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Sunday, September 29, 2024

PhilHealth pay coverage grows, P6.3B released

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The Philippine Health Insurance Corporation (PhilHealth) is urging health care facilities (HCFs) located in areas with high concentration of COVID-19 cases as determined by the Inter-Agency Task Force/National Task Force Against COVID-19 (IATF-NTF) to avail of its Debit-Credit Payment Method (DCPM).

In a statement, PhilHealth said it has implemented the DCPM to fast-track the settlement of its payables to HCFs to ensure continuous delivery of services during the COVID-19 pandemic. 

As of June 14, 2021, PhilHealth already disbursed more than P6.3 billion to 206 HCFs under the DCPM.

The DCPM was first made available to HCFs treating COVID-19 patients in the National Capital Region, Batangas, Bulacan, Cavite, Laguna, Pampanga, and Rizal.

In view of IATF Resolution Nos. 121, 118-A, 116-C, 114-C, 114-A, and 113-A, s. 2021, PhilHealth said that it is expanding coverage for the DCPM to the following provinces and cities:

Luzon — Abra, Apayao, Benguet, Bataan, Cagayan, City of Santiago, Ifugao, Lucena City, Naga City, Puerto Princesa City, Quezon, Quirino.

Visayas — Iloilo, Negros Oriental.

Mindanao — Agusan del Sur, Butuan City, Cagayan de Oro City, Davao City, Dinagat Islands, Surigao del Sur, Zamboanga City, Zamboanga del Norte, Zamboanga del Sur, Zamboanga Sibugay.

Interested health care facilities in these cities and provinces are required to submit their Letter of Intent (LOI) to the concerned PhilHealth Regional Office to qualify for fast-tracked payments under DCPM.

Pursuant to Section V of PhilHealth Circular No. 2021-0006, the DCPM shall only be applicable to (the applying HCFs’) in-process claims received from March 8, 2020 to April 7, 2021. 

On the other hand, claims returned, denied, under investigation and those approved for payment as of April 7, 2021 are not qualified under the DCPM. 

The HCFs also must have claims for COVID-19, have no Interim Reimbursement Mechanism (IRM) balance on record, and have not been served with any suspension of accreditation during the applicable period.

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