Aplikasi

INA-CBG
National Casemix Center (NCC)
Pusat Pembiayaan dan Jaminan Kesehatan
Kementerian Kesehatan RI
2017
Update Aplikasi dan Informasi
Alur Migrasi Data Aplikasi INA-CBG 4.1 ke 5.1
UPDATA DATA PROFIL RS
Integrasi
Peran dan Hubungan
RUMAH
SAKIT

KEMENTRIAN
BPJS
KESEHATAN
Bagan Alur Data
DC KEMENKES

Unverified Claim

Verified claim
Alur Pengiriman Data
Metode Pengiriman data
Per-Klaim
Per- Tgl Pulang
Website
User : kode RS
Pass : Kode RS
Kenapa harus Kirim?
DATA BILLING ?????? Reklasifikasi
Tokoh dalam Re-Klasifikasi
Tim Tarif
Kementerian
Kesehatan

Proses Reklasifikasi
Reklasifikasi membutuhkan kontribusi
INA-CBG dan kerjasama dari Stake
Dokter Holder
(Asosiasi RS
Profesi)
RE- KLASIFIKASI
Grand Design
Penyusunan
INA-Grouper
 Development Plan
of INA-CBG 2015-2019

2015 2016 2017 2018 2019

1. Refinement of
1. Updating Algorhitm 1. Developing 1. Finalizing Ina
tariff 2. Develop Ina Grouper Grouper
monitoring Implementation
2. Refinement 2. Updating tariff 2. Setting manual
system INA-Grouper
of Algorhitm 3. Developing 3. Capacity 3. Piloting Ina
INAGrouper building Grouper
4. Capacity building
Alur Proses Re-Klasifikasi

EXPERT PANEL MEETING

Eye & Adnexa
Procedure or Diagnosis Cluster (PDC) in INA-CBG
Before and After Reclassification
Category BEFORE (existing) AFTER
1 Retina Procedures
2 Glaucoma & Cataract Complex Procedures
3 Major Corneal, Scleral, Conjunctival Procedures
4 Enucleation & Orbital Procedures
5 Lens Procedures
1. Prosedur Ekstraokuler dan Mata
Procedure 6 Eyelid Procedures
2. Prosedur Lensa dan Intra Okuler
7 Dacriocystorhinostomy Procedures
8 Other Corneal, Scleral, Conjuntival Procedures
9 Strabismus Procedures
10 Lacrimal Procedures
11 Other Eye Procedures
1 Acute & Major Infections
1. Infeksi Mata Akut Mayor 2 Neurological Vascular Disorder of Eye
Diagnosis 2. Gangguan Persarafan Mata 3 Hyphema & Medically Managed Trauma
3. Gangguan Mata Lain-lain 4 Malignancy of Eye
5 Other Disorder of Eye
Psychiatry Procedure & Diagnosis Cluster (PDC) in INA-CBG
Before and After Reclassification
Category BEFORE (Existing) AFTER
1 Schizophrenia 1 Dementia and other organic disorder
2 Major Depression 2 Substance Abuse And Addiction Disorder
3 Personality Disorder 3 Schizophrenia and Schizoaffective Disorder
4 Bipolar disorder including mania 4 Mood and Bipolar Disorder
5 Depressive disorders 5 Anxiety Disorder and Other Neurosis
6 Phobia anxiety and other neuroses 6 Somatoform Disorder
Dementia & other organc brain disturbance
7 7 Eating Disorder
Diagnosis including mental retardation
8 Childhood mental disorders 8 Sleep Disorder
9 Anorexia nervosa and bulimia 9 Sexual Disorder
10 Other mental and behavioral disorders 10 Other Mental Disorder
11 Personality Disorder
12 Impulse Control Disorder
13 Mental Retardation
14 Childhood and Adolescent Disorder
Procedure - Substance detoxification and rehabilitation
ENT & Dentistry
Procedure or Diagnosis Cluster (PDC) in INA-CBG
Before and After Reclassification
BEFORE (Existing) AFTER
1 Tumor Kerongkongan, Mulut, Hidung dan Telinga 1 Malignancy
2 Disequilibrium 2 ENT Trauma & Deformity
3 Epistaxis 3 Otitis Media & Upper Respiratory Infection
4 Peradangan Epiglotis, Telinga Tengah, ISPA & Laringotrakeitis 4 Epiglotitis & Celulitis of Face-Neck
5 Diagnosis Tenggorokan, Mulut, Hidung dan Telinga 5 Benign Neoplasm
6 Hearing Impairment*
7 Epistaxis
8 Hard Tissue in Oral Cavity
9 Other ENT-Mouth Diagnosis
10 Disequilibrium
11 Soft Tissue in Oral Cavity
ENT & Dentistry Procedure or Diagnosis Cluster (PDC) in INA-CBG
Before & After Reclassification
BEFORE (Existing) AFTER
1 Prosedur Komplek Laring 1 Laryngectomy
2 Prosedur komplek Leher & Kepala 2 Tracheostomy
3 Prosedur Mastoid & Sinus 3 Major Head & Neck Proc
4 Prosedur Tonsil & Adenoid 4 Major Nose & Sinus Proc
5 Prosedur Tenggorokan, Mulut, Hidung dan Telinga Lain-lain 5 Maxillo-Facial Surgery
6 Inner Ear Proc
7 Tympanoplasty, Mastoidectomy, & Middle Ear Proc
8 Proc for Rhinosinusitis & Nasal Polyp
9 Pharingeal & Laryngeal Proc
10 Cleft Lip & Palate Repair
11 Rhinoplasty*
12 Tonsil &/ Adenoidectomy
13 Minor Nose & Sinus Proc
14 Myringotomy w/ Ear Insertion & Other Ear Proc
15 Oral Surgery Proc
16 Salivary Proc
17 Misc. ENT & Mouth Proc
18 Minor Head & Neck Proc
19 Conservative Oral Dental Proc
20 Hearing & Vestibular Assessment
21 Rehabilitative Oral & Dental Proc
22 Other ENT & Mouth Non-OR Proc
 PATCH UPDATE (terbaru)
Fitur Monitoring Klaim (pending, layak, tidak layak dll)
Kasus-kasus yg ungroup (no cbg assign)
Fitur perhitungan naik kelas
Fitur restore 2 database (terutama untuk rs khusus)
Fitur Remote desktop
Petunjuk Teknis
Aplikasi INA-CBG
v5.1
 Contact Center

Aplikasi : aplikasi.inacbg@gmail.com
Non Aplikasi : ncc.kemkes@gmail.com
 Terimakasih
BETTER FINANCING FOR BETTER HEALTH