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PIA Press Release

PhilHealth eyes universal coverage

By Miriam P. Aquino

San Fernando City, La Union (10 July) -- The Philippine Health Insurance Corporation (PhilHealth) are having a 7-day roadshow around the region meeting all the Hospital Service Providers to update them on what is to be expected and to gather from them all issues as well as recommendations to help strengthen the PhilHealth national insurance coverage amid the worsening economic situation brought about by the unstoppable increase in prices of oil and food worldwide.

In an interview with Dr. Arlene Grace Guico, one of the members of the PhilHealth Board of Directors and at the same time President of the World Citi Medical Center, said that the roadshow aims for expanded coverage while at the same time listening to suggestions and recommendation for a possible increase in PhilHealth benefits to individual members and their dependents.

In a conference with all the Hospital Service Providers (Private and Public) of La Union held at the Villa Estrella in Bauang, this province, she said that the universal coverage of PhilHealth through accreditation of more hospitals and clinics nationwide. She said that at present, there are over 75 percent of accreditation health providers but they are still aiming for more to achieve their target of a universal membership.

Guico reminded that not all health professionals in the region are PhilHealth accredited but a great number are already applying for such. She even reminded that membership to hospitals and doctors only lasts for three years so they have to renew before their membership expires in order to avoid the so-called "ghost claims."

Indigent members sponsored by local government units (LGUs) should renew membership on a yearly basis.

In Region I, Dr. Leo Douglas Cardona, Jr. PhilHealth Regional Director disclosed that the there is a considerable number of accredited hospitals and doctors in the region in terms of participation rate with 80 percent coverage. The province of La Union alone showed 90 percent of accredited members covering 350,000 households.

On the issue of ghost claims by some medical practitioners whose membership have already expired, and were not able to renew their membership but are still claiming for financial benefits, Dr. Guico said that Philhealth's Adhoc Committee on Appeals of Administrative Cases have made moves in the investigation of all the personalities involved in irregularities following the due process of law..

She added that PhilHealth has set good control measures in safeguarding PhilHealth funds by enlisting the services of consultants to prevent fraudulent claims.

In response to the President's social reform program, PhilHealth has now accredited almost 25million members, not too far from its target of 30 million coverage nationwide. This includes membership of the poorest of the poor (indigents) thru the LGU assistance and lawmakers enrolling poor constituents in their respective congressional districts.

On the issue that PhilHealth cards were widely utilized as a political weapon by the administration during the past elections, Cardona and Guico explained that "this being the case, the good thing is that there has been a continuity of the program regardless of whoever is in power or has taken the post among the local executives because they have learned to adopt the program by heart for the sake of the indigents."

On matters concerning delayed refunds to members who have exceeded payments in their hospital bills, Guico said that there is no cause for worry because all these have been taken into account by PhilHealth but members should wait for four to six months processing period.

As a humanitarian gesture to typhoon victims, members were given a moratorium for the delayed remittances of member's contributions. (PIA La Union) [top]

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