The Philippine Health Insurance Corp. (PhilHealth) on Wednesday announced that it is relaxing its policies when it comes to claiming Z Benefit packages for selected orthopedic implants for those affected by the 6.9 magnitude earthquake that struck Cebu province on Sept. 30.
In a statement, the state-run insurer noted that there was only one accredited health facility in Cebu that was authorized to provide Z Benefit packages for orthopedic implants, prompting the PhilHealth Board to effect special policy relaxations in order to widen access.
‘This is not just a matter of policy, but of timely action to save lives and limbs. By easing restrictions, we are ensuring that those injured in this calamity receive the proper treatment without delay or undue cost,’ said PhilHealth acting President and CEO Dr. Edwin Mercado.
‘We are loosening policies not to compromise standards, but to maximize access to care at a time when scarcity of accredited providers could mean the difference between recovery and permanent disability,’ he added. Taking effect retroactively on Sept. 30, PhilHealth said health care institutions in Cebu have been granted provisional accreditation to claim Z Benefit packages for orthopedic implants, covering injuries sustained during the quake.
Among the services offered by contracted providers of Z Benefit packages include implants for hip arthroplasty or hip replacement surgery, implants for hip fixation, implants for pertrochanteric fracture, implants for femoral and tibial shaft fracture, implants for total knee replacement, and implants for upper extremities. Earthquake victims needing urgent orthopedic intervention will also be exempted from the 24-hour confinement rule. No co-payment policy is also extended to those with eligible injuries.
The deadline for the filing of claims is also extended up to 120 calendar days from the date of discharge, and will also include retroactive coverage for admissions up to 60 days before Sept. 30. PhilHealth added that it will reduce the requirements for claiming benefits to only include forms 1 and 2, as well as the operative record.
Health-care professionals accredited by PhilHealth will also be compensated for performing surgeries regardless of where it is conducted, even in health facilities that they are not affiliated with.
These provisional measures will be in effect until the ‘state of calamity’ declaration in Cebu is lifted, said PhilHealth.