Brilio.net - The Social Security Administering Body (BPJS) is an institution tasked with providing health and employment insurance for the public, civil servants and private sector employees. This program has existed since 2014 through the legal basis of Law Number 24 of 2014.
BPJS has two types of social security, namely BPJS Health and BPJS Employment. BPJS Health is used as insurance coverage in the health sector. Meanwhile BPJS Employment is a guarantee for employees who have retired , experienced permanent disability or even died.
This article explores more about BPJS Health. Specifically related to one of the services covered by BPJS Health, namely surgery, both minor surgery and major surgery. However, the operations covered by BPJS Health are only medical operations and not cosmetic, aesthetic operations or operations abroad.
For those of you who are active BPJS Health users, you must know what operational services are covered by BPJS. To understand better, let's look at a complete review of the types of operations that BPJS can cover, complete with procedures, as reported by brilio.net from various sources on Friday (14/6).
Types of surgical services covered by BPJS Health.
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Based on the Guidelines for Implementing National Health Insurance (JKN) in Minister of Health Regulation (PMK) Number 28 of 2014, includes:
1. Tonsillectomy
2. Gallbladder surgery
3. Oral surgery
4. Vascular surgical operations
5. Caesarean section
6. Hernia surgery
7. Heart surgery
8. Cancer surgery
9. Cataract surgery
10. Lymph node surgery
11. Cyst surgery
12. Eye surgery
13. Myoma surgery
14. Odontectomy surgery
15. Pen removal operation
16. Knee joint replacement surgery
17. Thymectomy operation
18. Tumor surgery
19. Appendectomy
All active BPJS Health participants can get equal health services and insurance.
Surgical procedures covered by BPJS Health.
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To be able to get surgical services covered by BPJS Health, you need to follow several procedures, such as the following:
1. Make sure you have received treatment at a first level health facility, namely a health center, clinic or general practitioner as recorded in BPJS Health.
2. After that, the doctor from the first level health facility (health facility) will issue a referral letter, if the patient is diagnosed with an illness that requires surgery.
3. Next, the treating doctor will make a referral letter for surgery to the specialist department at the hospital.
4. The referral letter will later be used for further screening regarding the patient's condition when treated by a specialist doctor at the hospital.
5. If the patient's condition allows for surgery, the specialist will make an operation schedule.
6. The next step is to ensure that the patient in question immediately receives surgery according to the diagnosis.
7. If a patient arrives in an emergency condition, he or she can immediately receive surgery covered by BPJS Health, even without a referral letter.
8. The patient can be transferred to the Emergency Department (IGD) to immediately receive help first.
9. Finally, the emergency category is determined by the targeted health service.
Required documents required for the operation process.
1. BPJS Health Card or Healthy Indonesia Card (KIS).
2. Personal identity card (KTP/KK)
3. Referral letter from the Puskesmas or first level health facility.
4. Patient card obtained from the hospital after the patient registers.
How to register for BPJS online.
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Registering for BPJS can be done online, as follows:
1. Prepare the required documents:
- Active email address.
- Active cellphone number.
- Family Card Number (KK).
- Population Identification Number (NIK).
2. Steps to register for BPJS online:
- Download the JKN Mobile application first.
- Open the application then click "Register".
- Select the menu in the application "New Participant Registration".
- Next, read the terms carefully then press "agree".
- Enter your NIK and captcha code contained in the application.
- Fill in all the requested data, then click the "next" option.
- Choose any health facility you want.
- Input email address and click "save".
- Wait a few moments for verification via email.
- Next, open the virtual account sent by BPJS Health then make a premium payment.
- If the premium payment is successful, you are registered as a participant.
- Your BPJS Health card is now available in the application in virtual form.