‘WARD-ONLY COVERAGE’: Zero-balance billing excludes ER, outpatient, and cosmetic procedures

By Rjay Zuriaga Castor

The Department of Health Western Visayas (DOH-6) clarified that only patients admitted to basic or ward accommodations in the three DOH-retained hospitals in the region are covered by the government’s Zero-Balance Billing (ZBB) program.

Three DOH-retained hospitals in the region are currently implementing the program: the Western Visayas Medical Center (WVMC) in Mandurriao, Iloilo City; Don Jose S. Monfort Medical Center (DJSMMC) in Barotac Nuevo; and the Western Visayas Sanitarium and General Hospital (WVSGH) in Santa Barbara, all in Iloilo province.

DOH-6 director Dr. Helen Tobias stressed that the ZBB program is limited to patients admitted under basic or ward accommodations and does not cover those who choose private or semi-private rooms, seek treatment in private hospitals, or opt for private physicians.

Also excluded from the program are patients receiving services through the outpatient department, those treated only in the emergency room, and those undergoing aesthetic medicine procedures.

“There is no problem if we go to a DOH or public hospital compared to a private hospital, especially if we are hard up in our finances. But once you choose a private doctor or a room that is not basic accommodation, you are already excluded from ZBB,” she said in a press conference on Tuesday, June 16.

She assured the public that patients admitted to public hospitals under the ZBB program continue to receive quality medical care, noting that DOH-managed hospitals have specialists available to handle various medical conditions.

Under the program, patients admitted to basic accommodations are entitled to coverage for room and board, professional fees of attending physicians, laboratory tests, diagnostic procedures, medicines, and medically necessary treatments.

Hospital and professional fees incurred by a patient under the ZBB are shouldered by the applicable PhilHealth benefit packages, while the balance is charged to the DOH hospital’s budget.

“Through the ZBB we continue to ensure the indigent and financially vulnerable patients can receive essential healthcare services in government hospitals without incurring out-of-pocket expense,” she said.

The ZBB program stems from a national policy that President Ferdinand Marcos Jr. announced in his fourth State of the Nation Address on July 28, 2025, under which the government covers the bills of patients admitted to basic or ward accommodation in DOH hospitals. The program is implemented in the basic or ward accommodation of 87 DOH hospitals nationwide. Presidential Communications OfficeGMA News Online

The policy is part of the Universal Health Care program and the broader No Balance Billing policy, with PhilHealth shouldering costs alongside additional funds from the Philippine Charity Sweepstakes Office and the Philippine Amusement and Gaming Corporation. iSensey

The DOH has also moved to widen the program beyond its own facilities, with about PHP 1 billion allocated this year to pilot zero-balance billing in selected secondary and tertiary local government hospitals. Presidential Communications Office

However, Tobias acknowledged that bed capacity remains a challenge in government hospitals, particularly for patients requiring admission to basic wards.

She said some patients may temporarily stay in emergency rooms while waiting for available ward beds.

“That is the reason why we are trying, most of our DOH hospitals are aiming to increase their bed capacity to cater all patients in Iloilo, including other parts of Western Visayas,” she said.

Meanwhile, Dr. Carl Andre Diesca, supervising administrative officer of the Billings and Claims Section of WVMC, reiterated that patients who are admitted to basic accommodations but later choose a private doctor or specialist of their own preference are automatically excluded from the program.

“If you are admitted in basic accommodation and you choose to be attended by a specialist of your own choice, you are automatically out of ZBB,” he said.

According to Diesca, the standard practice at WVMC is that patients who request private attending physicians are transferred to non-basic or private rooms.

WVMC currently has an authorized bed capacity of 691 beds, with more than 70 allocated for private or non-basic accommodations.

The remaining beds are designated for basic accommodations and charity services.

He said the hospital records an average of 80 patient discharges daily, or more than 2,500 discharges per month.

Diesca added that WVMC has also streamlined its discharge process by bringing billing documents directly to patients’ bedsides for signature, eliminating the need for patients to queue at the billing section before leaving the hospital.

At DJSMMC, 3,948 patients admitted under basic accommodations from January to May this year benefited from the ZBB program.

No data for WVSGH was presented.

WVSGH can accommodate more than 100 patients and expand capacity to around 300 when needed, while DJSMMC has a bed capacity of approximately 200 to 300 beds.