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This is the new operational guide for the BPJS benefit coordination scheme

Reporter: Handoyo | Editor: Adi Wikanto

JAKARTA. The Social Security Administering Body (BPJS) for Health issues implementing guidelines (operational guidelines) regarding the benefit coordination scheme or Coordination of Benefit (CoB) National Health Insurance (JKN). This rule is claimed to provide more incentives for BPJS Kesehatan participants and additional health insurance parties.

These provisions are contained in the BPJS Kesehatan Directors Regulation Number 47 of 2016 concerning Guidelines for the Implementation of Benefit Coordination in the Social Health Security Program.

Head of the Department of Communication and Public Relations of BPJS Kesehatan, Irfan Humaidi, said that after the implementation of these guidelines, the direct benefit coordination scheme could work. “Then they (additional health insurance) need a process to go to OJK,” said Irfan, Tuesday (13/12).

Irfan explained that the new benefit coordination scheme provides an opportunity for additional health insurance companies to issue products that are correlated with BPJS Kesehatan.

Just for the record, several points in the provisions contained in the regulation regarding the coordination of this benefit are related to participation coordination, which includes registration of business entities, data entry of workers and family members, data changes, to the printing of participant identities.

Socialization coordination, namely BPJS Kesehatan and additional health insurance, can conduct socialization together to health facility participants and related parties. Contribution collection coordination, and information system coordination.

These implementing guidelines are reviewed at least once a year to ensure they match the needs of the organization. However, changes to these operational guidelines can be carried out more quickly if there is a change in organizational strategy.

In addition, there were policy changes, based on audit recommendations from the internal control unit, feedback from users of the guidelines, and there were opportunity for improvment (OFI) based on business process assessment and / or other assessments.

BPJS Watch advocacy coordinator Timboel Siregar said the scheme offered for the coordination of these benefits has not attracted additional health insurance to join. “In this collaboration, BPJS Kesehatan only appreciates the calculation of class c,” said Timboel.

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