TO promptly cascade updated circulars and advisories governing the implementation of the National Health Insurance Program (NHIP), the Philippine Health Insurance Corporation (PhilHealth) in Region XII recently conducted a forum with representatives of its accredited hospital and non-hospital facilities at the FB Hotel, City of Koronadal.

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

“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 like how we entrust all our members under your care,” Health Care Delivery and Management Division Chief, Dr. Antoniette M. Ladio said.

Ladio thoroughly discussed the revised guidelines stated in the Conduct of the Health Care Provider Performance Assessment System (HCP-PAS) per PhilHealth Circular 2016-026 reminding them to be conscious about how they follow rules set by PhilHealth in terms of facility and personnel capabilities.

The circular also specifically states the necessary sanctions for medical practice violation they might commit in the course of delivering health care services to PhilHealth members.

During the open forum, Management Services Division Chief, Merlie C. Sabug reminded the participants 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 protocols done in their facilities because failure to follow PhilHealth’s policies will mean breach of contract and they will be answerable as well.

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

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Effective July 1, 2017, the Point-of-Service program has been implemented and the social health insurance benefit shall be shouldered by the National Government through 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 in their PhilHealth Member Registration Forms (PMRF) if they are classified as Financially Capable or FC or Financially Incapable or FI for us to determine their categories,” Dr. Henry F. Manzares, Head of the Benefits Administration Section stressed.

Point-of-Service per PhilHealth Circular 2017-0011 is the latest program implemented by the Corporation, prioritizing enrolment of those who are not yet members of PhilHealth for coverage under the NHIP. Its specific guidelines were discussed by Nevin Hallegado, Membership Section Head, for the health care providers to accommodate all patients who are not yet registered as PhilHealth members. 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,” said Bienvenido L. Borra, Administrative Officer IV. (END) (Hanah G. Naanep)

(Reference: Dr. Israel Francis A. Pargas, Head Executive Assistant and Concurrent OIC-Vice President for Corporate Affairs Group, Cel No. 0917-8089399)