“One of BPJS Kesehatan's commitments is to ensure that the participants of the National Health Insurance-Healthy Indonesia Card (JKN-KIS) receive quality, professional, and satisfying health services. Thus, as a form of compliance with regulations, (filtering and) selecting health facilities is absolutely necessary and must be fulfilled by healthcare facilities that will work with BPJS Kesehatan," Director of Healthcare Services at BPJS Kesehatan Lily Kresnowati noted in a written statement received here on Thursday.
Kresnowati explained that the measure was taken in a bid to adapt to the new regulations and the new normal era.
Her administration side will conduct credentialing and re-credentialing during the period from October to December 2021 throughout Indonesia, with focus on advanced-level referral health facilities that will cooperate in 2022.
The policy for healthcare facilities will be synchronized with Government Regulation Number 47 of 2021 on implementation of the hospital sector and Regulation of the Health Ministry Number 14 of 2021 on business activities standards and products of risk-based business licensing in the health sector.
According to Kresnowati, for health facilities looking to partake in the selection, participants should fulfill administrative requirements, such as licensing, medical personnel practice permits, accreditation, and the health facility's taxpayer corporate number.
As for the technical criteria, BPJS Kesehatan will take into account these healthcare facilities based on their competent medical personnel and the scope of services, and facilities and infrastructure, including beds, systems, procedures, administration, and cooperation evaluation.
The selection process of health facilities will involve the local district or city health office, associations of health facilities, and professional associations.
BPJS Kesehatan has developed an application called the Health Facilities Information System to expedite and simplify the collaboration process with health facilities. It is a web-based application for easy accessibility via the public internet, and the cooperation application process can be monitored transparently.
In the application, healthcare facilities can easily upload the required data. This aims to ensure that all health facilities serving JKN-KIS participants are of high quality and in accordance with existing regulations.
Kresnowati also warned that fraud in healthcare services would not only have an impact on the condition of the Health Social Security Fund (DJS), but it would also affect participants and the health facilities.
"We expect that the fraud potential can be minimized and health services for participants can run optimally. In addition, during the COVID-19 pandemic and the start of the new normal era, there needs to be a common understanding of the ethics of providing health services by BPJS Kesehatan, healthcare facilities, participants, and stakeholders," she added.
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Translator: Hreeloita D S, Mecca Yumna
Editor: Sri Haryati
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