JKN patients with these conditions need long-term treatment with expensive cost and medications. Through the JKN Program, we expect that they can receive adequate health service without having to worry about costs.
Jakarta (ANTARA) – Patients of the National Health Insurance (JKN) with nine health disorder conditions can be handled by hospitals immediately without referral, President Director of state-run Healthcare and Social Security Agency (BPJS Kesehatan) Ghufron Mukti stated here, Monday.
These nine exceptions comprise JKN patients, who routinely undergo hemodialysis, chemotherapy, radiotherapy, and have thalassemia, hemophilia, psychiatric condition, leprosy, multi-drug resistance tuberculosis (MDR-TB), as well as HIV/AIDS.
Earlier, the referral letter for JKN patients with these conditions lasted 30 days, though now, it lasts until 90 days. In addition, if the letter has expired, it can be immediately extended by the hospitals through the V-Claim Application.
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The policy is part of referral simplification that has been implemented since September 2021. At the start, the referral simplification policy only applied for JKN patients that required hemodialysis, thalassemia, and hemophilia treatment.
However, as JKN members’ demand rose, BPJS Kesehatan gradually expanded the condition criteria scope for JKN patients that can utilize “special access” through simplification of the referral mechanism.
“JKN patients with these conditions need long-term treatment with expensive cost and medications. Through the JKN Program, we expect that they can receive adequate health service without having to worry about costs,” he explained.
BPJS Kesehatan also prepares a special route through referral simplification to facilitate them in accessing health treatment at hospitals.
During the Regional Hospital Association (Arsada) XIII National Work Meeting, Mukti also highlighted several existing challenges in implementing the referral system in Indonesia.
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These include the ambiguity of the referral system regulation and the gap between the competence standard based on the hospitals’ classification with the real competence of the hospitals.
Other challenges involve the unequal availability of communication and data network as well as health service system that have not been entirely integrated with one another.
“The key in successfully implementing the referral system lies is optimizing FKTP’s (First Level Health Facilities’) function as the gatekeeper, service standardization, authority management, as well as sustainable, accurate, and up-to-date information system,” he noted.
Mukti encouraged the dissemination of information on the program to health service providers and JKN members, so that they can gain an understanding and accept the referral system mechanism.
“Our expectation is that the Regional Hospital Association (Arsada) can help in optimizing the implementation of this JKN referral system on the field,” he remarked.
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