Non Operatif

Max 100,000
Min 70,000

No Nama Pasien NO KLAIM Bulan Jatah Kelas

1 MUHAMMAD MIRZA HAKIM AL-FATIH 0197r0150622v000106 Juli 2

2 FADHLY AMALUL HAFIZ 0197r0150622v000103 Juli 2
3 TITIN ISMAWATI 0197R0150722V000007 Juli 3
4 IKA PUTRI 0197r0150722v000010 Juli 3
5 RAFIFAH KHAIRIN MADINA 0197r0150722v000019 Juli 2
6 KUKUH PRASETYAWAN 0197R0150722V000023 Juli 3
7 EKA WIJAYANTI 0197r0150722v000027 Juli 3
8 HERRYS AGHISTA RACHMAN 0197R0150722V000017 Juli 1
9 DEA SANDRA VERONICA 0197R0150722V000034 Juli 2
10 SIGAR DINAR ANGGIH FATONY 0197r0150722v000025 Juli 2
11 LEMBAH KRISTIANINGTIAS 0197r0150722v000033 Juli 1
12 LENI YUNIARTI 0197r0150722v000042 Juli 2
13 DIAN MITAYANI 0197r0150722v000046 Juli 3
14 RICAH INDAH FAUZIAH 0197r0150722v000048 Juli 3
15 CINDI NOVITA SARI 0197r0150722v000056 Juli 3
16 ABD ROCHMAN 0197r0150722v000063 Juli 1
17 BUDIONO 0197r0150722v000064 Juli 2
18 LELY AFRIANTI 0197r0150722v000058 Juli 1
19 DESI RATNA SARI 0197r0150722v000071 Juli 2
20 SALMAICA CANDIA 0197r0150722v000073 Juli 2
21 TIARA AGMI DESERIA 0197r0150722v000069 Juli 2
22 BY NY SALMAICA CANDIA 0197r0150722v000079 Juli 3
23 FITRIYAH MADASARI 0197R0150722V000085 Juli 2
24 YUYUN SETYOWATI 0197r0150722v000087 Juli 3
25 SEPTIYAN DIAN TRISTIANA 0197r0150722v000089 Juli 2
26 INTAN DEWI ANGGRAENI 0197r0150722v000097 Juli 3
27 MAWAR KANASAWA NURNAWI PUTRI 0197R0150722V000099 Juli 2
DPJP Juni
Wahyu - -
Dr. SOEWARSI 660,000 -
Rizal FITNI 8,832,546 -
Mahfudz 900,000 -
Faria 3,161,178 -
Debby 300,010 -
Bambang 4,135,931 -
Dr. IGD 1,350,000 -
KEPERAWATAN & ADM 5,035,925 -
KRU OK 4,766,117 -
 Penempatan Klas los DPJP Jenis Penunjang Tarif INA (Disetujui)

2 3 dr. Soewarsi Non Operatif 1,334,400

2 4 dr. Soewarsi Non Operatif 3,913,100
3 3 dr. Mahfudz Non Operatif 1,112,000
3 2 dr. Faria Non Operatif 1,789,200
1 4 dr. Soewarsi Non Operatif 2,586,400
3 2 dr. Bambang Operatif 4,069,600
3 3 dr. Faria Non Operatif 1,789,200
1 6 dr. Mahfudz Non Operatif 1,509,900
2 3 dr. Faria Non Operatif 1,814,000
2 4 dr. Mahfudz Non Operatif 1,334,400
1 3 dr. Bambang Operatif 3,510,800
2 3 dr. Faria Operatif 5,614,200
3 3 dr. Rizal Operatif 4,422,400
3 3 dr. Rizal Operatif 4,422,400
3 3 dr. Rizal Operatif 4,422,400
vip 2 dr. Bambang Operatif 4,650,800
2 2 dr. Bambang Operatif 3,986,400
1 2 dr. Mahfudz Non Operatif 1,556,800
1 3 dr. Rizal Operatif 5,306,800
2 3 dr. Rizal Operatif 5,306,800
2 4 dr. Faria Operatif 5,306,800
3 5 dr. Debby Non Operatif 3,114,700
1 3 dr. Rizal Operatif 5,306,800
3 3 dr. Rizal Operatif 4,422,400
1 3 dr. Rizal Operatif 5,306,800
3 3 dr. Rizal Operatif 4,422,400
2 2 dr. Faria Operatif 1,814,000
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -

jepal Rad, USG, Lab Japel Medis

Klas I 118750 95000
Klas II 106250 85000
Klas III 93750 75000
 Berdasarkan Klas yang ditempati (per hari)
Maksimal (3 hari)

Jepel Operatif = Setuju

Japel IGD = Setuju
Japel Keperawatan & Admin (kebersamaa) = setuju
Japel Rawat jalan = Setuju
Japel Radiologi = Setuju
JRS = sesuai pembagian --> setuju
Japel Ruangan = dibagi berdasarkan kelas
Klas VIP 100000
Klasi I 90000
Klas II 80000
Klas III 70000
100000
90000
80000
70000
 100.00% 100.00%
JRS (A) JRS (B) Operatif
40% 58% 51%

Jasa Dokter

Target Rencana Indirect Indirect

Biaya Keuntungan
Keuntung pengemba Cost Cost (non
Investasi dan Risiko
an ngan (operatif) Operatif) Non
Operatif
Operatif

Iur (Naik
5.00% 5.00% 5.00% 21.00% 4.00% 21.50% 30.00% 12.50%
Kelas)

66,720 66,720 66,720 280,224 53,376 286,896 - 166,800

195,655 195,655 195,655 821,751 156,524 841,317 - 489,138
55,600 55,600 55,600 233,520 44,480 239,080 - 139,000
89,460 89,460 89,460 375,732 71,568 384,678 - 223,650
431,000 150,870 150,870 150,870 633,654 120,696 648,741 - 377,175
203,480 203,480 203,480 854,616 162,784 874,964 1,220,880 508,700
89,460 89,460 89,460 375,732 71,568 384,678 - 223,650
75,495 75,495 75,495 317,079 60,396 324,629 - 188,738
90,700 90,700 90,700 380,940 72,560 390,010 - 226,750
66,720 66,720 66,720 280,224 53,376 286,896 - 166,800
175,540 175,540 175,540 737,268 140,432 754,822 1,053,240 438,850
280,710 280,710 280,710 1,178,982 224,568 1,207,053 1,684,260 701,775
221,120 221,120 221,120 928,704 176,896 950,816 1,326,720 552,800
221,120 221,120 221,120 928,704 176,896 950,816 1,326,720 552,800
221,120 221,120 221,120 928,704 176,896 950,816 1,326,720 552,800
3,488,100 406,945 406,945 406,945 1,709,169 325,556 1,749,864 2,441,670 1,017,363
199,320 199,320 199,320 837,144 159,456 857,076 1,195,920 498,300
77,840 77,840 77,840 326,928 62,272 334,712 - 194,600
884,500 309,565 309,565 309,565 1,300,173 247,652 1,331,130 1,857,390 773,913
265,340 265,340 265,340 1,114,428 212,272 1,140,962 1,592,040 663,350
265,340 265,340 265,340 1,114,428 212,272 1,140,962 1,592,040 663,350
155,735 155,735 155,735 654,087 124,588 669,661 - 389,338
884,500 309,565 309,565 309,565 1,300,173 247,652 1,331,130 1,857,390 773,913
221,120 221,120 221,120 928,704 176,896 950,816 1,326,720 552,800
884,500 309,565 309,565 309,565 1,300,173 247,652 1,331,130 1,857,390 773,913
221,120 221,120 221,120 928,704 176,896 950,816 1,326,720 552,800
90,700 90,700 90,700 380,940 72,560 390,010 544,200 226,750
Nama Dokter Mei
Wahyu 677,320
dr. Soewarsi 1,090,600
Rizal -
Mahfudz 560,880
Faria -
Debby 1,869,600
Bambang 1,180,000
IGD 712,000
Keperawatan & 1,662,120
Kru OK 1,800,000

Japel Operatif 30% + Visite ruangan

Jepel Non Opera12,5% (dengan range yang
Japel IGD 50000
Perawat & Adm 5%
Japel Rad 70000

Japel
Klas VIP 228,000
Klas I 150,000
Klas II 120,000
Klas III 90,000

Obgyn
Japel Operator 968,394
Ruangan 300,000
1,268,394

Poli 55000
IGD 50000
 #REF! 210000 96.00%
Non Operatif
34%
Direct Cost

Pos
subsidi Penunjang
Japel Non (Koreksi Rata Rata Visite silang Jasa visite (Pemeriksaan Rad,
Operatif Japel / hari jasa Per Hari Maksimal / (kurang dokter USG Laborat dll)
(Koreksi) (LOS) (LOS) minimal lebih ruangan
Pembagia
n Japel)
Cek Jasa
Visite Pelayanan 7.00%
Ruangan
55,600 60,000 180,000 60,000 - 4,400 180,000 93,408
122,284 60,000 240,000 60,000 62,284 240,000 273,917
46,333 60,000 180,000 60,000 - 13,667 180,000 77,840
111,825 60,000 120,000 60,000 51,825 120,000 125,244
94,294 60,000 240,000 60,000 34,294 240,000 211,218
254,350 60,000 120,000 60,000 194,350 120,000 284,872
74,550 60,000 180,000 60,000 14,550 180,000 125,244
31,456 60,000 360,000 60,000 - 28,544 360,000 105,693
75,583 60,000 180,000 60,000 15,583 180,000 126,980
41,700 60,000 240,000 60,000 - 18,300 240,000 93,408
146,283 60,000 180,000 60,000 86,283 180,000 245,756
233,925 60,000 180,000 60,000 173,925 180,000 392,994
184,267 60,000 180,000 60,000 124,267 180,000 309,568
184,267 60,000 180,000 60,000 124,267 180,000 309,568
184,267 60,000 180,000 60,000 124,267 180,000 309,568
508,681 60,000 120,000 60,000 448,681 120,000 569,723
249,150 60,000 120,000 60,000 189,150 120,000 279,048
97,300 60,000 120,000 60,000 37,300 120,000 108,976
257,971 60,000 180,000 60,000 197,971 180,000 433,391
221,117 60,000 180,000 60,000 161,117 180,000 371,476
165,838 60,001 240,004 60,001 105,837 240,004 371,476
77,868 60,002 300,010 60,002 17,866 300,010 218,029
257,971 60,003 180,009 60,003 197,968 180,009 433,391
184,267 60,004 180,012 60,004 124,263 180,012 309,568
257,971 60,005 180,015 60,005 197,966 180,015 433,391
184,267 60,006 180,018 60,006 124,261 180,018 309,568
113,375 60,007 120,014 60,007 53,368 120,014 126,980
 Juni Juli Agustus
3,368,560 369,000 -
2,046,720 1,549,800 -
1,240,000 - 1,756,600
747,840 4,703,520 1,854,840
- 246,000 3,305,200
3,064,801 - 1,771,200
- 4,056,000 3,179,600
1,068,000 827,500 1,140,000
3,037,636 2,055,150 1,827,272
2,700,000 4,700,000 5,400,000

0% + Visite ruangan
2,5% (dengan range yang kurang dari 70000 dan tidak lebih dari 100000)

100000 70000-100000
90000
80000
70000

Klas 2 Bedah Umum

1,000,000 742,628 1,000,000
 180,000 200,000 180,000
1,180,000 942,628 1,180,000

65000
47000
 Non Operatif Jasa Dokter Rad, Lab, Total A Total B
5%
34% Visite Operatif & 96% 96%
Konsul (4%)
40% DARI
50,000
TARIF INA Obgyn

Jasa Kebersamaa
Penunjang
Dokter n (remun
(Pemeriksaan Rad, Obat
USG Laborat dll) Jasa Dokter Rad, Lab, non dokter)
dr. Operator
IGD Visite
Operatif &
Konsul

real cost 14.00% real cost 5.00% 52.27%

80,906 186,816 149,013 50,000 60,000 66,720 -

80,906 547,834 424,231 50,000 60,000 195,655 -
130,695 155,680 185,518 50,000 60,000 55,600 -
80,906 250,488 499,037 50,000 60,000 89,460 -
80,906 422,436 584,022 50,000 60,000 150,870 -
- 569,744 564,328 50,000 60,000 203,480 638,187.27
- 250,488 307,647 50,000 60,000 89,460 -
367,718 211,386 411,947 50,000 60,000 75,495 -
- 253,960 283,351 50,000 60,000 90,700 -
- 186,816 155,027 50,000 60,000 66,720 -
197,473 491,512 967,863 50,000 60,000 175,540 550,557.27
80,906 785,988 116,893 50,000 60,000 280,710 880,408.64
80,906 619,136 886,394 50,000 60,000 221,120 693,512.73
80,906 619,136 951,617 50,000 60,000 221,120 693,512.73
80,906 619,136 906,436 50,000 60,000 221,120 693,512.73
- 1,139,446 429,054 50,000 60,000 406,945 1,276,327.50
- 558,096 364,149 50,000 60,000 199,320 625,140.00
80,906 217,952 167,365 50,000 60,000 77,840 -
135,608 866,782 794,729 50,000 60,000 309,565 970,908.41
80,906 742,952 994,079 50,000 60,000 265,340 832,202.73
216,514 742,952 926,580 50,000 60,000 265,340 832,202.73
- 436,058 286,551 50,000 60,000 155,735 -
80,906 866,782 836,198 50,000 60,000 309,565 970,908.41
80,906 619,136 816,671 50,000 60,000 221,120 693,512.73
80,906 866,782 843,638 50,000 60,000 309,565 970,908.41
135,608 619,136 793,410 50,000 60,000 221,120 693,512.73
80,906 253,960 326,705 50,000 60,000 90,700 284,468.18
 3000000 1000000

Inhause
Perawat Perawat Bidan/ Pemerata
Dr. Anastesi Ast. Anastesi On Loop RR
Bedah Instrumen Perawat an
Lain

20.91% 5.00% 4.32% 3.64% 1.82% 1.82% 1.14% 9%

- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
255,274.91 61,044.00 52,719.82 44,395.64 22,197.82 22,197.82 13,873.64 110,989
- - - - - - - -
- - - - - - - -
- - - - - - - -
- - - - - - - -
220,222.91 52,662.00 45,480.82 38,299.64 19,149.82 19,149.82 11,968.64 95,749
352,163.45 84,213.00 72,729.41 61,245.82 30,622.91 30,622.91 19,139.32 153,115
277,405.09 66,336.00 57,290.18 48,244.36 24,122.18 24,122.18 15,076.36 120,611
277,405.09 66,336.00 57,290.18 48,244.36 24,122.18 24,122.18 15,076.36 120,611
277,405.09 66,336.00 57,290.18 48,244.36 24,122.18 24,122.18 15,076.36 120,611
510,531.00 122,083.50 105,435.75 88,788.00 44,394.00 44,394.00 27,746.25 221,970
250,056.00 59,796.00 51,642.00 43,488.00 21,744.00 21,744.00 13,590.00 108,720
- - - - - - - -
388,363.36 92,869.50 80,205.48 67,541.45 33,770.73 33,770.73 21,106.70 168,854
332,881.09 79,602.00 68,747.18 57,892.36 28,946.18 28,946.18 18,091.36 144,731
332,881.09 79,602.00 68,747.18 57,892.36 28,946.18 28,946.18 18,091.36 144,731
- - - - - - - -
388,363.36 92,869.50 80,205.48 67,541.45 33,770.73 33,770.73 21,106.70 168,854
277,405.09 66,336.00 57,290.18 48,244.36 24,122.18 24,122.18 15,076.36 120,611
388,363.36 92,869.50 80,205.48 67,541.45 33,770.73 33,770.73 21,106.70 168,854
277,405.09 66,336.00 57,290.18 48,244.36 24,122.18 24,122.18 15,076.36 120,611
113,787.27 27,210.00 23,499.55 19,789.09 9,894.55 9,894.55 6,184.09 49,473
 Perawat Perawat
dr. Operator Visite Ruangan Dr. Anastesi Ast. Anastesi
Bedah Instrumen

60.83% 20.26% 6.75% 6.08% 3.04%

70000-100000%
- 180,000.00 - - - -
- 240,000.00 - - - -
- 180,000.00 - - - -
- 120,000.00 - - - -
- 240,000.00 - - - -
742,627.74 120,000.00 247,295.04 82,431.68 74,262.77 37,131.39
- 180,000.00 - - - -
- 360,000.00 - - - -
- 180,000.00 - - - -
- 240,000.00 - - - -
640,656.93 180,000.00 213,338.76 71,112.92 64,065.69 32,032.85
1,024,489.05 180,000.00 341,154.85 113,718.28 102,448.91 51,224.45
807,007.30 180,000.00 268,733.43 89,577.81 80,700.73 40,350.36
807,007.30 180,000.00 268,733.43 89,577.81 80,700.73 40,350.36
807,007.30 180,000.00 268,733.43 89,577.81 80,700.73 40,350.36
1,485,200.73 120,000.00 494,571.84 164,857.28 148,520.07 74,260.04
727,445.26 120,000.00 242,239.27 80,746.42 72,744.53 36,372.26
- 120,000.00 - - - -
1,129,799.27 180,000.00 376,223.16 125,407.72 112,979.93 56,489.96
968,394.16 180,000.00 322,475.26 107,491.75 96,839.42 48,419.71
968,394.16 240,004.00 322,475.26 107,491.75 96,839.42 48,419.71
- 300,010.00 - - - -
1,129,799.27 180,009.00 376,223.16 125,407.72 112,979.93 56,489.96
807,007.30 180,012.00 268,733.43 89,577.81 80,700.73 40,350.36
1,129,799.27 180,015.00 376,223.16 125,407.72 112,979.93 56,489.96
807,007.30 180,018.00 268,733.43 89,577.81 80,700.73 40,350.36
331,021.90 120,014.00 110,230.29 36,743.43 33,102.19 16,551.09
DPJP MEI Mei JUNI Juni JULI
Wahyu 227,538 677,320 1,800,000 3,368,560 210,550
Dr. SOEWARSI 600,000 1,090,600 1,668,063 2,046,720 1,280,663
Rizal FITNI - - 1,107,007 1,240,000 -
Dr. RASTITA 1,282,375 2,100,840 490,000 1,535,040 -
Henny 1,468,394 1,426,000 2,575,401 3,779,999 3,416,369
Debby 1,600,000 1,869,600 2,279,138 3,064,801 -
Bambang 942,628 1,180,000 - - 2,992,135
Dr. IGD 800,000 712,000 1,200,000 1,068,000 950,000
KEPERAWATAN & ADM 3,071,350 1,662,120 4,128,745 3,037,636 2,999,960
KRU OK 1,101,898.10 1,800,000 1,663,071 2,700,000 3,161,076
On Loop

3.04%

- 180,000.00 dr. Soewarsi Juli Layak

- 240,000.00 dr. Soewarsi Juli Layak
- 180,000.00 dr. Mahfudz Juli Layak
- 120,000.00 dr. Faria Juli Layak
- 240,000.00 dr. Soewarsi Juli Layak
37,131.39 862,627.74 dr. Bambang Juli Layak
- 180,000.00 dr. Faria Juli Layak
- 360,000.00 dr. Mahfudz Juli Layak
- 180,000.00 dr. Faria Juli Layak
- 240,000.00 dr. Mahfudz Juli Layak
32,032.85 820,656.93 dr. Bambang Juli Layak
51,224.45 1,204,489.05 dr. Faria Juli Layak
40,350.36 873,512.73 dr. Rizal Juli Layak
40,350.36 873,512.73 dr. Rizal Juli Layak
40,350.36 873,512.73 dr. Rizal Juli Layak
74,260.04 1,605,200.73 dr. Bambang Juli Layak
36,372.26 847,445.26 dr. Bambang Juli Layak
- 120,000.00 dr. Mahfudz Juli Layak
56,489.96 1,150,908.41 dr. Rizal Juli Layak
48,419.71 1,012,202.73 dr. Rizal Juli Layak
48,419.71 1,072,206.73 dr. Faria Juli Layak
- 300,010.00 dr. Debby Juli Layak
56,489.96 1,150,917.41 dr. Rizal Juli Layak
40,350.36 873,524.73 dr. Rizal Juli Layak
56,489.96 1,150,923.41 dr. Rizal Juli Layak
40,350.36 873,530.73 dr. Rizal Juli Layak
16,551.09 404,482.18 dr. Faria Juli Layak
Juli DPJP Mei Juni Juli
369,000 Bambang, Sp #REF! 0 #REF!
1,549,800 Debby, Sp.A #REF! #REF! 0
- Faria, Sp.OG 0 0 #REF!
- Henny, Sp.OG #REF! #REF! #REF!
3,380,000 dr. Rastita, #REF! #REF! 0
- dr. Soewarsi, #REF! #REF! #REF!
4,056,000 Wahyu, Sp. J #REF! #REF! #REF!
827,500 10,200,055 5% PT dr. Jaga IGD 800,000 1,200,000 950,000
2,055,150 6,754,906 di kita Kep & Adm 3,071,350 4,128,745 2,999,960
4,700,000 Kru OK 1,101,898.10 1,663,071 3,161,076
DPJP Mei Juni Juli
Bambang, Sp 55,000 - 385,000
Debby, Sp.A 165,000 165,000 -
Faria, Sp.OG - - 55,000
Henny, Sp.OG 110,000 110,000 165,000
dr. Rastita, 110,000 55,000 -
dr. Soewarsi, - - -
Wahyu, Sp. J 110,000 110,000 -
dr. Jaga IGD
Kep & Adm
Kru OK