Swindlers and Philhealth PDF Print E-mail
Friday, 29 May 2015 08:33

Table Talk

BY Mike S Apostol

Overheard from a neighboring table at Hanazono Japanese Restaurant the other night was a casual conversation of two respectable looking individuals, perhaps both doctors and private practitioners. They both agree that they are happier when a patient pays them directly after a hospital surgery rather than a Philhealth billing. They said before Philhealth releases payment for their medical services, which takes time even months, they ask for so many requirements and documents. It is not only tedious but time consuming and sometimes, because of so many patients, documents are mixed up by their medical secretaries and to produce another document is near impossible. Although private practicing doctors are not really hard-up, but delayed Philhealth payments also affect their daily budgeting like payment for their clinic-rent in the hospital, wages of their secretaries and other daily incidental expenses.

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Three good friends of mine seated beside me opined after listening to the doctor’s problem, that they should not blame Philhealth for their payment incovenience but some of their colleagues, who are having lying-in clinics and made a profitable business of their medical venture, who sometimes cheat the Philhealth by bloating medical bills for payment and many times the Philhealth allegedly discovered that some patients who only went for check-ups on a simple illness are made to appear in their Philhealth medical bills that there was some surgery performed. Some crooked medical practitioners sometimes allegedly charge Cesarian section surgery for a simple and natural birth. This information are unconfirmed but records at the Philhealth allegedly reveal that some medical clinics are blacklisted or banned from Philhealth medical insurance services.

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The alleged Philhealth billing abuse and anomaly is enough reason for the government medical insurance system to be strict and require many documents before payment, to ensure that all transactions are on the level and likewise Philhealth monthly contribution from all members are protected and not stolen by unscrupulous individuals. The biggest danger according to a friend is when a hospital whose big and major stockholders are businessmen, and whose motive to open a hospital purely profit and not saving lives. It is very rare to find a businessman who will think and feel the way a doctor does. Indeed true and we agree.

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In the municipalities and barangays, rural private practitioners are the owners of the clinic, pharmacist and drug dispensers,, chief accountant, treasurer, and disbursing officer all rolled into one. They grow rich for a short time and most of their clinical emloyees are midwives and few nurses. These are potential “cost centers” for the Philhealth. This is the reason too why Philhealth is now so strict in their reimbursements.

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Incidentally, are retired pensioners from government and private employment, who have  retired from the service on a mandatory retirement scheme, Philhealth members for life? Philhealth office must find time to inform the public by way of media information. This is a very important piece of information for retired senior citizens, who have given contributions for Medical Health Insurance  for many, many years while still employed. Philhealth should advise the many retired senior citizens of the city on how to go about this exemption, and the necessary documents to be able to avail of this privilege. This will be the best service of Philhealth for retired pensioners whose journey to the great beyond is already approaching.

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Scoop: There are many very respected and compassionate doctors in the city but some “crooked” ones are destroying their respected image. Perhaps, we should separate the “rotten tomatoes” among the doctors ranks to save those that have pure  heart and intentions.