解决医院BPJS索赔问题的社会化

Harris Rambey, Irmayani Irmayani, D. Panjaitan, Arif Sudjatmiko
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引用次数: 0

摘要

印度尼西亚作为一个福利国家,其目标是实现公共福利。这是印尼政府通过健康保险发展社会保障的基础。在实践中,创建BPJS的目标与现实不兼容,这可以通过各种各样难以解决的问题来证明。其中之一是BPJS的索赔管理问题。由于本研究的主题是健康保险,具体来说是管理索赔。本研究采用规范性的法律研究方法,采用成文法方法、概念方法和案例方法。研究表明,尽管政府努力解决这一问题,但由于一些抑制因素,这些努力并没有奏效。需要IMP(身份监控程序)概念的形成和应用的解决方案,并将其与Disduk capital集成到BPJS。实施IMP的概念是期望最小化BPJS的赤字,并解决索赔管理的所有原因问题。
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SOSIALISASI PROBLEM SOLVING KLAIM BPJS DI RUMAH SAKIT
Indonesia as a welfare state aims to realize public welfare. This underlies the development of social security by the Indonesian government, which one is through health insurance. In Practice, the goal of creating BPJS is not compatible with reality, provable by a wide variety of issues that are difficult to solve. One of them is the problem with the management of claims for the BPJS. As for the subject of this study is health insurance, specifically management claims. The study uses normative legal research methods to adopt a statute approach, a conceptual approach, and a case approach. Studies have shown that despite efforts by the government to address the problem, but those efforts didn’t work because of some inhibitory factors. Needed solutions to the formation and application of the IMP (Identity Monitoring Program) concept and it is integrated with Disduk Capil to BPJS. The concept of IMP’s implementation is expected to a minimized deficit on BPJS and solving gone of the causes problems is claim management.
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