PhilHealth incentives are aboveboard and duly authorized by law

This refers to Bernardo Peralta’s letter titled “No reason to praise  PhilHealth” (Opinion, 10/10/14).

We fully acknowledge Peralta’s personal opinion on the incentives PhilHealth gave to its employees, but we again would like to assure him that the subject allowances mentioned in the 2012 audit of the Commission on Audit were aboveboard and regular, and were all given with sufficient basis as provided for in Section 16 (n) of Republic Act No. 7875, as amended. The law duly authorizes  PhilHealth “to organize its office, fix the compensation of and appoint personnel as may be deemed necessary and upon the recommendation of the President of the Corporation.”

The incentives, which were given to more than 5,800 employees for their dedication to and hard work in fulfilling our mandate, were even covered by presidential approval in 2007.

On the issue of payment of his benefit for professional fees, the usual process back then was to fully reimburse the hospital and the doctors upon submission of good claims.  But in cases where his/her benefits were not deducted prior to discharge and the member paid in full or in part, PhilHealth would pay in favor of the member, provided that the nondeduction was  properly indicated in the claim forms and/or appropriate supporting documents—such as official receipt or doctor’s waiver—enclosed in the claim.

We assure him and the rest of our members that this is no longer the case with our new payment system (case-based or case rate system) wherein payments to the hospital and attending physicians are paid singularly to the facility or to the member only if warranted per PhilHealth Circular 31, s.2013.

To further help Peralta with his concerns, we invite him to call our Action Center at 441-7442 or  e-mail us at [email protected].

—DR. ISRAEL FRANCIS A. PARGAS,
OIC-vice president, Corporate Affairs Group,
Philippine Health Insurance Corp. (PhilHealth)