Manila Bulletin has released news that the Private Hospitals Association of the Philippines, Inc. (PHAPI) plans to make Philhealth members pay their full hospital bills. Private hospitals will no longer remove the philhealth subsidized portion from the medical bills before the computation of the total fees for payment. This decision has been caused by Philhealth's delay in paying the hospitals their dues.
The current process should be as follows:
1. Member informs the hospital that he is a Philhealth member.
2. The hospital provides the member with a philhealth form to fill out and submit to the hospital records.
3. The hospital's billing department will compute the total costs of all medical expenses and subtract the Philhealth subsidy form the member's bill. The member will only have to pay for the amount not subsidized by Philhealth and his other medical insurances.
If PHAPI's plan pushes through, the process will probably be as follows:
1. The hospital's billing department will subtract only the costs from non-Philhealth medical insurances of the member (such as HMO, or medical insurance).
At this point, I am not sure if the hospital will indicate how much the Philhealth subsidized portion should be, for easy reference of the member and his medical insurance(s).
2. The member must keep the hospital receipts and medical abstracts and other pertinent documents during his confinement. These should be attached to a filled out Philhealth claim form to be submitted to the Philhealth office for reimbursement of the subsidized portion.
3. The member has to file the request for reimbursement with Philhealth and wait for Philhealth to approve his request and give him his money.
This change in process is a lot of bad news for our countrymen for several reasons:
1. Philhealth members must have the money to pay for their hospital bills at the time of their hospitalization. Not everyone has enough money to be able to handle emergency expenses. I can predict a rise in the business of loans and more of us falling into debt because of unexpected medical emergencies.
2. Philhealth members will have to suffer through the beaureaucracy of additional paperwork, and slow processing of reimbursement. I have one testimony from a close friend where this process has already been implemented last march, and Philhealth has promised them a one month timeline for the reimbursement. To this day, they have not yet received their reimbursement.
Also, the fact that you have to take a day off work to submit your papers to Philhealth for a reimbursement would be a big concern. Not everybody can afford to lose a day's worth of pay, or even a day's worth of workload, just to be able to file reimbursement requests.
3. This will cause even higher congestion at public hospitals where, I assume, the Philhealth subsidy will be honored prior to the payment of the final bill.
At the end of it all, it's the common man that suffers because of inefficiencies in the system. I can only cross my fingers and hope that our government looks into this issue and addresses it quickly. In the current process, only Philhealth wins because they get away with not paying their hospitals on time, but the citizens still get the quality healthcare that they deserve. In the new process, we citizens lose on all counts because we may not even get the treatments for our ailments, we may end up in debt, and we also have to start fighting a battle for our financial compensation. The private hospitals wouldn't worry abotu us because they would get paid anyway, and Philhealth may simply twiddle their thumbs.
The current process should be as follows:
1. Member informs the hospital that he is a Philhealth member.
2. The hospital provides the member with a philhealth form to fill out and submit to the hospital records.
3. The hospital's billing department will compute the total costs of all medical expenses and subtract the Philhealth subsidy form the member's bill. The member will only have to pay for the amount not subsidized by Philhealth and his other medical insurances.
If PHAPI's plan pushes through, the process will probably be as follows:
1. The hospital's billing department will subtract only the costs from non-Philhealth medical insurances of the member (such as HMO, or medical insurance).
At this point, I am not sure if the hospital will indicate how much the Philhealth subsidized portion should be, for easy reference of the member and his medical insurance(s).
2. The member must keep the hospital receipts and medical abstracts and other pertinent documents during his confinement. These should be attached to a filled out Philhealth claim form to be submitted to the Philhealth office for reimbursement of the subsidized portion.
3. The member has to file the request for reimbursement with Philhealth and wait for Philhealth to approve his request and give him his money.
This change in process is a lot of bad news for our countrymen for several reasons:
1. Philhealth members must have the money to pay for their hospital bills at the time of their hospitalization. Not everyone has enough money to be able to handle emergency expenses. I can predict a rise in the business of loans and more of us falling into debt because of unexpected medical emergencies.
2. Philhealth members will have to suffer through the beaureaucracy of additional paperwork, and slow processing of reimbursement. I have one testimony from a close friend where this process has already been implemented last march, and Philhealth has promised them a one month timeline for the reimbursement. To this day, they have not yet received their reimbursement.
Also, the fact that you have to take a day off work to submit your papers to Philhealth for a reimbursement would be a big concern. Not everybody can afford to lose a day's worth of pay, or even a day's worth of workload, just to be able to file reimbursement requests.
3. This will cause even higher congestion at public hospitals where, I assume, the Philhealth subsidy will be honored prior to the payment of the final bill.
At the end of it all, it's the common man that suffers because of inefficiencies in the system. I can only cross my fingers and hope that our government looks into this issue and addresses it quickly. In the current process, only Philhealth wins because they get away with not paying their hospitals on time, but the citizens still get the quality healthcare that they deserve. In the new process, we citizens lose on all counts because we may not even get the treatments for our ailments, we may end up in debt, and we also have to start fighting a battle for our financial compensation. The private hospitals wouldn't worry abotu us because they would get paid anyway, and Philhealth may simply twiddle their thumbs.
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