To help the Philippine Health Insurance Corporation (PhilHealth) efficiently coordinate Information Technology (IT)-related transactions with its stakeholders, South Cotabato Governor Reynaldo S. Tamayo, Jr. has pledged to support the state health insurer during a recent meeting with PhilHealth President and Chief Executive Officer, Emmanuel R Ledesma, Jr. in Tupi, South Cotabato.
“I appreciate the programs of PhilHealth. In fact, the South Cotabato Provincial Hospital provides the No Balance Billing Policy. People from the province and neighboring areas have already availed the same. During pandemic, I have exclusively accommodated Covid 19 patients to the Upper Valley Community Hospital now Soccsksargen General Hospital in order to contain the virus. I just want to improve our IT system. I am willing to help. Having our own will help us minimize expenses, minimize delay and minimize hassle in our transactions and it is in line with the government’s plan to improve our electronic system services,” Tamayo said.
With South Cotabato’s performance in terms of establishment of its Health Care Provider Network (HCPN), PhilHealth has committed to have it included in the report that the Corporation will submit for possible inclusion in President Ferdinand Marcos, Jr.’s second State of the Nation Address in July this year.
Ledesma welcomed the development, saying: “It is an opportunity for corporate improvement. There are few things that we would like to address in the Corporation with Atty. Eli (Santos), our COO and that is computerization and digitalization. Of course, there are issues on claims, fraudulent claims, so hopefully, with more computerized system, we will be able to minimize the problem,” he said.
As an IT graduate who belong to the first batch of graduates in the Philippines with combined Computer Engineering and Computer Science courses, the Governor said that he knew the process, and his concern are the claims of private institutions that are submitted through the PhilHealth portal.
“I just wonder why the need to hire a private corporation that will serve as our gateway to your portal when we can also make our own. We should manage our own and have somebody take control of the system and clean the data for transmission to your portal,” he added.
The Governor likewise requested PhilHealth to have its own quality control officer to get rid of the Return-To-Hospital (RTH) issues. He recommended that they should be based in the hospitals so that claims processing shall be done by PhilHealth immediately as the facilities submit their documents.
“At present you are doing well. I have projected for least 300 million expenses in the hospital in 2022 for the salary, drugs and meds, the entire operating expenses. We received 450 million from PhilHealth. In other words, we have gained at least 150 million which at present is being used for the hospital expansion,” he added.
Other than IT-related concerns, the Governor, as National Chairman of the Union of Local Authorities, also committed to PhilHealth the Local Chief Executives’ support in the area of operations-related matters.
“Don’t worry, I’ll help you because PhilHealth has helped me a lot in marketing free hospitalization coverage that was able to sustain us for four years now. If you mean to call the attention both of the government and private hospitals, feel free to drop my name,” he said.
With South Cotabato’s performance in terms of establishment of its Health Care Provider Network (HCPN), PhilHealth has committed to have it included in the report that the Corporation will submit for possible inclusion in President Ferdinand Marcos, Jr.’s second State of the Nation Address in July this year.
Other than IT-related concerns, the Governor, as National Chairman of the Union of Local Authorities, also committed to PhilHealth the Local Chief Executives’ support in the area of operations-related matters.
As of February 2023, PhilHealth Regional Office XII (PRO) Vice President, Dr. Hector Zenon Leonardo P. Malate said that the Region has been processing claims within 26 days.
He likewise turned over the list of indigent members in Tupi under Listahanan 2 with their corresponding PhilHealth IDs for distribution to the recipients.
Ledesma also told Tamayo that PhilHealth will implement benefit enhancements starting 2023 which include rationalization of select inpatient case rates, increase in hemodialysis coverage from 144 to 156 sessions, introduction of the outpatient severe acute malnutrition package, mental health package, and rationalization of some Z benefit packages.
“We will put it all together… plus your support from the LGU which is very more important,” Ledesma added.
Also present during the said meeting were PhilHealth Executive Vice President and Chief Operating Officer Atty. Eli Dino D. Santos, Area IV Vice President Gregorio C Rulloda, CPA, and other officers from PhilHealth Regions XII and XI offices.
