PhilHealth opens contracting for Z Benefit Packages to private hospitals

PhilHealth logo (Photo courtesy of Philippine Medical Association)

MANILA – The Philippine Health Insurance Corporation (PhilHealth) has called for private health care institutions to apply for contracting services for the delivery of any of the agency’s existing Z Benefit Packages.

The call was made on Thursday by PhilHealth President and CEO Alexander A. Padilla in line with the goal of the agency to achieve Universal Health Care for all Filipinos and insure that “Bawat Pilipino, Miyembro; Bawat Miyembro, Protektado; Kalusugan Natin, Segurado.”

According to Padilla, the Z Benefit Packages, designed to address catastrophic illnesses, were initially made available in selected government hospitals nationwide.

“It is 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,” Padilla said.

He explained that the appeal is meant to invite private hospitals to increase accessibility and provide more options for PhilHealth 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 nang matagalan at mahal na gamutan, binuksan namin ang pribilehiyong maging partner namin para sa Z Benefits ang mga pribadong institusyon. Malaking tulong ito sa mga miyembro na nangangailangan ng agarang serbisyong medikal,” the PhilHealth official.

He also said that before the year ends, they will be having contracts with the medical institutions with the capacity to provide the health services in the Z Packages available for PhilHealth members in the country.

Private health care institutions that intend to become contracted facilities for the Z Benefit Packages must adhere to the No Balance Billing or “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.

To date, PhilHealth has 17 contracted facilities for 11 different kinds of Z Packages.

Total payments for Z Packages for CY 2014 reached PhP245,010,000, the highest of which was for Coronary Artery Bypass Graft with 162 claims amounting to PhP89,100,000; followed by End Stage Renal Disease with 128 claims amounting to PhP76,150,000.