In the light of on-going crisis situation resulting from the recent eruption of Taal volcano in Talisay, Batangas, the Philippine Health Insurance Corporation (PhilHealth) is extending certain privileges to ensure continued provision of responsive health care benefits to members at all times especially during fortuitous events where help is needed the most.
Pursuant to its Circular 34, s. 2013, claims of non-accredited health care facilities on behalf of members or their beneficiaries shall be covered, provided that the concerned facilities are duly licensed or certified by the Department of Health. The same also extends to services by non-accredited health care professionals but are holders of valid license issued by the Professional Regulations Commission.
Also covered are claims for medical treatments done as an outpatient or inpatient relative to both direct and indirect effects of a fortuitous event within improvised or satellite facilities, as well as for patients being transferred from or managed by health care personnel from accredited facilities in evacuation areas or improvised health care facilities.
The circular also extends special privileges such as exemption from the 45 days annual benefit limit and the policy on ‘single period of confinement’ where patients can avail of full coverage even if their series of confinements have intervals of less than 90 days.
During such fortuitous events, admissions of less than 24 hours shall also be paid while filing period of claims is extended from 60 days to 120 days from discharge of the patient. Also granted under the policy include extension of deadlines in the payment of premium contributions, reimbursement for both referring and receiving health care facilities, priority in the processing of claims, extension of deadline for submission of health care facility reports, extension of accreditation of providers as applicable, among others.
“We recognize that uninterrupted availability and access to health care are crucial during calamities, that is why we assure our affected Kababayans of their PhilHealth benefits, as well as our partner hospitals and even those not yet accredited with us that their services will be reimbursed,” Ricardo C. Morales, PhilHealth President and CEO said, adding that these privileges are granted only in areas declared under state of calamity or emergency.
For more details on the mechanics of these privileges, PhilHealth encourages members and facilities to call 02 8441-7442 or visit the nearest PhilHealth office.
