Gov’t Urges BPJS to Accelerate Payment of Claims for COVID-19 Patients Care

Coordinating Minister for Maritime Affairs and Investment Luhut B. Pandjaitan (Photo by: Communication Bureau of Coordinating Ministry for Maritime Affairs and Investment)

In a bid to ensure the smooth process of COVID-19 patients’ care in hospitals, Coordinating Minister for Maritime Affairs and Investment, concurrently Deputy Chair of COVID-19 Control Policy Committee and National Economic Recovery Luhut B. Pandjaitan requested the Social Security Agency for Health (BPJS Kesehatan) to accelerate payment of claims for treatment of COVID-19 patients.

“I ask the BPJS to immediately coordinate with Ministry of Health to verify hospital data whose claims are facing problems so as not to affect the cash flow of hospitals that treat COVID-19 patients,” Luhut said during a coordination meeting in Jakarta, Tuesday (29/9).

In response to the Minister, the Acting Director General of Health Services Abdul Kadir said that out of 1,906 hospitals providing COVID-19 cares throughout Indonesia, only 1,356 hospitals have submitted claims. “Most of them are from these three provinces, namely East Java, West Java, and North Sumatra,” he told the Minister.

For this reason, Luhut instructed Governors who were present at the coordination meeting, namely Governor of the Special Capital Region of Jakarta Anies Baswedan, Governor of East Java Khofifah Indar Parawansa, Governor of West Java Ridwan Kamil, and Governor of Bali Wayan Koster to coordinate with the BPJS.

“Immediately instruct the health offices, the regional representatives of BPJS Kesehatan to coordinate with hospitals that have not submitted claims and hospitals that have not completed the verification of claims so that the handling of COVID-19 patients is not slowed down,” Luhut said.

In addition, the President Director of BPJS Kesehatan Fahmi Idris stated that the BPJS has paid claims of Rp4.4 trillion to hospitals in eleven priority provinces. “Currently, there is Rp2.8 trillion in claim values in the verification process,” he stated.

Meanwhile, to ease the hospitals in submitting the claims, Fahmi said that, together with Ministry of Health and the BPKP (Development and Finance Supervisory Agency), the BPJS has relaxed the screening process of claim verification.

“Through the amendment of Decree of Minister of Health Number HK 228/2020 on reimbursement procedures for hospitals treating COVID-19 cases to Decree of Minister of Health Number HK 446/2020, the screening criteria for claim verification disputes are reduced from 10 to only 4,” he said. Currently, claims cannot be paid by the BPJS if the documents submitted are incomplete; the insurance criteria are incompatible to the needs; the diagnosis of comorbidities is not in accordance with the provisions; the diagnosis of comorbidities is the main diagnosis.

Luhut also asked Fahmi to include additional therapeutic treatments for COVID-19 patients, such as intravenous, immunoglobulin, convalescent plasma, stem cells, and anti-interleukin which are still in clinical stages, into the list of claimable therapies.

“For humanities, BPJS should cover the medicinal therapies as mentioned by Governor Anies, especially, since we can produce most of the medicine domestically,” he said adding that it should include the care for babies born to mothers with COVID-19.

Luhut also instructed the Governors to monitor the availability of medicine according to the standard COVID-19 patient care protocols drawn up by Ministry of Health together with five medical specialist associations.

“To all Governors and representatives of regional heads, I ask that in the second week of October, check the supply of medicine for all COVID-19 Referral Hospitals, there should be no victims due to lack of medicine as well as the availability of medical equipment and isolation rooms,” Luhut concluded. (Communication Bureau of Coordinating Ministry for Maritime Affairs and Investment/UN)

Translated by: Fairuzzamani Inayatillah
Reviewed by: Mia M. Bonaedy