The Social Health Insurance Academy of the Philippine Health Insurance Corporation conducted Social Health Insurance Educational Series (SHInES) at FB Hotel, City of Koronadal attended by the Local Chief Executives, Provincial/Municipal Health Officers and local print and broadcast media including Information Officers of government agencies in Sarangani and South Cotabato.
SHInES is PhilHealth’s way of updating its stakeholders with new policies including their roles and responsibilities as partners in implementing the National Health Insurance Program.
|Philhealth 12 OIC-Regional Vice President, Dr. Miriam Grace G. Pamonag in an interview during Philhealth SHInES held July 31, 2014 at FB Hotel, City of Koronadal|
Chief Operations Officer, Ramon F. Aristoza, Jr added that as PHilHealth increases the number of its beneficiaries, benefits and services; the demand for information dissemination also increases.
“…with this, there’s a need to cascade correct and timely information to our clients from various sectors… Whether good or bad from PhilHealth, still it’s a news and you can help us on that,” Aristoza said.
During the open forum, DXCP Station Manager, Bobot Cruz raised issues on lifetime member coverage, double membership, declaration of legal spouse under customary law, employer’s role in remitting employees’ premium and health care providers’ abuse in terms of admitting patients beyond service capability.
“Some hospitals are admitting patients and let them stay along the alley, is it allowed?” he asked.
Senior Vice President for Corporate Affairs Group, Dr. Israel Francis Pargas said that this is allowed provided there is an epidemic in the area and there are no other health care providers to cater for emergency cases.
Joy Cawayan of FEBC-DXKI Marbel on the other hand asked about PhilHealth’s way of checking on double membership, double payment and multiple admissions.
“Health care provider portals installed in the hospitals and non-hospital based facilities and PhilHealth’s Customer Information System can provide all the data,” Pargas answered.
The station Manager of Radyo Natin Isulan clarified on the non-renewal of sponsored members and its relation to the of-point-of-care program of PhilHealth.
“Sponsored members who were not renewed by their sponsors may enrol under the informal economy or may be enrolled by the DOH-retained facilities and other government hospitals who have applied for the point-of- care program of PhilHealth,” Pamonag replied.
“PhilHealth as a health care institution is indeed of big help for us. Hope that there will be more activities like this in the future,” Garry Lumawag of RMN Koronadal said.
His question on benefit availment of members who cannot be located and those who are relocated is answered by Pargas that enlistment done through the Rural Health Units by RHU personnel certified by Barangay Officials settle the issue.
“If PhilHealth has already covered 82% of the population, where are you going to get the remaining 18%?” RPN-DXDX station manager, James Catalan asked.
Aristoza said that PhilHealth is looking into the enrolment of rebels, unwanted children and others under the care of the Department of Social Welfare and Development.
“Other than being our partners, you can be our watchdog. Tell us anything you know about the operation, the way how our members patronize the services and the way how our partners in service provide this to our clients. Ito ang kahalagahan ng inyong pagiging miyembro,” Pargas added.
|South Cotabato Governor, Daisy P. Avance-Fuentes said, “We’re glad that Philhealth has come down to share their knowledge about the program. Sana ay marami pang grasya ang hatid ng kanilang mga bagong polisiya.”|
Most of the Municipal Health Officers’ concerns are on the coverage of pregnant women and children, indigenous people and applicability of the no balance billing policy for barangay health workers in their respective areas.
“Can we also include accreditation of Barangay Health Stations to the accreditation of RHUs?” Rosalina Roxas of LGU Maitum asked.
Since PhilHealth follow a certain standard of service provision per facility according to their service capability, Dr. Francisco T. Soria said that it is not yet regulated to date but Philhealth is coming up with policies that would answer the needs of members in far flung areas.
Other matters recommended were inclusion of G6PD confirmation test in the newborn care package and acceptance of Chieftain Certification for the declaration of multiple spouses among indigenous people. (Hanah G. Naanep)