This time the theme of my writings shall be general in nature; things that will be of general interest to everyone. It can be about Life, Travels, People, Food, Music , Gadgets, Lifestyle and whatever I feel may catch the fancy of the public.
For this edition, I am helping out the Philippine Hospital Association in disseminating its proposed amendments to the PHIC Circular 13-2012 where hospital members are required to sign their "Performance Commitment". It is actually a guideline that warrants the rules, procedures and practices that hospitals need to follow in order to maintain their PHIC members status and/or be slapped with penalties and fines.
Dr. Bu Castro, PHA Presidents and Dr. Rustico Jimenez, PHAP President, sent this letter dated June 25, 2012 to PHIC'S President Dr. Eduardo Banzon:
June 25, 2012
DR. EDUARDO BANZON
President
PHILIPPINE HEALTH INSURANCE CORPORATION
17th Floor, City State Centre Bldg.,
Shaw Blvd., Pasig City
Dear Dr. Banzon,
Respectfully, please allow us to propose the following amendments to the Performance Commitment (re: Philhealth Circular No. 13-2012) as suggested by our member-hospitals as follows:
*Present Provisions:
**Proposed Provisions:
*9. That we shall abide with all the implementing rules and regulations, memorandum circulars, office orders, special orders and other administrative issuances by PhilHealth affecting us.
**That we shall abide with all reasonable, fair and humane implementing rules and regulations, memorandum circulars, office orders, special orders and other administrative issuances by PhilHealth affecting us.
*10. That we shall abide with all administrative orders, circulars and such other policies, rules and regulations issued by the Department of Health and all other related government agencies and instrumentalities governing the operations of IHCPs in participating in the NHIP.
**That we shall abide with all reasonable, fair and humane administrative orders, circulars and such other policies, rules and regulations issued by the Department of Health and all other related government agencies and instrumentalities governing the operations of IHCPs in participating in the NHIP.
*15. That we shall provide the necessary drugs, supplies and services with no out-of-pocket expenses on the part of the members as contained in PhilHealth's 'No Balance Billing (NBB) Policy’.
**That, insofar as available in our hospital, we shall provide the necessary drugs, supplies and services with no out-of-pocket expenses on the part of the members as contained in PhilHealth's 'No Balance Billing (NBB) Policy’.
*24. That we shall electronically encode the drugs and supplies used in the care of the patient in our information system, which shall be made available for PhilHealth use.
**That, insofar as our hospital is capable considering our financial difficulties, we shall electronically encode the drugs and supplies used in the care of the patient in our information system, which shall be made available for PhilHealth use.
*30. That we shall extend full cooperation with duly recognized authorities of PhilHealth and any other authorized personnel and instrumentalities to provide access to patient records and . . . to undermine the NHIP and make available all pertinent official records and documents including the provision of copies thereof.
**That, we shall extend full cooperation with duly recognized authorities of PhilHealth and any other authorized personnel and instrumentalities to provide access to patient records and . . . . to undermine the NHIP and make available all pertinent official records and documents including the provision of copies thereof, Provided that the inspection shall be orderly and that our rights to private ownership and privacy are respected.
*32. That at any time during the period of our participation in the NHIP, upon request of PhilHealth, we shall voluntarily and unconditionally sign and execute a new 'Performance Commitment' to cover the remaining portion of our engagement or to renew our participation with the NHIP as the case may be, as a sign of our good faith and continuous commitment to support the support the NHIP.
**That at any time during the period of our participation in the NHIP, upon request of PhilHealth, we shall voluntarily and unconditionally sign and execute a new 'Performance Commitment' to cover the remaining portion of our engagement or to renew our participation with the NHIP as the case may be, insofar as it is fair, reasonable and humane to our existence, as a sign of our good faith and continuous commitment to support the support the NHIP.
*33. That we shall take full responsibility for any inaccuracies and/or falsities entered into and/or reflected in our patients' records as well as in any omission, addition, inaccuracies and/or falsities entered into and/or reflected in claims submitted to PhilHealth by our institution.
**That, unless proven to be a palpable mistake or excusable error, we shall take full responsibility for any inaccuracies and/or falsities entered into and/or reflected in our patients' records as well as in any omission, addition, inaccuracies and/or falsities entered into and/or reflected in claims submitted to PhilHealth by our institution.
*41. To suspend, shorten, pre-terminate and/or revoke our privilege of participating in the NHIP including the appurtenant benefits and opportunities at any time during the validity of the commitment for any violation of any provision of this Performance Commitment.
**After a fair hearing and given the opportunity to be heard, to suspend, shorten, pre-terminate and/or revoke our privilege of participating in the NHIP including the appurtenant benefits and opportunities at any time during the validity of the commitment for any violation of any provision of this Performance Commitment.
*42. To suspend, shorten, pre-terminate and/or revoke our accreditation including the appurtenant benefits and opportunities incident thereto at any time during the term of the commitment due to verified adverse reports/findings of pattern or any other similar incidents which may be indicative of any illegal, irregular or improper and/or unethical conduct of our operations.
**After a fair hearing and given the opportunity to be heard, to suspend, shorten, pre-terminate and/or revoke our accreditation including the appurtenant benefits and opportunities incident thereto at any time during the term of the commitment due to verified adverse reports/findings of pattern or any other similar incidents which may be indicative of any illegal, irregular or improper and/or unethical conduct of our operations.
*43. To deny our accreditation and consequently participation in the NHIP should there be a case, regardless of the nature thereof, filed by us against PhilHealth, its Officers and/or any of its Personnel. Provided that, if in the discretion of PhilHealth, the specific nature of the case is such that it will not directly or indirectly affect a healthy business relationship with us, PhilHealth, upon the recommendation of the Accreditation Committee, may favorably consider the approval of our accreditation.
DR. EDUARDO BANZON
President
PHILIPPINE HEALTH INSURANCE CORPORATION
17th Floor, City State Centre Bldg.,
Shaw Blvd., Pasig City
Dear Dr. Banzon,
Respectfully, please allow us to propose the following amendments to the Performance Commitment (re: Philhealth Circular No. 13-2012) as suggested by our member-hospitals as follows:
*Present Provisions:
**Proposed Provisions:
*9. That we shall abide with all the implementing rules and regulations, memorandum circulars, office orders, special orders and other administrative issuances by PhilHealth affecting us.
**That we shall abide with all reasonable, fair and humane implementing rules and regulations, memorandum circulars, office orders, special orders and other administrative issuances by PhilHealth affecting us.
*10. That we shall abide with all administrative orders, circulars and such other policies, rules and regulations issued by the Department of Health and all other related government agencies and instrumentalities governing the operations of IHCPs in participating in the NHIP.
**That we shall abide with all reasonable, fair and humane administrative orders, circulars and such other policies, rules and regulations issued by the Department of Health and all other related government agencies and instrumentalities governing the operations of IHCPs in participating in the NHIP.
*15. That we shall provide the necessary drugs, supplies and services with no out-of-pocket expenses on the part of the members as contained in PhilHealth's 'No Balance Billing (NBB) Policy’.
**That, insofar as available in our hospital, we shall provide the necessary drugs, supplies and services with no out-of-pocket expenses on the part of the members as contained in PhilHealth's 'No Balance Billing (NBB) Policy’.
*24. That we shall electronically encode the drugs and supplies used in the care of the patient in our information system, which shall be made available for PhilHealth use.
**That, insofar as our hospital is capable considering our financial difficulties, we shall electronically encode the drugs and supplies used in the care of the patient in our information system, which shall be made available for PhilHealth use.
*30. That we shall extend full cooperation with duly recognized authorities of PhilHealth and any other authorized personnel and instrumentalities to provide access to patient records and . . . to undermine the NHIP and make available all pertinent official records and documents including the provision of copies thereof.
**That, we shall extend full cooperation with duly recognized authorities of PhilHealth and any other authorized personnel and instrumentalities to provide access to patient records and . . . . to undermine the NHIP and make available all pertinent official records and documents including the provision of copies thereof, Provided that the inspection shall be orderly and that our rights to private ownership and privacy are respected.
*32. That at any time during the period of our participation in the NHIP, upon request of PhilHealth, we shall voluntarily and unconditionally sign and execute a new 'Performance Commitment' to cover the remaining portion of our engagement or to renew our participation with the NHIP as the case may be, as a sign of our good faith and continuous commitment to support the support the NHIP.
**That at any time during the period of our participation in the NHIP, upon request of PhilHealth, we shall voluntarily and unconditionally sign and execute a new 'Performance Commitment' to cover the remaining portion of our engagement or to renew our participation with the NHIP as the case may be, insofar as it is fair, reasonable and humane to our existence, as a sign of our good faith and continuous commitment to support the support the NHIP.
*33. That we shall take full responsibility for any inaccuracies and/or falsities entered into and/or reflected in our patients' records as well as in any omission, addition, inaccuracies and/or falsities entered into and/or reflected in claims submitted to PhilHealth by our institution.
**That, unless proven to be a palpable mistake or excusable error, we shall take full responsibility for any inaccuracies and/or falsities entered into and/or reflected in our patients' records as well as in any omission, addition, inaccuracies and/or falsities entered into and/or reflected in claims submitted to PhilHealth by our institution.
*41. To suspend, shorten, pre-terminate and/or revoke our privilege of participating in the NHIP including the appurtenant benefits and opportunities at any time during the validity of the commitment for any violation of any provision of this Performance Commitment.
**After a fair hearing and given the opportunity to be heard, to suspend, shorten, pre-terminate and/or revoke our privilege of participating in the NHIP including the appurtenant benefits and opportunities at any time during the validity of the commitment for any violation of any provision of this Performance Commitment.
*42. To suspend, shorten, pre-terminate and/or revoke our accreditation including the appurtenant benefits and opportunities incident thereto at any time during the term of the commitment due to verified adverse reports/findings of pattern or any other similar incidents which may be indicative of any illegal, irregular or improper and/or unethical conduct of our operations.
**After a fair hearing and given the opportunity to be heard, to suspend, shorten, pre-terminate and/or revoke our accreditation including the appurtenant benefits and opportunities incident thereto at any time during the term of the commitment due to verified adverse reports/findings of pattern or any other similar incidents which may be indicative of any illegal, irregular or improper and/or unethical conduct of our operations.
*43. To deny our accreditation and consequently participation in the NHIP should there be a case, regardless of the nature thereof, filed by us against PhilHealth, its Officers and/or any of its Personnel. Provided that, if in the discretion of PhilHealth, the specific nature of the case is such that it will not directly or indirectly affect a healthy business relationship with us, PhilHealth, upon the recommendation of the Accreditation Committee, may favorably consider the approval of our accreditation.
**To deny our accreditation and consequently participation in the NHIP should there be a case, regardless of the nature thereof, filed by us against PhilHealth, its Officers and/or any of its Personnel. Provided that, if in the discretion of PhilHealth, the specific nature of the case is such that it will not directly or indirectly affect a healthy business relationship with us, PhilHealth, upon the recommendation of the Accreditation Committee, may favorably consider the approval of our accreditation, Provided that this commitment shall not apply in cases of graft and corruption committed by any Philhealth Staff or employee, or violation of any applicable law, and in cases where we are mandated by law to file a responsive pleading to any case filed by Philhealth against us.
In behalf of our member hospitals, we humbly request that you consider the above suggestions.
Warmest regards and God Bless!
Yours truly,
DR. BU C. CASTRO RUSTICO JIMENEZ, M.D.
PHA President PHAPi President
In behalf of our member hospitals, we humbly request that you consider the above suggestions.
Warmest regards and God Bless!
Yours truly,
DR. BU C. CASTRO RUSTICO JIMENEZ, M.D.
PHA President PHAPi President
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