Only 34 of 845 claims for reimbursement okayed by PhilHealth 7

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THE Philippine Health Insurance Corp. (PhilHealth) 7 paid P763,266 for 34 approved Covid-19 Community Isolation Benefit Package (CCIBP) claims in Cebu.

Dina Cinchez, PhilHealth 7 public relations officer, said that as of Feb. 11, 2021, PhilHealth 7 received 845 CCIBP claims in the region.

A total of 800 claims were from Community Isolation Units (CIUs), or Department of Health (DOH)-certified public or private non-hospital facilities that serve as quarantine facilities for coronavirus disease 2019 (Covid-19) patients in Cebu.

Cinchez said 221 claims were returned because of lack of documentary requirements, while 58 were denied. The rest are being processed.

The CCIBP of the state health insurer replaced its Hospital Isolation Package on May 11, 2020.

The package includes all identified services required to effectively manage Covid-19 cases that need isolation, based on applicable guidelines adopted by the DOH whether suspect, probable or confirmed.

Cinchez said that as of their Feb. 11 data, PhilHealth had not received claims from the DOH-run International Eucharistic Congress Bayanihan Field Center.

The Central Visayas Center for Health Development Covid-19 Center located along Gen. Maxilom Ave. was one of the CIUs that filed a claim, being the first accredited CIU in Central Visayas.

The corresponding maximum reimbursement is P22,449 per claim. Patients will not be charged out-of-pocket payment for the services they availed themselves in CIUs.

Beneficiaries must meet the clinical and/or social criteria based on the DOH applicable issuances to avail themselves of the CCIBP.

Direct filing of claims by beneficiaries, however, is not allowed and the CIU, through its partner facility, can file a claim for patients who are already discharged after receiving all the mandatory services.

Cebu has 26 CIUs, including the Maayo Medical Clinic Corp. in North Park, Barangay Alang-alang, Mandaue City; Escario Central Hotel in Barangay Kamputhaw, Cebu City; and the Normal Oasis for Adaptation and a Home complex at the South Road Properties, among others. (WBS)