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PhilHealth approves higher capitation rate for Konsulta packages

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FILE: BUSINESS UNUSUAL. Philippine Health Insurance Corp. transactions go through the manual process, like in this branch in Mother Ignacia Avenue, Quezon City, on Tuesday (Sept. 26, 2023), four days after its system was attacked by the Medusa ransomware.

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The cyberhackers are reportedly demanding USD300,000 or about PHP17 million to decrypt the files, but the state health insurer said it won’t pay. (PNA photo by Joan Bondoc)

MANILA – The board of directors of Philippine Health Insurance Corporation (PhilHealth) has approved an increase in the capitation rate of its Konsulta package.

In a news release Thursday, the Department of Health (DOH) said the rate has increased to PHP1,700 per patient seen per year.

“Private Konsulta package providers (KPPs) will also be allowed to collect a co-payment of up to PHP900, while patients seen in public KPPs will not be charged extra,” it said.

Earlier, PhilHealth added mammography and ultrasound screening services that will help detect breast cancer and other conditions such as abdominal problems.

“It is the pleasure of the Board to now bring up primary care benefits with mammogram and ultrasound services not just in sandbox sites, but nationwide,” he said.

PhilHealth Konsulta is a primary care benefit package that provides capitation payments for free annual check-ups, selected diagnostics and medicines.

The increase in payments is expected to be implemented by June 2024.

The DOH said the implementation could be earlier depending on the completion of operational details such as information technology system enhancements.

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