In order to help achieve Universal Health Care for all Filipinos and true to its aspiration of ensuring that “Bawat Pilipino, Miyembro; Bawat Miyembro, Protektado; Kalusugan Natin, Segurado”, the Philippine Health Insurance Corporation (PhilHealth) issued a call for private health care institutions to apply for contracting services for the delivery of any of its existing Z Benefit Packages.
The Z Benefit Packages, which was designed to address catastrophic illnesses was initially available in selected government hospitals nationwide. It was designed for the treatment of breast and prostate cancer, acute lymphocytic leukemia, ventricular septal defect, tetralogy of fallot, coronary artery bypass graft, selected orthopaedic implants, among others. PhilHealth’s move to invite private hospitals hopes to increase accessibility and provide more options for its members.
“Para mas lalong mailapit sa ating mga miyembro ang benepisyo ng PhilHealth lalung-lalo na sa may mga malulubhang karamdaman kagaya ng breast cancer, sakit sa bato at puso na nangangailangan ng matagalan at mahal na gamutan, binuksan namin ang pribilehiyong maging partner namin para sa Z benefits sa mga pribadong institusyon. Malaking tulong ito sa mga miyembro na nangangailangan ng agarang serbisyong medikal,” said Alexander A. Padilla, PhilHealth’s President and CEO.
“Inaasahan po namin na bago matapos ang taong ito ay may makokontrata na kaming institusyong medikal na may kakayahang magbigay ng alinman sa aming mga Z Packages sa aming mga miyembro sa iba’t ibang bahagi ng bansa,” he said.
Private health care institutions that intend to become contracted facilities for the Z Benefit Packages must adhere to the No Balance Billing Policy or the “Walang Dagdag Bayad” policy for indigent and sponsored members who will avail themselves of the Z packages. A fixed co-pay option which entails an identified amount to be shouldered by the member on top of the Z package will be applied to non- indigent members. However, the amount should not exceed the benefit amount being paid for by PhilHealth.
Private health care institutions may apply for contracting by submitting a Letter of Intent (LOI) signed by the Medical Director indicating the Z packages their facility is capable of providing and their capacity to provide for the said services.
To date, PhilHealth has 17 contracted facilities for 11 different kinds of Z packages.
Total payments for Z packages for CY 2014 reached P 245,010,000, the highest of which was for Coronary Artery Bypass Graft with 162 claims amounting to P 89,100,000 followed by End Stage Renal Disease with 128 claims amounting to P 76,150,000.00. *
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