NAGA CITY --- Not even the intermittent power supply in the region could prevent the Bicol Medical Center (BMC) from accommodating the composite team from the Philippine Health Insurance Corporation (PhilHealth) for the re-orientation session on the different Z Benefit Packages.

Present were representatives from the Medical, Surgery, Pediatrics and other Departments of the BMC, including support staff members from the Billing, Social Work, Records, Finance, Pharmacy, Nursing and Administration Offices. They trooped to the BMC Auditorium to listen to members of PhilHealth’s Product Team for Special Benefits and officers from PhilHealth’s Regional Office V explain the details of the different packages that PhilHealth has crafted under the Z Benefits.

The re-orientation begun with Dr. Melanie Santillan, Product Team Head introducing the list of Z Packages that are currently being provided for by PhilHealth for catastrophic illnesses that require prolonged care and treatment. Merla Rose Reyes discussed in detail the new forms to be used by the contracted facility while Melchora Mateo of the Accreditation Department tackled the general provisions of the provider’s contract. Dr. Veronica Mateum, HCDMD Head of PhilHealth Regional Office V discussed the process flow when filing claims for reimbursement.

Questions raised during the open forum touched on who were the authorized signatories in the Member Empowerment (ME) Form, whether or not biopsy or other diagnostic work-up services are included in the Z Package, and whether or not the rates being used to reimburse drugs and medicines are based on the Drug Price Reference Index. Clarification was also sought regarding the Z Benefit rates for orthopaedic implants, and suggestions for tri-media efforts to inform the public, particularly the doctors, on the availability of the Z Packages were made.

In her message to participants, Dr. Mary Jane Uy, Chief of Medical Professional Staff of BMC said that the BMC’s active participation in the NHIP was “very important to our performance in the hospital that’s why we are inspired.” She added that “it made such an impact on the economic gains of our employees” and appealed for understanding among her colleagues on the need to comply with the requisites of PhilHealth. “We are here, continuously working together and adjusting to all the requirements that time and again PhilHealth imposes on us. Their plan is to enlarge its coverage so we can expect that there will always be changes and these changes will always be welcome because this made such a difference, not only to the hospital but to our employees, as well,” she said.

The BMC is a DOH hospital and is envisioned to be the premiere medical center in Bicol. It currently caters to patients from all over Bicolandia. A two-storey cancer center, a five-storey Medical Arts Building, an ER Center and a Trauma Center are being constructed within the BMC compound.

According to BMC Medical Center Chief Dr. Efren SJ. Nerva, PhilHealth reimbursements in 2014 reached P90.43 million, comprising about 41 percent of the hospital’s total income for that year. Since 2008, the percentage of PhilHealth reimbursements compared to BMC’s total income has consistently increased, peaking at about 45 percent in 2013.

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He also shared that at present, the BMC, which has a 500-bed capacity, is “overflowing with patients,” even reaching up to 150 percent occupancy rate. The BMC is contracted for Z benefits for breast and prostate cancer, but Nerva explained that since radiotherapy services are not yet available anywhere in the Bicol region, the BMC has not been able to go full-swing yet on the provision of the services.

Crediting PhilHealth for the assistance that it has given to BMC over the last seven years, Nerva said that PhilHealth reimbursements have greatly contributed to the “ongoing financial improvement of the BMC” and that these have “financed our quick fix (projects) and the acquisition of new equipment needed by our medical specialists in the practice of their profession.” When asked why he is bent on seeing the big-ticket projects for BMC into completion when he is about to retire from government service, Nerva stressed that, “I want to do something for the hospital that nurtured me.” (END)Maria Sophia B. Varlez