Panayam kay Acting President Rey Balena ng Philheath - Corporate Affairs Group ukol sa mammogram at ultrasound bilang bagong bahagi ng coverage ng Philhealth
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00:00Expanded benefits for neonatal sepsis and bronchial asthma.
00:05That is what we will discuss with Sir Ray Baleña,
00:08the Acting Vice President of the Corporate Affairs Group of PhilHealth.
00:12Sir Ray, good afternoon and welcome to Bagong Pilipinas.
00:16Good afternoon, Ma'am Nina and Usec Edu,
00:20and of course, to all the viewers of Bagong Pilipinas.
00:23PhilHealth is coming back to give good news to our countrymen.
00:29Yes, Sir. Welcome back.
00:30Sir Ray, when was the expanded benefits for neonatal sepsis and bronchial asthma of PhilHealth effective?
00:38Yes, Usec Edu, these two packages were the last two that we enhanced.
00:46And these two have already taken effect since May 1 of this year.
00:51So all the confinements and admissions starting May 1 and onwards
00:58we will apply our new rates for these two packages.
01:04How much did you increase the coverage of neonatal sepsis and bronchial asthma?
01:12It's very big, Ma'am Nina,
01:15because here in neonatal sepsis, it increased by 120 percent.
01:21Before, our benefit was 11,700.
01:25Our PhilHealth Board approved it to be 25,793.
01:31Meanwhile, for bronchial asthma in acute exacerbation,
01:35it increased by 150 percent.
01:38Before, it was only 9,000 pesos.
01:41Now, it's 22,488 pesos.
01:46Alright.
01:47Sir, how important is this expansion?
01:50In your analysis, many of our countrymen have this kind of disease,
01:55neonatal sepsis and bronchial asthma.
01:58Yes, Usec Edu, that's a very good question.
02:02In our studies, these two conditions are some of the conditions that are really burdensome to the patients.
02:13And not only to the patients, but also to their families.
02:16We also saw that the number of people who are claiming for this disease is high.
02:23In fact, for neonatal sepsis, this is what is referred to as low infection rate in blood of babies under 28 days.
02:33Usually, it affects babies below 28 days old.
02:41As you know, this is one of the main causes of death of babies.
02:46Three out of ten neonatal deaths are caused by this.
02:51In fact, last year, Usec Edu, PhilHealth paid a total of P733.8 million for 57,000 cases of neonatal sepsis.
03:03That's the situation when it comes to neonatal sepsis.
03:08When it comes to bronchial asthma, this is the attack of the disease.
03:13It needs to be hospitalized.
03:15The number of cases of this disease is also high.
03:18In fact, this is eight out of the mostly claimed cases of PhilHealth.
03:23Last year, we paid P717 million for more than 9,000 cases of bronchial asthma.
03:33We are hoping that Usec Edu will help the PhilHealth Board so that the patients can feel the help from PhilHealth.
03:45Alright.
03:46For our countrymen, you said neonatal sepsis is one of the main causes of death of babies.
03:56Why is this the case?
03:58Well, this is under the condition of cleanliness, for example, in the hospital.
04:10That's why we are helping our healthcare providers to ensure the quality of our services to our patients.
04:22For PhilHealth, our job is to ensure that we can substantially cover the confinement of our members and patients.
04:38For the PhilHealth members, what are the requirements to use these benefits for neonatal sepsis and bronchial asthma?
04:52Well, these packages, ma'am Nina, are open to all of us, Filipinos, members of PhilHealth.
04:58As long as the patient needs it, he can be hospitalized and admitted for these conditions.
05:05Our only reminder to our countrymen, ma'am Nina,
05:09make sure that the health facility we are going to is accredited by PhilHealth
05:16to ensure the quality of our services and to make sure that PhilHealth benefits will be used.
05:22Alright.
05:23Sir Ray, for our countrymen, can you tell us where our countrymen can avail of these extended benefits?
05:33Yes.
05:34Yes.
05:35These benefit packages can be availed in levels 1 to 3 of accredited health facilities of PhilHealth, public or private.
05:48In those levels of health facilities, we can avail of these new rates.
05:55For example, if the patient is confined or admitted for neonatal sepsis or bronchial asthma,
06:04in primary care facilities, meaning in lower facilities, our existing rates will still apply to them.
06:14Sir Ray, what enhanced PhilHealth benefits have been implemented?
06:22There are many, ma'am Nina.
06:24Since last year, our PhilHealth Board approved many enhancements.
06:29We started with chronic kidney disease stage 5 patients who need hemodialysis.
06:35Previously, we covered 90 sessions per year.
06:39We did 156 sessions.
06:43That means the standard requirement for three sessions in a week times 52 weeks is covered by PhilHealth.
06:52As of now, ma'am Nina, as part of the call to Congress, we are reviewing the possible enhancement and increase of our coverage,
07:05which we are paying per session.
07:07So you can expect, we will call again if we have good news about this.
07:13Our packages, ma'am Nina, for ischemic and hemorrhagic stroke, even for high-risk pneumonia,
07:19last year, the increase was more than double.
07:23Even our outpatient mental health package, in cooperation with DOH, we implemented it last year.
07:33This year, we started on our anniversary the decision of the PhilHealth Board that all of our case rates packages will increase by 30 percent.
07:45That means if 10,000 before, our package times plus 30 percent is already 13,000.
07:54That's a long list, ma'am Nina, more than 9,000 medical conditions and surgical procedures.
08:01Suffice it to say, in every compensable condition, we increased by 30 percent.
08:08You may have heard, our breast cancer package, 100,000 before, up to 1.4 million will be paid by PhilHealth.
08:20We have removed the restriction.
08:22Any stage of breast cancer is covered by us.
08:26Lately, we also increased bronchial asthma and neonatal sepsis.
08:33We still have a lot to enhance this year and in the coming years.
08:38Our countrymen should look forward to that.
08:40All right.
08:41Sir Ray, one more question for our countrymen.
08:45Are the PhilHealth packages covered by mammogram and ultrasound?
08:49Thank you very much, Usec Ed, for your question.
08:54One of them was approved by our PhilHealth Board.
08:59The mammogram and ultrasound of the upper abdomen, pelvis and breast are included in our consulta package.
09:12That's why we are calling on our countrymen to register with the consulta package provider of our choice
09:20because that is where we can avail if our consulta package provider really needs and recommends it.
09:28All right.
09:29Just to be clear, Sir Ray, this is a good news for women like me.
09:34Yes, ma'am.
09:35Because mammogram and ultrasound are expensive.
09:39That's why it is detected late because mammogram is being done when there are symptoms.
09:47So what you're saying is that all women can avail of free mammogram even if they don't have cancer?
09:58You're right, ma'am Nina.
10:00This is what we are calling for.
10:03We want to prevent the spread of cancer.
10:09That's why we included this in our consulta package so that this is in the context of primary care service.
10:19This means that we can help our countrymen, especially women, if they are at risk.
10:27That is determined by the consulta package provider of their doctor.
10:33They will be given mammogram or ultrasound for free.
10:40That is our commitment.
10:42That's why our budget for every patient under consulta was increased by our PhilHealth Board from P550 pesos per patient.
10:54It was increased to P1,700.
10:57Now, if the patients need such services, our capitation budget can be absorbed.
11:10Sir Ray, do you have anything to announce to the members of PhilHealth?
11:17Well ma'am Nina, our message is to continue boosting our PhilHealth benefits.
11:26That's why members will feel this whenever they avail of these benefit packages.
11:34But the consulta is very important because we don't need to get sick just to use the PhilHealth benefit.
11:41We already have a PhilHealth consulta to help us stay healthy.
11:46If we feel something, we can detect it early and we can solve it early.
11:53It will not depend on expensive medicines.
11:56We hope that we continue to support our PhilHealth to continue boosting our benefits.
12:06Sir Ray, for those who wished to visit and have additional questions for PhilHealth,
12:11what are our designated communication channels for now?
12:16For our countrymen who have additional questions, you can call 8662-2588.
12:26At any time, we will answer your questions.
12:29Even if it's an early day, holiday, or weekend, we will answer your questions.
12:35So call now.
12:37The moment you have a question about your PhilHealth benefits, just call 8662-2588.
12:47Thank you for your time, Sir Ray Baleña, Acting Vice President,
12:51Corporate Affairs Group of PhilHealth.
12:53Maraming salamat po at mabuhay po ang bagong Pilipinas.