PhilHealth reiterates its commitment to pay its obligations to its partner hospitals. It has sufficient funds to fulfill its obligations. Being a public fund, safeguards are in place based on accounting and auditing rules and regulations prior to disbursements. For 2021, as of May 17, 2021, PhilHealth paid a total of P25.38 B in claims, P4.88B of which are for COVID-19 related claims.
Recognizing the need of the hospitals for funds especially in highly critical areas for COVID as identified by the Inter-Agency Task Force (IATF) for the Management of Infectious Diseases, PhilHealth has introduced the Debit-Credit Payment Method (DCPM)
wherein 60% of good “in process claims” are paid outright to qualified hospitals minus 2% withholding tax, while the remaining 40% shall be paid after claims processing and reconciliation, minus 2% withholding tax. The accelerated payment method provides hospitals sufficient cash flow to continue providing the sick with quality health care during the pandemic.
To date, PhilHealth paid almost P6B in DCPM to 182 hospitals.###
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
PHILHEALTH ID NUMBER REQUIRED FOR COVID-19 VACCINATION
State agency Philippine Health Insurance Corporation (PhilHealth) called on all Filipinos to know and have their PhilHealth Identification Number (PIN) ready as this is now a requirement prior to receiving the Covid-19 vaccine.
The Department of Health (DOH) recently released its Department Memorandum 2021-0099 entitled “Interim Omnibus Guidelines for the Implementation of the National Vaccine Deployment Plan for COVID-19” which prescribes among others, that all potential vaccine recipients need to be registered using the unique identifiers and one of which is the vaccinee’s PIN.
“In order to avoid delays and problems during vaccination, we encourage our members to know and keep their PIN,” PhilHealth President and CEO Atty. Dante A. Gierran said. He added that “for those who do not know their PIN or not yet registered with PhilHealth, they should coordinate with any PhilHealth office or call us so we can provide them their PIN or facilitate their registration.”
Members can verify their PIN through any of the following: by calling (02) 8441-7442 (office hours only) orsending an SMS to our callback channel 0921-630-0009 using the format “PHIC callback PIN VERIF <space> Mobile Number or Metro Manila Landline <dash> Details of your Concern”. Members can also visit any Local Health Insurance Office or PhilHealth Express near them.
For those still unregistered with PhilHealth, members have to fill-out the PhilHealth Member Registration Form or PMRF that can be downloaded from https://www.philhealth.gov.ph/ downloads/ membership/pmrf_012020.pdf. The filled-out PMRF (in pdf or jpeg format), together with scanned copy or clear photo of any of the member’s valid IDs, can be sent to actioncenter@philhealth.gov.ph (with subject: “Register <space> Name <space> City/Province, Region”). Upon processing, their assigned PIN will be sent to the email address they have indicated in the PMRF.
“Mabuti na ang handa tayo para pagdating ng bakunahan ay hindi na natin problema pa ang paghahanap ng ating PIN“, Gierran concluded.