PhilHealth: Pampanga, best partner in healthcare in CL
District hospitals’ insurance claims reach P401M
By Angelique DC. Tuazon
LUBAO, Pampanga – Officials of the Philippine Health Insurance Corporation (PhilHealth) lauded the provincial government of Pampanga, headed by Governor Lilia “Nanay” G. Pineda, for being the best and model partner in healthcare throughout Central Luzon during a convergence meeting in this town Wednesday.
PhilHealth Branch Manager Henry Almanon noted the Capitol’s allotment of P32,409,600 for its 13,504 indigent hospital-sponsored members in 2014 alone under the Point of Care (POC) program.
Almanon also acknowledged the remarkable increase of district hospitals’ insurance claims from some P172-million in 2013 to P401,823,515.19 in 2014. Cases filed also increased from 42,800 in 2013 to 83,276 in 2014.
The province was able to collect P126,425,306 from 17,808 POC cases filed by members including their registered dependents.
Social Insurance Officer Elsie Bondoc, also commended the province for being the first to comply with the Automated Credit Payment Scheme (ACPS) wherein approved hospital claims are directly deposited to the district and provincial hospitals’ dedicated LandBank accounts.
Bondoc stressed, this would not be possible without the aid of the Sangguniang Panlalawigan, led by Vice Governor Dennis Pineda, by passing a legislation enabling the 11 district and provincial hospitals to open Landbank accounts to be utilized for ACPS thereby promoting a paperless, efficient, and secured mode of reimbursement of funds. The province collected P36,802,715.97 through ACPS.
PhilHealth also reported a significant decrease in Return to Hospital (RTH) cases or “denied claims” wherein the hospital failed to reimburse funds due to incomplete documents or misfiled claims.
Currently, the province has 7,383 RTH cases equivalent to only 8.8% of total cases filed amounting to some P60-million. However, Governor Pineda is still unsatisfied with this and aims for 100% reimbursement in 2015.
Pineda instructed medical social workers in-charge of filing PhilHealth claims to thoroughly inspect every document submitted to ensure that no claims will be denied or rejected this year.
