PhilHealth provincial manager, Maritess Que, explained that it had been implementing a new policy of the agency effective September 1, 2011 yet.
In the new case rates, 11 medical cases and 14 surgical cases are categorized and that when one of those cases belong to any of the category it will have a fixed rate that can be availed of by the member or patient.
Que said this is called the package rate, which already consists of room and board, doctor’s fee, medicines, laboratory and other hospital charges.
A PhilHealth member who refused to be identified, said she was surprised to know after her goiter operation that she is entitled only to a certain amount of deduction from PhilHealth under the category.
Que, however, clarified that those not in the list of medical and surgical cases being categorized, can also avail of the insurance benefits under the “fee per service” system, where the deduction will be computed.
The new case rates are part of the direction of the Aquino administration under the universal health care program, she said.*JG
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