By Perla Lena/PNA
ILOILO CITY — The no balance billing (NBB) policy of the Philippine Health Insurance Corp. (PhilHealth) has benefitted 88 percent of its target recipients in Western Visayas (Region 6) when they got admitted to health facilities observing its implementation as of October.
Data provided by PhilHealth’s Public Affairs Unit on Friday showed that 43 percent or 3,161,962 of the 95 percent member coverage of the state health insurance agency in Western Visayas are indigents.
The region has a population of 7.7 million and PhilHealth already covers 7.426 million.
Moreover, 9 percent or 669,319 are senior citizens; 2 percent or 168,957 are sponsored; and 3 percent or 215,095 are lifetime members.
The NBB is open to indigent, senior and lifetime members, sponsored and “kasambahay” (domestic helpers). It can be availed of in health institutions, particularly in government facilities.
“NBB implementation is a challenge really for PhilHealth. But it is not merely PhilHealth that has the mandate but it also extends to our providers, especially our government hospitals,” Janimhe Jalbuna, head of PhilHealth 6 (Western VIsayas) said in this week’s year-end report.
The high availment rate means members are “really benefitting from this,” she said.
NBB policy mandates that “no other fees or expenses shall be charged or be paid for by qualified patients above and beyond the packaged rate.”
In terms of claims, the indigent group posted the highest with 28 percent, followed by senior citizens with 22 percent. Sponsored patients posted an 8 percent availment and 7 percent for lifetime members.
The rest of the claims were 18 percent for informal members, and 17 percent for formal members.
Jalbuna also said that in terms of payment, PhilHealth-6 recorded a turnaround time of 22 days, faster than the 60-day allowable period. “There is no reason for providers not to provide benefits to our members,” she said.
Meanwhile, PhilHealth-6 Acting Regional Vice President Janet A. Monteverde said they have other programs to cover those who are unregistered with PhilHealth, such as the point of service in government hospitals.
She added that to achieve Universal Health Coverage, they continue to update their membership and likewise undertake data base cleanup.
