This refers to the letter of Oscar Vallarta that appeared in the Inquirer last June 8.
His PhilHealth check representing his refund in connection with the hospitalization of his wife at the East Avenue Medical Center was already sent through registered mail last May 31. He can get in touch directly with our NCR central branch at telephone number 332-3021 for the check details. The head of our NCR central branch actually replied to Vallarta’s letters to our president and CEO, Dr. Eduardo P. Banzon.
The delay in the processing of his claim was due to the fact that more members of the National Health Insurance Program are availing themselves of the benefits. We would like to assure the public, however, that we are taking several steps to fast track our claims processing and enhance our members assistance system.
For instance, we introduced the Case Rate Packages last year where definite amounts have been determined for at least 23 medical and surgical cases. Through this system, we are able to speed up reimbursements to our partner health care providers.
Also, we have deployed PhilHealth Customer Assistance, Relations and Empowerment Staff (PhilHealth CARES) in selected government facilities nationwide, including East Avenue Medical Center, to assist our members at the point-of-service for the purpose of minimizing problems encountered by members when availing themselves of PhilHealth benefits.
Using available technology, PhilHealth is also implementing the electronic claims submission project, wherein institutional health care providers can submit their claims online. It is intended to reduce the turnaround time and improve operational efficiency in the processing and payment of claims. This e-innovation project is being implemented in some Level 3 and 4 hospitals and we are encouraging all our accredited health care facilities to apply for the use of the system.
Rest assured that we are continuously innovating and improving our systems to meet the demands of our growing number of members.
—GREGORIO C. RULLODA,
vice president, Corporate Affairs Group,
Philippine Health Insurance Corp.