PhilHealth Conducts 2nd Quarter Reach Out Forum

In line with the continuing updates on the latest Circulars and Advisories governing the implementation of the National Health Insurance Program, PhilHealth XII has once again conducted another fora with its accredited hospital and non hospital facilities at FB Hotel, City of Koronadal lately.

At least 96 non hospital facility owners/ proprietors/ operators/ Municipal Health Officers and maternity care providers have attended the first day Forum while 102 government chief of hospitals and private hospital owners were present on the second day.

Members of the panel during the Reachout Forum with health care providers last July 6-7, 2017 at FB Hotel, City of Koronadal. Seated L-R: Legal Office representative, Gloria Amor L. Sequito; ITMS Head, Claudette A. Canlas; Health Care Delivery and Management Services Division Chief, Dr. Antoniette M. Ladio; Benefits Administration Section Head, Dr. Henry F. Manzares; Field Operations Division Chief, Engr. Eugenio C. Donatos II and Membership Section Head, Nevin L. Hallegado.

“We had been into this partnership for the past 18 years and it is important that by now, you have already embraced the importance of giving quality health care to our members. I urge each and every one to read everything that is stated in your Performance Commitment. We trust you for that, just how we entrust all our members under your care,” Health Care Delivery and Management Division Chief, Dr. Antoniette M. Ladio said.

Said HCDMD Chief thoroughly discussed the revised guidelines stated in the Conduct of the Health Care Provider Performance Assessment System (HCP-PAS) per Circular 2017-0033 reminding them to be conscious about the way how they follow rules set by PhilHealth in terms of facility and personnel capabilities.

It has also specifically stated the necessary sanctions for whatever medical practice violation they may execute in the course of delivering said health care services to PhilHealth members.

Participants coming from different areas in Region XII during the Reachout Forum with health care providers last July 6-7, 2017at FB Hotel, City of Koronadal.

During the open forum, Management Services Division Chief, Merlie C. Sabug reminded them to be prudent in filing claims. “File only what is legitimate and true about the members’ admission, as to the alleged bankruptcy of PhilHealth, I would like to assure you that as of now money/ funding is the least of our concerns. We are and will always be for the welfare of our clients/ members,” she said.

They were likewise reminded to be wary about the medical management protocol done in their facilities because failure to follow the corporation’s policy would mean breach of contract with PhilHealth and they will be held answerable to that.

Field Operations Division Chief, Engr. Eugenio C. Donatos II on the other hand said that members who have availed of the Point of Care service from January 1 – June 30 this year are all entitled to avail of their benefits until December 2017.

Effective July 1, 2017, Point of Service has been implemented and the member’s enrolment in this regard shall be shouldered by the National Government thru the Department of Budget and Management.

“Point of service members with admission dates effective July 1, 2017 onward are covered by the NO Balance Billing Policy once admitted in government facilities on a ward type of accommodation. Kindly tag them on their PhilHelath Member Registration Forms (PMRF) if they are classified as Financially Capable or FC or Financially Incapable or FI for us to determine their categories,” stressed by the Benefits Administration Head, Dr. Henry F. Manzares.

Point of Service per Circular 2017-0011 is the latest program implemented by the corporation prioritizing those without PhilHealth to be enrolled and be covered by the National Health Insurance Program.

Its specific guidelines were discussed by the Membership Section Head, Nevin Hallegado, for the health care providers to accommodate all patients without PhilHealth.

As the corporation evolved into its 21st year, PhilHealth has now expanded its coverage to enroll the remaining 8% Filipinos without PhilHealth. This includes those who have dual citizenship and foreign nationals with certificate of retirement who opt to stay in the country.

Inactive members have the privilege to avail of their benefits provided they would update their member data record and contribution.

All other issues and concerns asked by the participants were answered by the panelists.

“It is PhilHealth’s ultimate goal to cover all Filipinos from all walks of life and you are our partners in the successful implementation of this program,” Administrative Officer IV, Bienvenido L. Borra said. (hanah g. naanep, PRO III)