
Tarif Inacbg 1,399,368,300 1,200,000,000
1,000,000,000
800,000,000
600,000,000
400,000,000
200,000,000
117 144 104 4
-
Jumlah
1,000,000,000
800,000,000
600,000,000
400,000,000
200,000,000
117 144 104 4
-
Jumlah

Klaim terbayar

Bulan Rawat Jalan Rawat Inap Total Klaim


Desember 967,405,400 1,028,517,100 1,995,922,500

2,500,000,000

2,000,000,000

1,500,000,000

1,000,000,000

500,000,000

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI DESEM

JUMLAH TARIF

GRAND TOTAL
NO BULAN
RS INACBG SELISIH TARIF KLAIM TERBAYAR

DESEMBER
RAJAL 415,405,604 559,968,100 144,562,496
1
RANAP 1,659,916,403 1,399,368,300 (260,548,103) 1,995,922,500
TOTAL 2,075,322,007 1,959,336,400 (115,985,607)
RS MEKAR SARI

RATA - RATA
RATA -RATA RATA- JENIS
LOS TARIF
TARIF RS RATA LOS PELAYANAN
INACBG

146,373 197,311 Rawat Jalan


677,335 330,800 Echokardiografi
USG Kandungan
222,033 311,300
& Kebidanan
5,373,382 4,630,564 Katarak
127,754 114,444 Fisioteraphy
953,288 825,500 HD
224,686 229,118 Total

RATA - RATA
RATA -RATA RATA- JENIS
LOS TARIF
TARIF RS RATA LOS PELAYANAN
INACBG

Rawat Jalan
454 5,345,446 4,567,440 3.88 Echokardiografi
USG Kandungan
566 4,739,143 3,802,797 3.93
& Kebidanan
429 3,871,671 3,051,684 4.13 Katarak
1,449 4,686,322 3,833,886 3.97 Fisioteraphy
HD
1,449 4,547,716.17 3,833,886 3.97 Total

Klaim Rawat Inap


Desember 2017
1,659,916,403
Kelas 1
1,399,368,300 Kelas 2
Kelas 3
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

7 144 104 4 50,591,147

Jumlah
Iur Naik Kelas
Tarif RS
Tarif Inacbg

7 144 104 4 50,591,147

Jumlah

Tagihan BPJS Terbayar


Desember
2017
2,500,000,000
1,995,922,500 Rawat Jalan
2,000,000,000
Rawat Inap
1,500,000,000 Total Klaim

967,405,400 1,028,517,100
1,000,000,000

500,000,000

-
Desember

KIT MEKAR SARI DESEMBER 2017

SELISIH JUMLAH PERSENTASE


PERSENTASE KLAIM
KLAIM TERBAYAR KLAIM
TERBAYAR DARI TARIF
DENGAN JUMLAH TERBAYAR DARI
INA/KODING
TARIF INACBG TARIF RS

36,586,100 102% 96%


TARIF RS
TARIF
GROUPING
Rawat Jalan
INACBG Desember
2017 Rawat Jalan
415,405,604 559,968,100 Echokardiograf
1,200,000,000
147,659,000 72,114,400 USG Kandungan
1,000,000,000 Kebidanan
Katarak
1,332,200 1,867,800 800,000,000
Fisioteraphy
59,107,200 50,936,200 600,000,000
HD
128,775,999 115,359,600 400,000,000 Total
215,443,079 186,563,000 200,000,000
967,723,082 986,809,100
-
TARIF RS TARIF GROUPING INACBG

JUMLAH
KASUS

2,838
218 Jumlah Kasus
Jenis Pelayanan
6 5,000
11 4,500 4,307
Rawat Jalan
1,008 4,000
226 3,500 Echokardiograf
4,307 3,000 2,838
USG Kandungan
2,500 Kebidanan
2,000
Katarak
1,500
1,008
1,000 Fisioteraphy
500 218 226
6 11 HD
0
JUMLAH KASUS
Total
lan
er
Rawat Jalan
Echokardiograf
USG Kandungan &
Kebidanan
Katarak
Fisioteraphy
HD
Total

NG INACBG

asus
yanan
4,307
Rawat Jalan

Echokardiograf

USG Kandungan &


Kebidanan

Katarak

Fisioteraphy

HD

Total
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SAR
TRIMESTER I 2017

JENIS TARIF GROUPING


NO JUMLAH KASUS TARIF RS
PELAYANAN INACBG

1 RJTL 8,451 1,471,464,025 1,706,337,700


Echokardiografi 504 384,605,700 166,723,200
USG Kandungan
& Kebidanan 36 8,170,900 12,003,600
Katarak 27 144,601,575 98,234,100
Fisioteraphy 3,847 500,815,598 455,818,700
HD 554 518,693,232 450,976,000
13,419 3,028,351,030 2,890,093,300

JENIS TARIF GROUPING


NO JUMLAH KASUS TARIF RS
PELAYANAN INACBG

2 RITL:
-kls 1 260 1,368,074,872 1,154,720,300
-kls 2
441 1,815,482,170 1,643,533,900
-kls 3 318 1,221,930,781 1,018,731,800
subtotal 1,019 4,405,487,823 3,816,986,000
Iur Naik Kelas 172,910,230
Grand Total 4,232,577,593 3,816,986,000

Jenis Pelayanan Jumlah


Kelas 1 260
Kelas 2 441 Klaim
Kelas 3 318 Trim
Rata - rata LOS 4
4,500,000,000
Iur Naik Kelas 172,910,230
4,000,000,000
Tarif RS 4,232,577,593
Tarif Inacbg 3,816,986,000 3,500,000,000
3,000,000,000
2,500,000,000
2,000,000,000
1,500,000,000
1,000,000,000
500,000,000
260 441 318
-
Jum
2,000,000,000
1,500,000,000
1,000,000,000
500,000,000
260 441 318
-
Jum

Klaim terbayar

Bulan Rawat Jalan Rawat Inap Total Klaim


Trimester I 2,834,876,000 3,820,127,500 6,655,003,500

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI TR

JUMLAH TARIF

NO BULAN
RS INACBG SELISIH TARIF

TRIMESTER I
RAJAL 3,028,351,030 2,890,093,300 (138,257,730)
1
RANAP 4,232,577,593 3,816,986,000 (415,591,593)
TOTAL 7,260,928,623 6,707,079,300 (553,849,323)
W PASIEN BPJS RS MEKAR SARI
MESTER I 2017

RATA-
RATA -RATA RATA - RATA
SELISISH LOS RATA
TARIF RS TARIF INACBG
LOS
234,873,675 174,117 201,910
(217,882,500) 763,107 330,800
3,832,700 226,969 333,433
(46,367,475) 5,355,614 3,638,300
(44,996,898) 130,183 118,487
(67,717,232) 936,269 814,036
(138,257,730) 225,676 215,373

RATA-
RATA -RATA RATA - RATA
SELISIH LOS RATA
TARIF RS TARIF INACBG
LOS

(213,354,572) 1,045 5,261,826 4,441,232 4.02


4,116,740 3,726,834 3.77
(171,948,270) 1,663
(203,198,981) 1,203 3,842,550 3,203,559 3.78
(588,501,823) 3,911 4,323,344 3,745,816 3.84

(415,591,593) 3,911 4,153,658 3,745,816 3.84

Klaim Rawat Inap


Trimester I 2017
00 4,232,577,593
00 3,816,986,000 Kelas 1
Kelas 2
00
Kelas 3
00 Rata - rata LOS
00 Iur Naik Kelas
00 Tarif RS
Tarif Inacbg
00
00
00 172,910,230
260 441 318 4
-
Jumlah
00
Tarif Inacbg
00
00
00 172,910,230
260 441 318 4
-
Jumlah

Total Tagihan BPJS Terbayar


Trimester I 2017
7,000,000,000 6,655,003,500

6,000,000,000
Rawat J
5,000,000,000
Rawat I
4,000,000,000 3,820,127,500
Total Kl
2,834,876,000
3,000,000,000
2,000,000,000
1,000,000,000
-
Trimester I

BPJS RUMAH SAKIT MEKAR SARI TRIMESTER I 2017

SELISIH JUMLAH
KLAIM PERSENTASE KLAIM PERSENTASE KLAIM
GRAND TOTAL KLAIM
TERBAYAR TERBAYAR DARI TERBAYAR DARI
TERBAYAR
DENGAN JUMLAH TARIF INA/KODING TARIF RS
TARIF INACBG

6,655,003,500 (52,075,800) 99% 92%


TARIF
JENIS PELAYANAN TARIF RS GROUPING Rawat Jalan
INACBG Trimester I
Rawat Jalan 1,471,464,025 1,706,337,700 2017
Echokardiografi 384,605,700 166,723,200
4,000,000,000
USG Kandungan &
2,000,000,000
Kebidanan 8,170,900 12,003,600
Katarak 144,601,575 98,234,100 -
TARIF RS TARIF GROUPING INA
Fisioteraphy 500,815,598 455,818,700
HD 518,693,232 450,976,000
Total 3,028,351,030 2,890,093,300

JUMLAH
JENIS PELAYANAN
KASUS
Jumlah Kasu
16,000
Jenis Pelayan
Rawat Jalan 8,451
14,000 13,41
Echokardiografi 504
USG Kandungan & 12,000
Kebidanan 36 10,000
8,451
Katarak 27 8,000
Fisioteraphy 3,847 6,000
HD 554 3,847
4,000
Total 13,419
2,000 554
504 36 27
0
JUMLAH KASUS
S Terbayar
2017
6,655,003,500

Rawat Jalan
Rawat Inap
Total Klaim
Rawat Jalan
Trimester I Rawat Jalan
Echokardiograf
2017 USG Kandungan &
Kebidanan
Katarak
Fisioteraphy
HD

TARIF RS TARIF GROUPING INACBG

Jumlah Kasus
Jenis Pelayanan
13,419
Rawat Jalan

Echokardiograf

USG Kandungan &


Kebidanan

3,847 Katarak

Fisioteraphy
4 36 27 554
HD
JUMLAH KASUS
Total
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SAR
TRIMESTER II 2017

JENIS TARIF GROUPING


NO JUMLAH KASUS TARIF RS
PELAYANAN INACBG

1 RJTL 9,143 1,263,091,101 1,785,449,100


Echokardiografi 555 375,329,600 183,594,000
USG Kandungan
49
& Kebidanan 9,898,900 15,253,700
Katarak 21 115,684,120 83,680,900
Fisioteraphy 3,543 475,975,940 432,650,000
HD 689 651,810,480 568,769,500
14,000 2,891,790,141 3,069,397,200

JENIS TARIF GROUPING


NO JUMLAH KASUS TARIF RS
PELAYANAN INACBG

2 RITL:
-kls 1 323 1,744,072,068 1,375,462,400
-kls 2
414 2,009,479,597 1,559,149,400
-kls 3 383 1,710,363,625 1,317,444,600
subtotal 1,120 5,463,915,290 4,252,056,400
Iur Naik Kelas 152,290,375
Grand Total 5,311,624,915 4,252,056,400

Jenis Pelayanan Jumlah


Kelas 1 323
Kelas 2 414 Klaim Ra
Kelas 3 383 Trimeste
Rata - rata LOS 4
Iur Naik Kelas 152,290,375 6,000,000,000

Tarif RS 5,311,624,915 5,000,000,000


Tarif Inacbg 4,252,056,400
4,000,000,000

3,000,000,000

2,000,000,000

1,000,000,000
323 414 383 4 152
-
Jumlah
2,000,000,000

1,000,000,000
323 414 383 4 152
-
Jumlah

Klaim terbayar

Bulan Rawat Jalan Rawat Inap Total Klaim


Trimester II 3,049,377,900 3,959,493,400 7,008,871,300

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR SARI TR

JUMLAH TARIF
NO BULAN
RS INACBG SELISIH TARIF
TRIMESTER II
RAJAL 2,891,790,141 3,069,397,200 177,607,059
1
RANAP 5,311,624,915 4,252,056,400 (1,059,568,515)
TOTAL 8,203,415,056 7,321,453,600 (881,961,456)
W PASIEN BPJS RS MEKAR SARI
MESTER II 2017

RATA -RATA RATA - RATA RATA-


SELISISH LOS
TARIF RS TARIF INACBG RATA LOS

522,357,999 138,148 195,280


(191,735,600) 676,270 330,800
5,354,800 202,018 311,300
(32,003,220) 5,508,768 3,984,805
(43,325,940) 134,343 122,114
(83,040,980) 946,024 825,500
177,607,059 206,556 219,243

RATA -RATA RATA - RATA RATA-


SELISIH LOS
TARIF RS TARIF INACBG RATA LOS

(368,609,668) 1,279 5,399,604 4,258,398 3.96


4,853,815 3,766,061 4.13
(450,330,197) 1,708
(392,919,025) 1,539 4,465,701 3,439,803 4.02
(1,211,858,890) 4,526 4,878,496 3,796,479 4.04

(1,059,568,515) 4,526 4,742,522 3,796,479 4.04

Klaim Rawat Inap


Trimester II 2017
5,311,624,915
Kelas 1
Kelas 2
4,252,056,400
Kelas 3
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg

323 414 383 4 152,290,375

Jumlah
Tarif RS
Tarif Inacbg

323 414 383 4 152,290,375

Jumlah

Total Tagihan BPJS Terbayar


Trimester II 2017
8,000,000,000
7,008,871,300
7,000,000,000
6,000,000,000 Rawa
Rawa
5,000,000,000
3,959,493,400 Total
4,000,000,000
3,049,377,900
3,000,000,000
2,000,000,000
1,000,000,000
-
Trimester II

PJS RUMAH SAKIT MEKAR SARI TRIMESTER II 2017

SELISIH JUMLAH
KLAIM PERSENTASE KLAIM PERSENTASE KLAIM
GRAND TOTAL KLAIM
TERBAYAR TERBAYAR DARI TERBAYAR DARI
TERBAYAR
DENGAN JUMLAH TARIF INA/KODING TARIF RS
TARIF INACBG

7,008,871,300 (312,582,300) 96% 85%


TARIF
JENIS PELAYANAN TARIF RS GROUPING Rawat Jal
INACBG Trimeste
Rawat Jalan 1,263,091,101 1,785,449,100 2017
Echokardiografi 375,329,600 183,594,000
3,500,000,000
USG Kandungan & 3,000,000,000
Kebidanan 9,898,900 15,253,700 2,500,000,000
Katarak 115,684,120 83,680,900 2,000,000,000
1,500,000,000
Fisioteraphy 475,975,940 432,650,000 1,000,000,000
HD 651,810,480 568,769,500 500,000,000
Total 2,891,790,141 3,069,397,200 -
TARIF RS TARIF GROU

JUMLAH
JENIS PELAYANAN
KASUS
Jumlah Kasu
16,000
Jenis Pelayan
Rawat Jalan 9,143 14,00
14,000
Echokardiografi 555
USG Kandungan & 12,000
Kebidanan 49 10,000 9,143
Katarak 21 8,000
Fisioteraphy 3,543 6,000
HD 689 4,000 3,543
Total 14,000
2,000 555 689
49 21
0
JUMLAH KASUS
Terbayar
017
,008,871,300

Rawat Jalan
Rawat Inap
Total Klaim
Rawat Jalan
Trimester II Rawat Jalan
2017 Echokardiograf
USG Kandungan &
Kebidanan
Katarak
Fisioteraphy
HD
Total

TARIF RS TARIF GROUPING INACBG

Jumlah Kasus
Jenis Pelayanan
14,000
Rawat Jalan

Echokardiograf

USG Kandungan &


Kebidanan

Katarak
3,543
Fisioteraphy
5 689
49 21
HD
JUMLAH KASUS
Total
UTILIZATION REVIEW PASIEN BPJS RS MEKAR SARI
TRIMESTER II 2017

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISISH
PELAYANAN KASUS
INACBG

1 RJTL 9,143 1,263,091,101 1,785,449,100 522,357,999


Echokardiografi 555 375,329,600 183,594,000 (191,735,600)
USG Kandungan
49 5,354,800
& Kebidanan 9,898,900 15,253,700
Katarak 21 115,684,120 83,680,900 (32,003,220)
Fisioteraphy 3,543 475,975,940 432,650,000 (43,325,940)
HD 689 651,810,480 568,769,500 (83,040,980)
14,000 2,891,790,141 3,069,397,200 177,607,059

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING SELISIH
PELAYANAN KASUS
INACBG

2 RITL:
-kls 1 323 1,744,072,068 1,375,462,400 (368,609,668)
-kls 2 414 2,009,479,597 1,559,149,400 (450,330,197)
-kls 3 383 1,710,363,625 1,317,444,600 (392,919,025)
subtotal 1,120 5,463,915,290 4,252,056,400 (1,211,858,890)
Iur Naik Kelas 152,290,375
Grand Total 5,311,624,915 4,252,056,400 (1,059,568,515)
S MEKAR SARI

RATA - RATA RATA-


RATA -RATA
LOS TARIF RATA
TARIF RS
INACBG LOS

138,148 195,280
676,270 330,800
202,018 311,300
5,508,768 3,984,805
134,343 122,114
946,024 825,500
206,556 219,243

RATA - RATA RATA-


RATA -RATA
LOS TARIF RATA
TARIF RS
INACBG LOS

1,279 5,399,604 4,258,398 3.96


1,708 4,853,815 3,766,061 4.13
1,539 4,465,701 3,439,803 4.02
4,526 4,878,496 3,796,479 4.04

4,526 4,742,522.25 3,796,479 4.04


UTILIZATION REVIEW PASIEN BPJS RS MEKAR
SEMESTER I 2017

JENIS TARIF GROUPING


NO JUMLAH KASUS TARIF RS
PELAYANAN INACBG

1 RJTL 16,304 2,756,770,168 3,192,860,230


Echokardiografi 1,007 732,016,500 333,115,600
USG Kandungan
& Kebidanan 60 12,692,300 19,213,000
Katarak 47 213,825,575 144,384,100
Fisioteraphy 7,405 988,195,618 895,231,900
HD 1,226 1,159,364,002 1,005,712,000
26,049 5,862,864,163 5,590,516,830

JENIS TARIF GROUPING


NO JUMLAH KASUS TARIF RS
PELAYANAN INACBG

2 RITL:
-kls 1 518 2,705,553,048 2,179,212,000
-kls 2
859 3,829,970,165 3,252,706,000
-kls 3 673 2,749,925,682 2,129,708,400
subtotal 2,050 9,285,448,895 7,561,626,400
Iur Naik Kelas 311,497,615
Grand Total 8,973,951,280 7,561,626,400

Jenis Pelayanan Jumlah


Kelas 1 518
Kelas 2 859
Kelas 3 673
Rata - rata LOS 4
10,000,000,000
Iur Naik Kelas 311,497,615
9,000,000,000
Tarif RS 8,973,951,280
8,000,000,000
Tarif Inacbg 7,561,626,400
7,000,000,000
6,000,000,000
5,000,000,000
4,000,000,000
3,000,000,000
2,000,000,000
1,000,000,000
518 859
-
4,000,000,000
3,000,000,000
2,000,000,000
1,000,000,000
518 859
-

Klaim terbayar

Bulan Rawat Jalan Rawat Inap Total Klaim


Semester I 5,566,626,800 7,521,538,900 13,088,165,700

Klaim TL % dari Total Tarif INA % Klaim TL/Bulan


25,446,680 0.46% 0.08%
48,032,160 0.64% 0.11%

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT MEKAR S

JUMLAH TARIF
NO BULAN
RS INACBG SELISIH TARIF
SEMESTER I
RAJAL 5,862,864,163 5,590,516,830 (272,347,333)
1
RANAP 8,973,951,280 7,561,626,400 (1,412,324,880)
TOTAL 14,836,815,443 13,152,143,230 (1,684,672,213)
W PASIEN BPJS RS MEKAR SARI
ESTER I 2017

RATA-
RATA -RATA RATA - RATA
SELISISH LOS RATA
TARIF RS TARIF INACBG
LOS
436,090,062 169,086 195,833
(398,900,900) 726,928 330,800
6,520,700 211,538 320,217
(69,441,475) 4,549,480 3,072,002
(92,963,718) 133,450 120,896
(153,652,002) 945,648 820,320
(272,347,333) 225,071 214,615

RATA-
RATA -RATA RATA - RATA
SELISIH LOS RATA
TARIF RS TARIF INACBG
LOS

(526,341,048) 2,064 5,223,075 4,206,973 3.98


4,458,638 3,786,619 3.85
(577,264,165) 3,308
(620,217,282) 2,600 4,086,071 3,164,500 3.86
(1,723,822,495) 7,972 4,529,487 3,688,598 3.89

(1,412,324,880) 7,972 4,377,537 3,688,598 3.89

Klaim Rawat Inap


Semester I 2017
000
8,973,951,280
00 Kelas 1
00 7,561,626,400 Kelas 2
00 Kelas 3
Rata - rata LOS
00
Iur Naik Kelas
00
Tarif RS
00 Tarif Inacbg
00
00
00 311,497,615
518 859 673 4
-
Jumlah
00 Tarif Inacbg
00
00
00 311,497,615
518 859 673 4
-
Jumlah

Total Tagihan BPJS Terbayar


Semester I 2017
14,000,000,000 13,088,165,700

Jumlah Rupiah TL/Bulan 12,000,000,000


4,222,989.73 10,000,000,000
7,962,920.07 8,000,000,000 7,521,538,900

6,000,000,000 5,566,626,800

4,000,000,000
2,000,000,000
-
Semester I

BPJS RUMAH SAKIT MEKAR SARI SEMESTER I 2017

SELISIH JUMLAH
KLAIM PERSENTASE KLAIM PERSENTASE KLAIM
GRAND TOTAL KLAIM TERBAYAR TERBAYAR TERBAYAR DARI TERBAYAR DARI
DENGAN JUMLAH TARIF INA/KODING TARIF RS
TARIF INACBG

13,088,165,700 (63,977,530) 100% 88%

a. < 2 % Berkas Hilang atau tidak tertagih (Tidak layak )


Rawa :96 pasien Tidak Layak dengan tarif RS sebesar Rp. 25.446.68
Rawa :17 pasien Tidak Layak dengan tarif RS sebesar Rp. 48.032.1
TARIF
JENIS PELAYANAN TARIF RS GROUPING Rawat Jalan
INACBG Semester I
Rawat Jalan 2,756,770,168 3,192,860,230 2017
Echokardiografi 732,016,500 333,115,600
7,000,000,000
USG Kandungan &
Kebidanan 6,000,000,000
12,692,300 19,213,000
5,000,000,000
Katarak 213,825,575 144,384,100
Fisioteraphy 988,195,618 895,231,900 4,000,000,000

HD 1,159,364,002 1,005,712,000 3,000,000,000

Total 5,862,864,163 5,590,516,830 2,000,000,000


1,000,000,000
-
TARIF RS TARIF GROUPING
JUMLAH
JENIS PELAYANAN
KASUS

Rawat Jalan 16,304


Echokardiografi 1,007 Jumlah Ka
USG Kandungan & Jenis Pelay
Kebidanan 60
30,000
Katarak 47
Fisioteraphy 7,405 25,000
HD 1,226
Total 26,049 20,000
16,304
15,000

10,000
7,405

5,000
1,007 1,226
60 47
0
JUMLAH KASUS
S Terbayar
2017
13,088,165,700

Rawat Jalan
Rawat Inap
Total Klaim

f RS sebesar Rp. 25.446.680


if RS sebesar Rp. 48.032.160
Rawat Jalan
Semester I
2017 Rawat Jalan
Echokardiograf
USG Kandungan &
Kebidanan
Katarak
Fisioteraphy
HD
Total

TARIF RS TARIF GROUPING INACBG

Jumlah Kasus
Jenis Pelayanan
26,049
Rawat Jalan

Echokardiograf

USG Kandungan &


Kebidanan

Katarak
7,405
Fisioteraphy
007 1,226
60 47 HD
JUMLAH KASUS
Total
UTILIZATION REVIEW PASIEN BPJS RS ME
TAHUN 2017

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING
PELAYANAN KASUS
INACBG

1 RJTL 37,830 5,425,753,951 6,864,332,030


Echokardiografi 2,164 1,515,264,000 715,851,200
USG Kandungan
& Kebidanan 145 30,407,000 45,673,500
Katarak 109 564,553,305 409,980,000
Fisioteraphy 14,413 1,902,277,556 1,731,389,700
HD 2,601 2,463,461,064 2,140,774,500
57,262 11,901,716,876 11,908,000,930

TARIF
JENIS JUMLAH
NO TARIF RS GROUPING
PELAYANAN KASUS
INACBG

2 RITL:
-kls 1 1,185 6,428,935,532 5,102,116,900
-kls 2
1,706 7,774,139,851 6,424,638,100
-kls 3 1,429 6,069,546,812 4,740,113,600
subtotal 4,320 20,272,622,195 16,266,868,600
Iur Naik Kelas 627,877,279
Grand Total 4,320 19,644,744,916 16,266,868,600

Jenis Pelayanan Jumlah


Kelas 1 1,185
Kelas 2 1,706
Kelas 3 1,429
25,000,000,000
Rata - rata LOS 4
Iur Naik Kelas 627,877,279
20,000,000,000
Tarif RS 19,644,744,916
Tarif Inacbg 16,266,868,600
15,000,000,000

10,000,000,000

5,000,000,000

1,185 1,7
-
Klaim terbayar

Rawat Jalan Rawat Inap Total Klaim


11,841,949,100 15,062,183,700 26,904,132,800

nov&des, dengan asumsi

ANALISIS RASIO KEUANGAN DARI UNIT JKN-BPJS RUMAH SAKIT ME

JUMLAH TARIF GRAND TOTAL


BULAN
KLAIM TERBAYAR

RS INACBG Klaim Terbayar


RAJAL 11,901,716,876 11,908,000,930 11,841,949,100 6,284,054
RANAP 19,644,744,916 16,266,868,600 15,062,183,700 (3,377,876,316)
TOTAL 31,546,461,792 28,174,869,530 26,904,132,800 (3,371,592,262)

Note :
1. Klaim November Tahap 2 masih ada pendingan sebesar Rp. 412,778,500
2. Klaim Desember Tahap 2 masih ada pendingan sebesar Rp. 384.538.500

BULAN RS INACBG Klaim Terbayar


RAJAL 11,901,716,876 11,908,000,930 11,841,949,100
RANAP 19,644,744,916 16,266,868,600 15,062,183,700
TOTAL 31,546,461,792 28,174,869,530 26,904,132,800
31,546,4

19,644,744,916
19,644,744,916

PERSENTASE
KLAIM PERSENTASE 11,901,716,876
TERBAYAR DARI KLAIM TERBAYAR
TARIF DARI TARIF RS
INA/KODING

95% 85%
RS

KPI Unit JKN


Tahun 2017

PERSENTASE KLAIM TERBAYAR


DARI TARIF INA/KODING
PERSENTASE KLAIM TERBAYAR
DARI TARIF RS
47.18%
52.82%
EW PASIEN BPJS RS MEKAR SARI
TAHUN 2017

RATA - RATA
RATA -RATA RATA-RATA
SELISIH LOS TARIF
TARIF RS LOS
INACBG

1,438,578,079 143,425 181,452


(799,412,800) 700,214 330,800
15,266,500 209,703 314,990
(154,573,305) 5,179,388 3,761,284
(170,887,856) 131,983 120,127
(322,686,564) 947,121 823,058
6,284,054 207,847 207,956

RATA - RATA
RATA -RATA RATA-RATA
SELISIH LOS TARIF
TARIF RS LOS
INACBG

(1,326,818,632) 4,739 5,425,262 4,305,584 4.00


4,556,940 3,765,907 3.95
(1,349,501,751) 6,737
(1,329,433,212) 5,664 4,247,409 3,317,084 3.96
(4,005,753,595) 17,140 4,692,737 3,765,479 3.97

3,377,876,316 17,140 4,547,394.66 3,765,479 3.97

Klaim Rawat Inap


Tahun 2017
,000,000
Kelas 1
19,644,744,916 Kelas 2
,000,000
16,266,868,600 Kelas 3
Rata - rata LOS
,000,000
Iur Naik Kelas
Tarif RS
,000,000 Tarif Inacbg

,000,000

1,185 1,706 1,429 4 627,877,279


-
Jumlah
Tagihan BPJS Terbayar
Tahun
2017
30,000,000,000 26,904,132,800
Rawat Jalan
25,000,000,000 Rawat Inap
20,000,000,000 Total Klaim
15,062,183,700
15,000,000,000 11,841,949,100
10,000,000,000

5,000,000,000

BPJS RUMAH SAKIT MEKAR SARI TAHUN 2017

SELISIH TARIF
SELISIH TARIF KLAIM PERSENTASE PERSENTASE
KLAIM TERBAYAR TERBAYAR KLAIM TERBAYAR KLAIM
DENGAN DENGAN DENGAN DARI TARIF TERBAYAR DARI
TARIF RS DENGAN TARIF INA/KODING TARIF RS
INACBG

(59,767,776) (66,051,830)
(4,582,561,216) (1,204,684,900) 95% 85%
(4,642,328,992) (1,270,736,730)

Tagihan BPJS Kesehatan


RS Mekar Sari Tahun 2017

31,546,461,792

28,174,869,530
26,904,132,800

19,644,744,916

16,266,868,600
15,062,183,700
28,174,869,530
26,904,132,800

19,644,744,916

16,266,868,600
15,062,183,700

11,901,716,876 11,908,000,930 11,841,949,100

RS INACBG Kl ai m Terbayar

RAJAL RANAP TOTAL


TARIF
JENIS
TARIF RS GROUPING
PELAYANAN
INACBG

Rawat Jalan 5,425,753,951 6,864,332,030


Echokardiografi 1,515,264,000 715,851,200 14,000,000,000

USG Kandungan 12,000,000,000


& Kebidanan 30,407,000 45,673,500
10,000,000,000
Katarak 564,553,305 409,980,000
Fisioteraphy 1,902,277,556 1,731,389,700 8,000,000,000
HD 2,463,461,064 2,140,774,500 6,000,000,000
Total 11,901,716,876 11,908,000,930
4,000,000,000

2,000,000,000

-
JENIS TA
JUMLAH KASUS
PELAYANAN

Rawat Jalan 34,992


Echokardiografi 2,164
USG Kandungan
& Kebidanan 145 60,000
Katarak 109
Fisioteraphy 14,413
50,000
HD 2,601
Total 54,424
40,000
34,992

30,000

20,000

10,000
Kelas 1
Kelas 2 2,164
1
Kelas 3 0
Rata - rata LOS
Iur Naik Kelas
Tarif RS
Tarif Inacbg
Rawat Jalan
Rawat Inap
Total Klaim
Rawat Jalan
Tahun
2017
Rawat Jalan
14,000,000,000
Echokardiograf
12,000,000,000 USG Kandungan &
Kebidanan
10,000,000,000
Katarak
8,000,000,000 Fisioteraphy
6,000,000,000 HD

4,000,000,000 Total

2,000,000,000

-
TARIF RS TARIF GROUPING INACBG

Jumlah Kasus
Jenis Pelayanan
60,000
54,424

50,000 Rawat Jalan

Echokardiograf
40,000
34,992
USG Kandungan &
30,000 Kebidanan

20,000 Katarak
14,413

10,000 Fisioteraphy

2,164 2,601
145 109 HD
0
JUMLAH KASUS
Total