PhilHealth accredits 2,000 service providers for Konsulta Package, looks for more

The Philippine Health Insurance Corporation (PhilHealth) said Sunday it is aiming to get more service providers to enroll under its Konsultasyong Sulit at Tama (Konsulta) Package next year as only 2,000 are currently accredited in the program.

Interviewed on Super Radyo dzBB, PhilHealth Corporate Communications Department senior manager Rey Baleña said they targeting a ratio of one facility to cater to the primary care needs of 20,000 people.

“Ngayong 2022, tayo ay nakapag-accredit na ng mahigit 2,000 na Konsulta providers. Nagpaparami pa tayo niyan kasi ang sabi sa batas, lahat ng Pilipino…Talagang crucial na makapag-accredit kami ng maraming pasilidad para sa gayon ay may mapagpipilian kayo,” he said. 

(In 2022, we have accredited over 2,000 Konsulta providers. We are increasing this number because the law states that it should be for all Filipinos... It is really crucial that we can accredit many facilities so that people will have a choice.)

PhilHealth earlier said the application for Konsulta accreditation is open to non-hospital facilities such as rural health units, ambulatory surgical clinics, and infirmaries. It also urged all accredited Level 1, 2, and 3, public and private hospitals to be accredited for the program.

Those interested can submit their application and self-assessment tools to the Local Health Insurance Office closest to them.

To be qualified, they must be compliant with the mandatory standards. Minimum requirements in terms of service include the conduct of preventive/screening service and health education, provision of required laboratory and radiologic services, and the dispensing of drugs and medicines.

Baleña said that for this year, they aimed to cover 1/4 of the Philippines’ 111 million population under the Konsulta package.

“Ang computation namin, mahigit sa 2,000…mga 2,400 siguro na mga provider ang sasapat para doon sa 25% ng population. For 2023, magta-target ulit tayo na certain portion ng population kasi talagang hindi kakayanin ‘yan ng agad-agad,” he added.

(Based on our computation, more than 2,000, maybe 2,400 providers will be enough for that 25% of the population. For 2023, we will again target a certain portion of the population because we really cannot handle that right away.)

PhilHealth is mandated to administer the National Health Insurance Program which aims to provide health insurance coverage and ensure affordable, acceptable, available, and accessible health care services for all Filipinos.

Former President Rodrigo Duterte in 2019 signed the Universal Health Care Act, making all Filipino citizens automatically enrolled into the National Health Insurance Program.

Under PhilHealth Circular 2020-0022, the Konsulta Package covers individual-based health services including initial and follow-up primary care consultations, health screening and assessment, and access to selected diagnostic services and medicines.

“Ito ‘yung ating tulong para lalong maging accessible sa bawat isa sa’tin…ang primary care services. Napakahalaga po na meron tayong access dito. Ito ang isa sa mga learnings natin from this pandemic, na ma-prevent natin ‘yung pagkakasakit earlier, ma-detect natin kung meron tayong sakit. Itong Konsulta, pinalalakas natin ito,” Baleña said.

(This is our help to make primary care services more accessible to each one of us. It is very important that we have access to it. This is one of our learnings from this pandemic, that we can prevent illness earlier and detect if we have a disease. We are strengthening this Konsulta.) — BM, GMA Integrated News