Hospitals Demand Payment of Rp 13.9 Trillion in Arrears

Several hospitals are critical. Hospital authorities have demanded that the government, as the bearer of all the costs of COVID-19-related services, accelerate the payment of the bills.

KOMPAS/NIKSON SINAGA

A nurse feeds a Covid-19 patient at a hospital in Medan, North Sumatra, Monday (14/6/2021). All costs of hospital services for Covid-19 patients are the responsibility of the government.

JAKARTA, KOMPAS – Hospital bills for the treatment of COVID-19 patients – amounting to Rp 13.9 trillion in arrears as of Wednesday – have yet to be settled, and hospital authorities have demanded that the government, as the bearer of all the costs of COVID-19-related services, accelerate the payment of the bills.

While hailing an improved process for paying hospital claims in 2020, including the payment of the arrears, Indonesian Hospital Association (Persi) health security service head Daniel Wibowo, when contacted from Jakarta on Wednesday, urged the government to speed up the payment process futher, considering the bleeding cash flow at a number of hospitals.

“Several hospitals are critical [in their need for cash to cover expenses]. Most of them only rely on payments from patients who pay in cash or from Health Care and Social Security Agency (BPJS Kesehatan) funds or other insurers," he said.

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With constraints related to filing claims having been resolved and the required online document filing having been fulfilled, Daniel hoped that the claim payment process could be made smoother.

The Health Ministry noted that as of July 21, Rp 22.8 trillion in COVID-19 health claims had been paid. This consisted of Rp 14.7 trillion for service claims in 2021 and Rp 8.1 trillion in arrears from 2020.

The arrears were said to be part of the service expenses in 2020 whose bill claims were filed in 2021. The bills came from private hospitals (Rp 11.9 trillion), regional hospitals (Rp 6.8 trillion), health ministry-owned hospitals (Rp 1.3 trillion) and Indonesian Military (TNI)-owned hospitals (Rp 1.04 trillion).

The remaining Rp 13.9 trillion in arrears, the payout of which is currently being sought by the hospitals, consists of Rp 4.9 trillion already verified by BPJS Kesehatan, as shown on the official report on the results of verification (BAHV) document, and Rp 9 trillion whose payment has been delayed because of a billing dispute.

Kompas/Wawan H Prabowo

A medical officer lifts a patient from an ambulance for identification or triage at the dr Chasbullah Abdulmajid Hospital, Bekasi City, West Java, Friday (16/7/2021). Triage is the process of determining which patients are prioritized to receive treatment first in the Emergency Room (IGD) of a hospital.

Reviewing procedures

The Health Ministry’s referral health services director, Rita Roga, said that the arrears for 2020 claims that had already received BAHV documentation from BPJS Kesehatan would still have to be reviewed in whole by the Development Finance Comptroller (BPKP).

Of the BAHV-verified Rp 4.9 trillion, Rp 558 billion has been reviewed by the BPKP and the payout process has started. “The bill claims that have been reviewed by BPKP still need to be processed before they can be transferred to the hospitals. We still have to ask for consent from the Finance Ministry," Rita said.

In relation to payment delays due to the billing dispute, Rita said the Health Ministry had assigned payment dispute teams (TPKP) in 34 provinces. Now, 28 provincial TPKPs have been formed through decrees from provincial health offices, while the remaining six provinces are still in the process.

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Bill claims deemed liable for disbursement by the TPKP will be followed up on by payment executing officers (PPK).

For claims that require revision, the team will request supporting data from the hospitals, after which the payout can be processed. If a bill claim is not liable because of a calculation mismatch, it cannot be disbursed.

“We hope that the hospitals really study the regulations so that there are no disputes about the filed bill claims or about the submission of the bill documents to BPJS Kesehatan. The regulations clearly stipulate that the name [of the patient] must be mentioned on the submitted bills. Unfortunately, the hospitals miss this at times,” Rita said.

KOMPAS/FERGANATA INDRA RIATMOKO

Residents visited the place for handling Covid-19 patients at the Dr Sardjito Central General Hospital, Yogyakarta, Sunday (4/7/2021). The availability of oxygen at the hospital was running low as the number of Covid-19 patients who came to the place increased.

Frontline services

As reported in Kompas on Tuesday, Saleh Partaonan Daulay, a member of House Commission XI from the National Mandate Party (PAN), said that paying hospital claims in arrears had to be prioritized by the government considering hospitals’ frontline role in handling COVID-19 and that hospitals needed operational support to avoid collapse.

The government has promised that the claimed sum of Rp 2.69 trillion in arrears from 2020 hospitalization expenses, which is said to have been delayed as a result of a prolonged audit, will be quickly disbursed.

The budget disbursement, set aside for hospital COVID-19 treatment in the second half of the year, is still being processed.

Finance Ministry budgeting director Isa Rachmatarwata, in a working meeting with House Commission IX on Monday, said that the process of arrears payment required a BPKP audit, so the disbursement could not carried out as immediately as hospitals demanded.

In 2020, the government spent over Rp 23 trillion for the treatment of hospitalized COVID-19 patients. The

Finance Ministry has paid claims of Rp 14.53 trillion for 200,545 patients at 1,575 referral hospitals. Beyond that, the 2020 arrears disbursed in 2021 amounted to Rp 6.1 trillion.

In the first half of this year, the ministry spent Rp 10.6 trillion as budgeted. For the second, the government estimates that it will pay Rp 11.97 trillion in hospital claims.

"The budget disbursement, set aside for hospital COVID-19 treatment in the second half of the year, is still being processed," said Isa.

This article was translated by Musthofid.