UHC law expedites healthcare process - Philhealth

• Source: https://pia.gov.ph/news/articles/1019461
• Saturday, March 9, 2019

By Jasper Marie O. Rucat (JMOR/PIA10)

CAGAYAN DE ORO CITY (PIA) – The newly signed Universal Health Care (UHC) law will expedite health care process and will provide 100 percent coverage to all Filipinos.

Merlyn Ybañez, Public Relations Officer of Philhealth Region 10, during the Talakayan sa PIA explained that as of December 2018, coverage of Philhealth in Northern Mindanao is at 98 percent.

Through this new law, there is assured Philhealth coverage to all Filipinos.

Under the law, no more IDs needed and can be availed of anytime.

Dr. Jonathan Ortigoza, Chief of Health Care Delivery Management Division of PhilHealth-10, said there is no perfect policy.

This means, he said, along the way, there may be some things that need to be tweaked or enhanced in the law.

“Nalipay mi nga napirmahan na. Wala pa ang IRR, makig dialogue pa mi sa different stakeholders nato (We are happy that it has been signed. There is no Implementing Rules and Regulations (IRR) yet, we are still going to talk with various stakeholders),” said Dr. Ortigoza.

IRR will be released 180 days after the effectivity of the law.

This law, he said, will cover all Filipinos but with certain qualifications.

Right now, Philhealth implements 9/12 paying scheme, which means that for the past 12 months, the member should have paid at least nine months to avail of the benefits.

With the new law, Ortigoza explained that for one to avail of the benefits immediately, he or she needs to just pay the missed contribution plus 3 percent penalty.

This is challenging because it needs a big budget and one source will be the Sin Tax, according to Ortigoza.

“Is this sustainable? For how many years? We are really hoping this can be sustained,” he said.

Philhealth aims to address these issues once IRR will be released.

Because we are a social health insurance, this should be equitable for all, he added.

There is a tendency that contribution will increase because of factors like inflation, but Ortiga assured that this will be gradual and affordable to members.

Right now, contribution is still at 2.75 percent.

Ybañez said one good thing about Philhealth is it has its Customer Service Management System that addresses all complaints nationwide.

Philhealth has to address complaints within three days.

There is also a portal or online system in hospitals, said Ybañez.

Members no longer need to go to Philhealth to get their Member Data Record (MDR).

Through e-claims, the turnaround time for PhilHealth to pay the hospitals have improved.

Ortigoza said the turnaround time before was 77 days, and now it is 51 days.

“We have the second fastest turnaround time in Mindanao, since the implementation of electronic claims,” he added.

"Philhealth is the premier health financing insurance industry in the country today, meaning it is a social health insurance. The goal is financial risk protection. We say, 'bawal magkasakit' or we cannot get sick but in case it cannot be avoided, at least when you go to the hospital, there is Philhealth to help with your expenses," Dr. Ortigoza said.