THE local government unit of Cebu Province signed a memorandum of agreement (MOA) with CareHealth Plus Systems International Inc. on May 19, 2021 to signify the accreditation of the health maintenance organization (HMO) as the health insurer in the 16 provincial and district hospitals in Cebu Province.
This means that members of CareHealth and their dependents can avail themselves of emergency consultation and treatment, outpatient services, and medical and surgical inpatient services in Capitol-owned hospitals, but only if they secure a letter of authority from the insurer.
The accreditation involves an investment of a cash bond of P200,000 from CareHealth, which will be returned to the company upon the termination of the contract.
According to Sugbo News, this is the first time a provincial government has accredited a private health insurer in hospitals that it owns and manages.
The Cebu Provincial Government said that it entered into this “landmark” agreement to enable its hospitals to cater to private sector patients who are covered by an HMO, on top of their coverage under state-run Philippine Health Insurance Corp. (PhilHealth).
Since the start of the coronavirus disease 2019 (Covid-19) pandemic, the Cebu Provincial Government noted that many private companies have transferred operations from Cebu City to different component cities and municipalities in Cebu Province.
However, due to the non-accreditation of HMOs, many patients from the private sector could not be referred to or confined in Capitol-owned hospitals as they need to be admitted to hospitals that have agreements with HMOs.
“While the employees of these private companies are already covered by PhilHealth, these private companies, as a policy, still provide their employees with private health care insurance on top of their PhilHealth insurance,” the MOA states.
CareHealth members and their dependents can now admit themselves to the provincial and district hospitals without having to pay an initial deposit as long as they have a signed LOA that needs to be submitted within 24 hours of admission.
The provincial and district hospitals need to submit a list of physicians who are applying for accreditation with the HMO. They will also have to coordinate with the insurer for the approval of all laboratory and diagnostic examinations and surgical procedures. (NRC with PR)