PhilHealth expedites reimbursements provides HCFs with needed funds

Recognizing the crucial role of the hospitals in providing unimpeded delivery of health care services to those who need it, the Philippine Health Insurance Corporation (PhilHealth) recently announced the implementation of the Debit-Credit Payment Method (DCPM) to fast-track payments to its partner-hospitals.

Under the DCPM, PhilHealth shall facilitate the settlement of accounts by paying 60% of the total amount of applicable HCF receivables minus withholding tax of 2%, while the remaining 40% (minus 2% withholding tax) of the total amount of good claims shall be paid following compliance to existing claims processing requirements and procedures, and full reconciliation of the 60% initially paid to the HCF.

Atty. Dante A. Gierran, PhilHealth President and CEO, said that, “The idea behind this [DCPM] is to immediately pay 60% of the total P7.01 billion of hospital claims in the National Capital Region (NCR) Plus area.”

Reimbursements through the DCPM only apply to in-process claims filed from March 8, 2020 to April 7, 2021. However, claims that were returned to hospitals, denied, and under further investigation shall not be paid under the DCPM. Likewise, claims approved for payment by April 7, 2021 were excluded from the payment.

The accelerated payment method shall afford hospitals sufficient cash flow to continue providing the sick with quality health care during the pandemic. In view of this, hospital funds are augmented to enable them to increase their capacity in managing more COVID patients.

All PhilHealth-accredited hospitals in the NCR Plus bubble (NCR, Bulacan, Cavite, Laguna, and Rizal) including Pampanga and Batangas treating COVID-19 patients may avail of this payment method. In compliance to the Inter-Agency Task Force (IATF) Resolution No. 111 dated April 22,2021 and IATF Resolution No.113-A dated April 29, 2021, PhilHealth is expanding the DCPM to high and critical areas that include the Cordillera Administrative Region (CAR) provinces of Abra and Ifugao and Region II cities of Santiago and Quirino.

Eligible HCFs must submit a properly accomplished undertaking duly signed by their respective owner or medical director subject to the concurrence of PhilHealth. “The DPCM is now on-going, and our Regional Offices are awaiting the facilities’ filing of their Letter of Understanding,” said Gierran. “Kapag na-submit ninyo iyong Letter of Understanding na pirmado ng may-ari ng ospital, medical director, o sinomang authorized representative ng ospital, meron tayong automatic credit na dapat bayaran ng PhilHealth sa ospital.”

Upon receipt of payment, the HCFs shall issue an electronic copy of the official receipt (OR) to the concerned PhilHealth office within five days and the original OR must be submitted within 15 days. PhilHealth shall withhold all succeeding payments to HCFs should they fail to submit the OR.

As of April 29, 2021, PhilHealth has disbursed payments to 114 HCFs under the DCPM amounting to P5.14 billion.

PhilHealth continues to provide ways to be responsive to the health needs of its stakeholders. END

Treat pandemic as disaster that needs preparedness, scientist says

“Let’s think of pandemics and even localized epidemics as disasters for which we need preparedness and mitigation strategies.”

Academician, Emeritus Prof. Michael Lim Tan of the University of the Philippines, says, during his presentation on “COVID-19, Circularity and Better Normal: Recovery and Rebuilding,” at the Annual Scientific Conference and 88th General Membership Assembly of the Department of Science and Technology-National Research Council of the Philippines (DOST-NRCP).

Further, Tan mentioned that the country’s unpreparedness with COVID-19 does not augur well for future public health emergencies as well as other natural disasters. What if, he supposed, the “Big One” turns out not to be an earthquake but a pandemic more serious than COVID-19.

Tan pointed out, “We just might outlive COVID-19, but COVID-19 is not going to be the last pandemic so it is not enough to speak of resilience, which often becomes as excuse for inaction, or for halfway measures.”

What the country needs is – to aim for a better normal, which includes avoiding mistakes of the past and addressing the “comorbidities” medical or social that made COVID-19 so destructive.

The four social concerns – the neglect of housing, transport, education, and social safety nets – are often referred to simply as “poverty,” which somehow obscured important skewed social relations and economic inequities.

On the concept of “circularity,” Tan explained that circularity relates closely to sustainability, which has been neglected especially in terms of S&T development for healthcare.

Poverty, he elucidated is not just low income, rather, this includes living in congested slums, shopping in congested groceries and malls, it’s taking congested public transport, it’s being more vulnerable to extortion from law “enforcers,” it’s paying more, in relation to income, when someone gets sick or dies.

Food and nutrition are parts of S&T and it is here where circularity is all the more important as the country faces serious problems on food security which will worsen during disasters.

While acknowledging government’s efforts in S&T, such as the abaca face masks, testing kits, and medicines, Tan observed that the Philippines has swallowed the “too small a country” argument hook, line and sinker. And here he cited the tiny Cuba, which has an 11 million population – even smaller than Metro Manila, yet they are developing four COVID-19 vaccines, of which the main one is called Soberana, for sovereignty.

“In contrast, we do not even produce our own syringes for the vaccines,” Tan mentioned.

A lot still need to be done and foremost is explaining efficacy. Even a high 93% efficacy rate will mean 70,000 people out of 1 million vaccinated people getting infected albeit mostly mildly. This is not being talked about enough but, like family planning in the past, each failure, each negative experience, (think vasectomy pregnancies!) sets back public health campaign, according to Tan.

There should be an information, education, and communication for vaccination: As vaccines come in, the country has to deal with widespread vaccine hesitancy, some related to growing denial of COVID-19 (“gawa gawa lang” or just fabricated), plus mistrust because of previous vaccine scares and Dengvaxia. Pulse Asia survey in November 2020 found that only 32% of Filipinos were willing to be vaccinated, which is far too low for herd immunity.

Tan acknowledged, however, that there are a lot of good things being done and he encouraged the documentation of these good practices among national and local governments, including kinder, more compassionate and science-based approaches, some in sharp contrast to unscientific methods.

Since over 1,500 gathered virtually for the annual scientific conference, the social scientists were urged to remind the government that it needs their research, quantitative and qualitative, to inform public policy. From these researches, for instance, information on what the people are doing are known, whether these are good things, such as gardening, or risky, such as the taking of Lianhua, which is a Chinese remedy with ephedrine, or some other practices, like “suob/tuob” (steam therapy), which people resort to that needs to be evaluated.

DOST-NRCP holds the biggest and largest database of science, including social science and humanities, experts in the country. For information and requirements on free membership for Filipino researchers and other free informative research-based webinars, please visit Research Pod page on Facebook, the NRCP’s basic research promotion page. (S&T Media Service, Geraldine Bulaon-Ducusin).

Professor Michael Tan during his presentation on “COVID-19, Circularity and Better Normal: Recovery and Rebuilding,” at the Annual Scientific Conference and 88th General Membership Assembly of the Department of Science and Technology-National Research Council of the Philippines (DOST-NRCP).

STARBOOKS Pens the Philippine Quill Award in its List of Achievementson Its 10th Year
STARBOOKS was honored for garnering the Excellence in Government Communication Programs award in the 18th Philippine Quill Awards, marking another achievement for being one of the knowledge products of the DOST-Science and Technology Information Institute (DOST-STII).

STARBOOKS stands for Science and Technology Academic- and Research-Based Openly-Operated KioskS, the country’s first S&T digital library in a box.

“This is the first time DOST-STII competed in the Quill, and this recognition represents further validation of the good work we have done in STARBOOKS even under extraordinary circumstances like the ongoing pandemic,” says DOST-STII Director Richard P. Burgos.

Moreover, he added that the Philippine Quill Awards recognized the impact of STARBOOKS in bringing knowledge on science, mathematics, and technical fields directly to the people, especially to students in economically-challenged schools and communities.

STARBOOKS competed against over 800 entries from both public and private sector organizations. All entries were carefully reviewed by seasoned communication professionals of the International Association of Business Communicators (IABC) Philippines, the organizing body of the Philippine Quill Awards, using the strictest global standards to measure and determine the very best in the practice of business communication.

This year’s award ceremonies, also the first time the event was held in virtual format, underscored the power of communications to empower communities and encourage the Filipino people to rise and overcome the most pressing challenges today.As the lead implementing agency for STARBOOKS, DOST-STII recognized early on the fundamental importance of constantly discovering new, oftentimes untested ways to engage its audiences to expand the scope and support for this highly-sought program now found in over 5,000 sites nationwide.
Come June 24 of this year, STARBOOKS will celebrate a decade of service fully secured in the realization that an organization, no matter how lean it is with limited resources, can still overcome the newest of challenges, and capture the most unforeseen of opportunities by being able to pivot and deliver in step with the changing times. 

The winning-Quill photos of STARBOOKS displayed at the Virtual Awards Night on 25 March 2021.