Kelompok 7 – Tarif dan Biaya

Summary

This transcript discusses the process of determining hospital rates, emphasizing the calculation of costs for consumables, doctor services, and other medical materials. It highlights how hospital rates are set based on agreements, consumables like medicines and BHP materials, and factors like electricity and water usage. Paramedic Hospital, which collaborates with various insurance companies, also offers subsidized care for low-income patients and promotional packages. The hospital ensures that patient costs are managed based on their treatment level, with special programs such as affordable consultations and medications available for disadvantaged patients.

Takeaways

• 😀 Hospitals generally set rates based on consumables, doctor's services, and raw materials such as BHP (medical supplies).
• 😀 The rate for procedures involves components like the doctor's service and materials used, such as medicine and BHP substances.
• 😀 The margin for rates is calculated by considering all costs, including consumables, doctor's services, and general expenses like electricity and water.
• 😀 Hospital rates typically undergo a yearly increase based on pre-calculated percentages, factoring in capital costs and margin adjustments.
• 😀 Paramedic Hospital accepts general insurance and has recently signed agreements for emergency coverage with local government districts.
• 😀 Cross-subsidies are implemented to help patients with varying financial capacities, adjusting rates accordingly.
• 😀 Hospital management has determined basic tariff rates and knows the limits for subsidies to accommodate low-income patients.
• 😀 Hospitals have the flexibility to revise and promote their rates, allowing them to adjust prices or create special promotions for patients.
• 😀 Paramedic Hospital offers a flat rate for certain services, like general consultations, where the price does not change based on the doctor.
• 😀 Insurance processes vary based on the benefits and terms of each insurance company, with a 30-day payment period for hospital claims.
• 😀 Paramedic Hospital has introduced affordable treatment programs, such as a discounted 69,000 IDR treatment package, to assist economically disadvantaged patients.

Q & A

How are hospital rates typically determined?

Hospital rates are usually determined by considering the costs of consumables, such as medicines and materials like gloves, as well as services provided by doctors. The costs also include general usage like electricity and water, and rates are adjusted annually based on various factors.

What are some examples of consumables included in the hospital rate calculation?

Examples of consumables include rough materials like gloves, masks, and other personal protective equipment (PPE) used by nurses. Additionally, drugs and other medical supplies like BHP materials are factored into the rates.

How are doctor's services priced in relation to hospital procedures?

Doctor’s services are priced based on an agreement between the hospital and the doctor. This can be structured with varying percentages like 60/40 or 80/20, depending on the agreement.

What components contribute to the cost of medical procedures in the ER?

In the ER, the cost of medical procedures includes the doctor's services and the consumables used during the procedure, such as medical supplies, medicine, and BHP materials. For example, the size of a wound will determine the amount of consumables required.

How are hospital rate increases handled annually?

Hospital rates are generally reviewed and adjusted once a year. The increase is usually calculated based on a predetermined percentage and is applied to the basic tariff for the hospital's services.

What types of insurance does Paramedic Hospital accept?

Paramedic Hospital accepts general insurance patients, as well as government insurance for specific services like the KESDA district hours and emergency LKMNIK hours, which are covered by Bekasi City. The hospital is also preparing to collaborate with e-PPCE.

How does Paramedic Hospital handle patients who cannot afford standard treatments?

For patients who cannot afford standard treatments, Paramedic Hospital offers subsidies. The hospital has a program where patients can receive general practitioner services for just 69,000 IDR, which includes consultation, medication, and administration.

What is the billing process for insurance at Paramedic Hospital?

For insurance billing, Paramedic Hospital has a 30-day payment term. The hospital works with multiple insurance companies, and the payment period typically ranges from 2 to 4 weeks, depending on the insurance provider.

How does the VIP treatment benefit affect patient costs at Paramedic Hospital?

When a patient has VIP treatment benefits through their insurance, the hospital adjusts the costs accordingly. This includes providing VIP-class treatment rooms and high-quality medication for patients with such benefits.

What kind of promotions does Paramedic Hospital offer to its patients?

Paramedic Hospital offers promotional programs like providing cheap treatments every Friday for the first 30 patients. Additionally, the hospital offers free consultations for 10 patients every Friday as part of their social initiatives.