The Philippine Health Insurance Corporation (PhilHealth) celebrates the 27th year of the National Health Insurance Program pursuant to Republic Act 7875, as amended which was signed into law on February 14, 1995.
This year’s observance will have the theme: “PhilHealth, Tumutugon sa Hamon ng Panahon” to give emphasis to its resilience and firm commitment in the face of numerous challenges brought about by the current pandemic. Despite uncertainties, PhilHealth had defied and continues to defy all odds that come its way in providing every Filipino with financial risk protection against costly hospitalizations.
PhilHealth and COVID-19
The COVID-19 pandemic that started in 2020 has greatly challenged the country, compromising the viability of numerous businesses, triggering massive layoffs and joblessness, and sending the nation’s economy to record high contraction.
But for countless members and their families afflicted with COVID-19, PhilHealth has been able to provide the needed financial relief from the high cost of treatment for the novel coronavirus.
As a crucial partner of the Government in its overall pandemic response, PhilHealth immediately put together benefit packages ranging from testing, facility-based and home isolation, treatment and hospitalization, and a vaccine injury compensation package for those who will experience serious adverse effects following COVID-19 inoculation.
As of January 22, 2022, PhilHealth paid more than 7 million to COVID claims amounting to P36.8 billion, where P22.2 billion was for COVID testing, P13.7 billion for hospitalization claims and P939.8 million for community isolation claims.
Undaunted by the pandemic
True to its mandate of ensuring every Filipino’s access to a full spectrum of essential, quality health services as mandated by the Universal Health Care Law, PhilHealth continued serving its members, partners and stakeholders despite mobility restrictions brought about by strict quarantine levels. This despite the fact that many in its ranks had to go on quarantine, seek treatment, or succumbed to the dreaded disease. Not to mention the various inquiries that aggravated the pandemic effects on the morale of its employees.
Despite all these, PhilHealth has not reneged on its mission to its members and healthcare providers through steadfast processing and payment of their benefit claims. While it had to reduce client traffic in its frontline offices due to human resource constraints, all while observing minimum health standards, PhilHealth continue to break more grounds to make its services accessible and felt by the people. It opened two additional offices in CARAGA.
On benefit payments, it released a staggering P162.6 billion covering more than 18.5 million in COVID and non-COVID claims filed by its healthcare delivery partners.
Accelerated payments to health facilities
Balancing its response to the clamor for fast tracked payments without compromising pertinent laws and regulations that govern the management of public funds, PhilHealth introduced the Debit-Credit Payment Method (DCPM) in the early part of 2021.
Through the DCPM, the agency is able to expedite settlement of its payables and to provide needed funds to health care facilities. The DCPM is already in its third wave benefitting hospitals treating COVID patients anywhere in the country.
As of January 20, 2022, PhilHealth has paid a total of P12.48 billion to 464 hospitals that applied to the DCPM.
The DCPM is just one of the many positive results of numerous dialogues with key partners in the healthcare provider sector. PhilHealth has opened its doors, and continues to hold talks with providers for the resolution of various issues that the current pandemic has brought to fore.
Uninterrupted services
This pandemic has likewise resulted to limited movement for the members who have not ceased seeking the services as well as from fulfilling their obligations to the Program. To respond to such demands, important and timely innovations in frontline services were introduced such as the PhilHealth Member Portal wherein members can access their membership and contribution records, and download their Member Data Record with just a few taps on their smart phones or gadgets essentially anywhere and everywhere.
The said Portal also enables self-paying members to pay their premium contributions online either via credit card, debit card or GCash.
PhilHealth’s Corporate Action Center (CAC) was also challenged by the current pandemic, but it did not waver in its resolve to continue serving the information needs of members. Complementing its automated voice response for basic queries is the Callback Channel wherein clients can simply text a request for callback to 0921-630-0009. Within 72 hours, agents will call them back for relevant information or assistance being requested. For the year 2021, more than 35,000 calls were received and acted upon by the CAC.
As it celebrates its 27th year and sets its sight beyond, PhilHealth vows to be more relevant and responsive to the growing healthcare needs of its 110 million members here and abroad. It is committed to level up its benefits and services by constantly strengthening its organizational, financial and more importantly its human resource capability to efficiently and effectively meet the demands of these changing times.
Hindi po kami titigil na tumugon sa anumang hamon ng panahon.