PhilHealth fast-tracks 4Ps benefit claims

CAGAYAN DE ORO CITY – The Philippine Health Insurance Corporation in northern Mindanao said it is now fast-tracking the processing of health benefit claims of grantees of the government’s Pantawid Pamilyang Pilipino Program.

Ian Alfredo Magno, Chief Social Insurance Officer of PhilHealth in Region 10, said the claims submitted by accredited hospitals will be processed immediately as long as the beneficiaries will be able show authentic and official identification card issued by the Department of Social Welfare and Development in northern Mindanao.

Magno, along with Social Insurance Officer Fatmah Guiling and Social Insurance Assistant Remea Vera Dacut, visited the DSWD regional office to discuss issues and concerns relative to hastening the processing of claims.

The 4Ps beneficiaries are covered by PhilHealth as sponsored members. They are issued their Member Data Record and PhilHealth Identification Number which will serve as their pass when availing of health care benefits at any accredited facilities in the country.

As sponsored members, they are entitled to full benefits including the recently introduced case rate payments for 23 medical and surgical cases wherein they no longer need to pay in excess of the PhilHealth set benefits in government facilities.

They can also avail of the ‘Z’ benefit package for catastrophic illnesses such as childhood acute lymphocytic leukemia, breast and prostate cancer, and kidney transplant, with financial coverage of P210,000, P100,000 each, and P600,000 respectively.

PhilHealth has initially partnered with selected reference and contracted government hospitals nationwide to provide the Z benefits.

The beneficiaries also enjoy primary care benefits such as consultations, regular blood pressure monitoring, and promotive health education on breastfeeding and counseling on lifestyle modification and smoking cessation. Medicines for diseases like asthma and acute gastroenteritis with no or mild dehydration, upper respiratory tract infection/pneumonia and urinary tract infection are also provided for by accredited healthcare providers.

To ensure access, PhilHealth has automatically accredited all Department of Health-licensed hospitals as Centers of Safety. Guiling emphasized that PhilHealth will only honor un-tampered identification cards.