PhilHealth celebrates 14th Anniversary
PhilHealth is celebrating its 14th Anniversary this February, the National Health Insurance Month, with the theme “Kalusugan ng Lahat PhilHealth ang Katapat.” As part of the celebration it holds an exhibit at SM City Iloilo starting February 13 as it opens its service desk at the mall.
To strengthen its collection for sustainability, it will be launching the tie up with M. Lhuiller Pawnshop as new collection window. M. Lhuiller has hundres of branches throughout the country and this project was initiated by PhilHealth Regional Office (PRO) VI.
It was learned that sixty two (62%) percent collection rate is gathered through the Over the Counter Collection (OTC) while 38% was through the Accredited Collecting Agents.
PhilHealth Regional Office (PRO) VI aimed to become an important player in the development of healthcare in Western Visayas, providing quality services in medical care to uplift the lives of members and in alleviating poverty. The year 2008 was quiet modest for our membership coverage in all sectors vis-à-vis population reached 86%, while coverage of the poor families is 49%. The overall premium collection pegged at 103% or P25 million above the target. Benefit availment by members climbed to P1.37 billion which is 5% higher compared to the 2007. Innovation on services/procedures was a centerpiece in providing efficient and customer friendly service.
Aside from reason of illness or injuries, PhilHealth covered certain outpatient procedures (OPB-DOTS), Normal Spontaneous Delivery (until 4th). Preventive services were given importance that certain services are being brought down to the Health Center level. PhilHealth directly pays this PhilHealth accredited non-hospital institutions that provided and ensured the health care needs of every member and all dependents.
In 2008, PRO VI total benefit payment reached P1.371 billion. Drugs and medicines accounted 32.48% or P445 million, X-ray/Laboratory/Others accounted 24% or P323 million, Room and Board at 19.38% or P265 million, Professional Fees at 18.92% or P259 million, and Operating Room Fee at 5.60% or P76 million.
Comparing 2008 against 2007 claims availment showed a slight increase in the amount paid with 5% growth, from P1.307 billion to P1.371 billion. Total number of claims paid also grew by 10% from 184,712 in 2007 to 203,410 in 2008. Per record, a total of 25,646 claims were either Returned To Sender and/or Denied for varied reasons.
As to Institutional Healthcare Providers, PRO VI has a total of 274 facilities were accredited. 112 Hospitals: 41 Primary, 45 Secondary and 26 Tertiary, 4 ambulatory clinics; 88 Rural Health Units, 17 Health Centers, 29 Maternity Care Clinics, and 24 Anti-TB DOTS centers.
A total of 423 Health Care Professionals were also accredited: 213 General Practitioners, 181 Medical Specialist at 181,25 Midwives, and 4 Dentist.
PRO VI, being an organization that views innovation as an agent of change, has ventured into providing enhancements in delivering efficient and quality service to its members and stakeholders. It garnered an award from Dr. Rey B. Aquino, PhilHealth President and CEO, a Regional Office that exemplifies optimal operations, given last December 19, 2008 and received by Asst Vice President Alberto C. Manduriao, the Regional Head. Among the innovations adopted are: the requirement of Statement of Accounts to Claim which resulted in the reduction of the average value per claim from P7,999.14 in 2006, P7,076 in 2007 to P6,742 in 2008 or 5% decrease; Bank Abstract System; Monthly Diskette Reporting System, and, the simplified All-in One Frontline Service of PhilHealth Members Assistance Center operating without a noon-break. (Larry Tabsing)