PhilHealth paid P81M for dengue claims

PHILHEALTH Regional Office VI paid more than P81 million for 8,005 dengue cases claims filed in Western Visayas from January to July 2019.

The amount is 223% higher compared to last year’s payment for claims on dengue condition alone for the same period.

PhilHealth data indicated that Negros Occidental had the most number of dengue confinements (40%) with 3,278 cases, followed by Iloilo with 2,484 and Aklan with 1,253. All patients availed and were covered by PhilHealth benefits.

PhilHealth provides benefits for dengue based on the severity of the condition according to PhilHealth 6 Head Janet A. Monteverde. 

“Patients diagnosed of dengue fever are given a package of P10,000 while P16,000 is paid for patients with severe dengue condition,” Monteverde said.

Monteverde also emphasized that patients confined in government hospitals are entitled to free hospitalization as guaranteed by the “no balance billing” (NBB) policy.

“Poor and elderly patients are not required to pay anything in excess of what PhilHealth covers.  Drugs and medicines, laboratory exams and other supplies needed in treating the patients as well as professional fee of the attending doctors are covered by NBB,” Monteverde said.

As of July 15 data, 54% of the total claims payment amounting to P44,098 million was availed by Indigent and Sponsored Program members, mostly confined in district hospitals in the region.

For patients who are not yet registered with PhilHealth or have gaps in their premium payment, Monteverde assured automatic coverage and entitlement to benefits through the Point of Service (POS) program of PhilHealth.

Under this policy, patients/members are referred to the Medical Social Worker of the hospital to be assessed whether financially capable or incapable to pay PhilHealth premiums.

Those assessed as poor or financially incapable will be covered for free under the Sponsored Program while those who are financially capable are required to pay the P2,400 for the entire year premium as Informal Sector member.

Once enrolled, patients automatically avail of PhilHealth benefits prior discharge.

Monteverde emphasized, however, that POS is currently implemented in government hospitals.

“We encourage our members to seek early consultations when failing ill especially when symptoms like fever persist for 2 to 3 days. Be assured that PhilHealth is ready to cover your medical expenses,” Monteverde said.