BAGUIO CITY – The Philippine Health Insurance Corporation Cordillera (PhilHealth-CAR) released its report presenting the projects accomplished under the Pinalawak at Bagong Benepisyo para sa Mamamayang Filipino (PBBM) program about the increased benefits, programs, healthcare facilities, and claims payment on Tuesday.
The Pinalawak program highlighted their increase in membership registration and PhilHealth’s collection efficiency of 105.6% in membership in 2022, 108.5% in 2023, and 86.05% in the most recent report in June 2024.
There is also an increase in collection efficiency of 92% in 2022, 90% in 2023, and 54% in the recent update of June 2024. PhilHealth-CAR also displayed the documentation of their Primary Care Provider Network (PCPN) first and second tranches held on July 14, 2024, and September 9, 2024, respectively.
The Bagong Benepisyo Program consists of activities regarding benefits. The Primary Care Social Mobilization and Campaign (PCSMMC), or Konsulta Caravan, was conducted in Luna, Apayao on July 14, 2023, at Tabuk People’s Gym Dagupan Centro, Tabuk, Kalinga on July 17, 2023, and the municipal gym of Sta. Maria, Alfonso Lista, Ifugao on September 15, 2023. The Konsulta Caravan occurred in Tayum Super RHU, Tayum Abra on October 6, 2023, and at Besao East Elementary School, Besao, Mountain Province on October 12, 2023.
PhilHealth-CAR conducted the PhilHealth Konsulta Kick-Off to celebrate PhilHealth’s 29th anniversary at the People’s Park, Baguio City on February 1, 2024. PhilHealth Konsulta Kick-Off and PhilHealth Kapihan happened at SM City Baguio Atrium on March 12, 2024. PhilHealth organized a Konsulta Caravan in Atok, Tublay, and Bokod Rural Health Unit, Benguet from May 20 to May 30, 2024,
PhilHealth-CAR also provided the figures regarding the Status of Konsulta Package Providers (KKPs) in the Cordillera Region with 59 KKPs in 2022, which later increased to 98 KKPs in 2023, and 102 KKPs in CAR as of July 2024.
PhilHealth-CAR also revealed the amount paid for the Konsulta Registration of its members and dependents. In 2023, there were 577,253 registrations to the Konsulta Package, which resulted in the payment of ₱26,932,947.66 to KKPs. As of July 2024, the registrations were at 735,383. Because of this, PhilHealth released the amount of ₱176,882,554.18 in payment to KKPs.
The Mamamayang Filipino Projects tackles the increased facilities and membership reimbursements. PhilHealth shows the status of Accredited Health Care Facilities (HFs) in the Cordillera. Fifty-nine HFs consisted of 31 infirmaries and 28 hospitals in 2022, 61 HFs that consisted of 33 Infirmaries and 28 Hospitals in 2023, and 61 HFs as of June 2024.
Philhealth paid the amount of ₱1,833,083,488.32 with a turnaround time of 22 days in 2024 with 192,163 claims. The top three paid claims were Hemodialysis at ₱335,908,532.30, pneumonia at moderate risk at ₱ 158,606,880.77, and cesarean section at ₱ 58,206,324.05.
The client’s satisfaction with PhilHealth CAR is 87.41% in 2022, 96.73% in 2023, and 98.10% in 2024. PhilHealth also received a Dangal ng Bayan Award 2023 and the Pink Orchid 2023.
They also celebrated the groundbreaking ceremony for the 2000 sqm. lot donated by the Municipal Government of Luna, Apayao.
The total registration of PhilHealth-CAR membership is 1,622,007 as of July 2024, from the target membership of 1,862,659 at the end of the year. For registered members per province, Abra has 203,728, Apayao has 94,671, Benguet has 442,401, Baguio has 439,779, Ifugao has a record of 144,872, Kalinga has 158,758, and Mountain Province has 138,398 members.
“Our local health insurance offices are actively looking for marketing activities para masusuyod po nila iyong mga hindi pa naka register sa PhilHealth,” according to Chief-FOD Imelda Cristeta D. Villamar. The collection of the region as of June 2024 is ₱1,017,046,000 or 54 percent of the target collection.
PhilHealth also encourages members to avail for the Consulta Package. “Ang reason kung bakit tayo mayroong Consulta Package, we are encouraging all constituents na dapat ma-register na sila kung saan nila gusto para mabilang na sila sa PhilHealth,” according to PhilHealth-CAR Regional Vice President Dr. Dominga Gadgad.
Dr. Gadgad also encourages the local government to initiate the transportation of hemodialysis patients so that they can have dialysis three times a week, which is included in the Hemodialysis Benefit Package. “If the LGU can handle the transport, arrange the schedule of patients per munisipyo,” she added.
PhilHealth is reminding members of the eligibility rules for dependent coverage. Children under 21 are considered dependents through their parents’ membership and must register independently once they reach age 21, as their parents’ membership will no longer cover them. Parents can be dependent through their children’s membership upon reaching the age of 60, or they can register as senior citizens where the national government will provide for them if they do not have children. By Michael Dadd, and Janine Laureta
