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Memo on UHC

The PCCP hosted a meeting with the Philippine Health Insurance Corporation (Philhealth) represented by Dr. Galvez and Mr. Balaoing last April 6, 2013. In attendance were Dr. Vince Balanag, and Council heads: Dr. Trinidad (COPD), Dr. Tanchuco (OILD), Dr. Samson (DATS) , Dr.Nolido (Lung Infections), Dr. Tan (Lung Malignancies) and myself. The goals of the meeting were as follows:

  1. To discuss the concept of Universal Health care (UHC) also known as Kalusugan Pangkalahatan (KP)
  2. To be updated regarding Philhealth Reimbursement Schemes
  3. To review the present state of case rate schemes for the top respiratory conditions

 
The meeting concluded with the following policies understood by those in attendance:

  1. The UHC or KP is of utmost importance to promote quality of care for all, including the underserved or “poorest of the poor.” It also recognizes the importance of improving the efficiency of payment for healthcare providers, which includes the hospital facility and the medical doctor.
  2. The No Balance Billing Policy (NBB) will be applied to patients who:
    1. Have an income of <7,000 pesos/month
    2. Are admitted to government hospitals
    3. Are admitted to the ward

    All these must be present, to apply.

  3. We are moving from Fee for service to Case Rate Packages or Partial case rate Packages where co-payment by the patient is added.
  4. Combination of Medical Case Rates – New forms for the CF2 will be released soon
    1. For the Primary or Main Condition, 100% Case Rate will be applied
    2. For the Secondary Condition, not more than 50% of the case rate will apply
    3. The PCCP will do the following:

    4. Remind all members to update their Philhealth Accreditation status
    5. Through the councils:
      1. Review the case rates and make suggestions/proposals for adjustments, if any, for the 5 respiratory conditions listed among the Top 20 medical conditions in the Philippines
      2. Prepare the Qualifier Form for the 5 conditions:
        1. Pneumonia – moderate risk and high risk
        2. Lower respiratory tract infection
        3. Pulmonary Tuberculosis
        4. Asthma
        5. Chronic Obstructive Pulmonary Disease
    6. I propose that, as a collegial body, we will endorse and support the Universal Health Care or Kalusugan Pangkalahatan.

    Please review the attached document and inform the Secretariat of any comments or suggestions.
     
    Respectfully,
    Mae Campomanes

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Insurance Proposal

The Membership Committee of the Philippine College of Chest Physicians (PCCP) would like to seek your opinion on a new proposal to provide higher insurance benefit to Fellows of good standing ages 64 year-old and below. Our current annual insurance benefit is Php 50,000 (Fifty Thousand pesos) for each Fellowwith the premium being paid by PCCP from our annual membership dues.

We would appreciate if you can give your thoughts and comments to this proposal.

Amount of insurance: Philam Life Insurance Company has offered a Comprehensive PCCP Members Benefit Package, renewableyearly and inclusive of the following benefits:

 

 Benefit

Description

Insurance Amount

Life Insurance

financial assistance extended to the family of an insured member who meets his untimely demise

Php 500,000.00

Accident Death and Dismemberment & Disablement

an amount over and above the Life Insurance for death or dismemberment due to accident

Php 500,000.00

Accident Medical Reimbursement

pays the actual cost, up to the amount selected for medical or surgical treatment and injuries resulting from an accident

Php 50,000.00

 

Annual Premium of Insurance: For the above benefits, Philam Life has pegged the amount of Php 2,307 (Two Thousand, Three Hundred Seven pesos ) for each member enrolled in this package. The PCCP Board of Directors has agreed to compensate the amount of Php 500 (Five Hundred pesos) andproposed that the balanceof Php1,807 (One Thousand, Eight Hundred Seven pesos) will be paid by each member. The premium is renewable annually and each member is expected to pay his/her share consistently. This insurance proposal does not require any pre-qualifying medical examination.

Please answer the survey on or beforeJUNE 30, 2013. If we do not hear from you on or before this date, we will presume that you do not agree to this new proposal.

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Insurance Proposal Survey

This survey is now closed.

Please submit your reply on or before July 31, 2013.  If we do not hear from  you on or before this date, we will presume that you do not agree to this new proposal.