More indigent families in Bacolod City are now enrolled under the sponsored program of PhilHealth, a press release from the Bacolod City Hall said yesterday.

With the additional 4,224 indigent families in Bacolod City from the total 117,634 enrollees this year in the entire province of Negros Occidental listed under the National Household Targeting System for Poverty Reduction sponsored through the National Government's budget, these Sponsored Program members can now gain access of the services and benefits afforded by the National Health Insurance Program of PHilHealth.

Regional Head, Marilyn Geduspan of the PhilHealth Regional Office VI, was set to conduct an orientation specifically for the sponsored members yesterday at the Negros Occidental Multi-Purpose Activity Center , for these members to be informed as to what and how they can avail of their benefits under PhilHealth, the press release said.

Sponsored program members are entitled to avail of the in-patient benefits covering subsidy for room and board, drugs and medicines, x-ray, laboratory and others, operating room fee and doctor's professional fee.

Apart from these benefits, PhilHealth also has an out-patient benefit package, which includes free diagnostic services like x-ray, sputum microscopy, CBC, fecalysis, urinalysis and other preventive health services on which sponsored indigent families can avail through the accredited Rural Health Unit in their LGU, the press release said.

PhilHealth is also set to introduce a standardized set of reimbursement for 22 common medical and surgical cases soon in various accredited facilities nationwide.

This new case rate payment, which is a shift from the usual “fee-for-service” scheme where providers are paid for each unit of service, will facilitate a “no balance billing” to eliminate/reduce the out-of-pocket expenses of the members and dependents, the press release said.

Among the medical cases identified to be paid on a case rate basis include: dengue, pneumonia, essential hypertension, cerebral infraction and hemorrhage, acute gastroenteritis, asthma, typhoid fever and newborn care package. Surgical cases on the other hand, include the following: radiotherapy, dialysis, normal deliveries and deliveries by caesarian section, appendectomy, cholecystectomy, hysterectomy, dilatation and curettage, thyroidectomy, herniorrhapy and mastectomy.

“This approach is envisioned as a step towards faster reimbursement of claims since there is already a fixed amount per diagnosis or procedure,” PhilHealth Chief, Dr. Rey Aquino emphasized in the press release.*

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