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PhilHealth to provide advance payment before hospitalization

Metro Manila, June 21 ----- The Philippine Health Insurance (PhilHealth) Corporation on Monday inked an agreement with several local and private groups to form primary care networks (PCN) that will allow advance payments to hospitals before services have been rendered.

“Ang bago rito what’s new here is the fact how PhilHealth pays,” PhilHealth Chairperson and Department of Health (DOH) Secretary Ted Horbosa said in a press briefing.

He said through the creation of service level agreement, funds will now be given to providers based on the number of PhilHealth members within a certain PCN. The program is in partnership with five local government units and two private sector groups of clinics and doctors. According to the DOH, the seven PCN are expected to pay ₱1.2 billion which may be used to improve infrastructure, equipment, and staff compensation even before the first patient starts availing of services. Herbosa, meanwhile, clarified that the program is currently under a “sandbox” or testing basis in pre-selected areas in the provinces of Bataan, Guimaras, Quezon, South Cotabato, and Baguio.

He said around two million Filipinos will benefit from the PCN innovation under the Universal Health Care (UHC) from the said areas, while another 300,000 Filipinos under the care of the LiFE group as well as QualiMed will also be subjected to the improvements in primary care financing. “Primary care and essential public health services, integrated with a broader health care network of hospitals and other facilities, is a key element needed for universal health care to happen,” he said.

Under the UHC law, the DOH and the local government units are mandated to ensure that all Filipinos are guaranteed access to quality and affordable health care goods and services. The current PhilHealth Konsultasyong Sulit at Tama (Konsulta) primary care benefit package covers patient consultations, any of 13 laboratory and diagnostic tests as ordered by the doctor, and 21 common medications that can be prescribed according to medical needs.



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