Difference between revisions of "Southern Leyte Province, Philippines"

'''Philhealth sets focus on delivering benefits to members'''

*Source: http://pia.gov.ph/?m=7&r=r08&id=65304

*Wednesday, November 23, 2011

:by Bong Pedalino

MAASIN CITY, Southern Leyte, Nov. 23 (PIA) -- Having attained its goal of providing universal coverage to as many Filipinos as possible, the Philippine Health Insurance Corporation (Philhealth) has been doing all it can to ensure that members do get the desired benefit payments due them.

And to make that happen, Philhealth’s current thrust revolved around Benefit Delivery Rate (BDR), an extensive program that listed at least four factors serving as roadmap to see how far their services have reached to the people that matter most, the hospitalized members, said Misael Paigan, head of Philhealth provincial service office.

During the Action Center cable TV this morning where he was the guest, along with Information Officer Henry Madula, Paigan discussed the four key components of BDR.

These included the continuing pursuit of membership coverage, expanding members’ access to Philhealth-accredited medical or health facilities, letting members know specific illness cases and the corresponding payments that can be availed, and seeing to that members get the value out of their Philhealth cards, such as no out of pocket expenses and completeness of needed medicines.

To drive home his point, Paigan disclosed that the total admission at the Salvacion Oppus Yniguez Memorial Provincial Hospital (SOYMPH) for the year 2010 was 12,856, but out of this number only 3,380 patients were able to use their Philhealth benefits, or 26% of the total.

Many of those patients, especially the sponsored indigents or senior citizens, were not aware that they have Philhealth cards, or beneficiaries of one member in the family, and so were unable to get refund of their hospitalization expenses, Paigan explained.

In an effort to address this gap, Paigan said Philhealth has established a link in accredited hospitals or clinics whose basic task was to refer a patient’s name in the database of the agency.

In most cases it will be found out that he or she was listed as one of the beneficiaries of an immediate family or relative who is an active Philhealth member, and so can be accorded due benefits.

For the BDR component on access, Information Officer Madula said virtually all rural health units around the province, including several Leyte towns under their coverage, were already accredited, and as such Philhealth’s services can be delivered to these facilities for members, like pregnant women who are members themselves or beneficiaries of active members.

Philhealth’s updated list of benefit payments included normal delivery in birthing facilities at accredited health outlets, where a member can avail a packaged rate of P 8,000.00 up to the fourth child, plus a mandated screening for newborn babies, P 1,750.00. (PIA-Southern Leyte/bong)