PhilHealth, LGU GenSan intensify anti-fraud campaign

By Danilo E. Doguiles

Friday 17th of August 2012

KORONADAL CITY, August 17 (PIA) -- PhilHealth-12 and the city government of General Santos have intensified their campaign against health care fraud by distributing member data records (MDRs) with the family picture of sponsored program members and their qualified dependents.

At a recent MDR distribution attended by General Santos Local Health Insurance Office head Nol Valila and City Social Welfare and Development Officer Rebecca V. Magante, 712 sponsored program members listed under the National Household Targeting System-Poverty Reduction (NHTS-PR) gathered at Brgy. San Jose, General Santos City.

Said members brought their spouses, children and parents aged 60-years-old and above to have their pictures taken and printed on the MDRs.

Dr. Miriam Grace G. Pamonag, Field Operations Division chief of PRO 12 said that this initiative will “put a face” to the MDR and ensure that only the intended beneficiaries will be able to use the MDRs for purpose of claiming PhilHealth benefits in any accredited hospitals and non-hospital facilities.

On the lower portion of the MDR this words are: “Ako ay miyembro ng PhilHealth na may benepisyong pangkalusugan. Sakop ng aking benepisyo ang aking asawa, mga anak na may edad 20 taon pababa at magulang na may edad 60 taon pataas. Wala kaming babayaran sa mga pangunahing operasyon at karamdaman kung magpapa-confine kami sa ward ng mga pampublikong ospital. Sagot ng PhilHealth ang konsultasyon, laboratory at ilan pang serbisyo ng aking pamilya mula sa aming health center. Kailangan ko lamang ipakita ang aking Health Insurance Card o Member Data Record kapag gagamit ng benepisyo.”

This message should also remind the MDR of his responsibility as a PhilHealth member.

To properly distinguish PhilHealth MDR from other documents, this is printed in a light yellow A4 size paper.

Further, PRO 12 urged all accredited health care providers to access the list of NHTS-PR members from http://www.philhealth.gov.ph/members/sponsored/nhts-pr_list.html to verify their status and eligibility.

PhilHealth Cares nurses assigned in selected hospitals in the region can also assist in the verification process through their Customer Service Information System (DED-PIA 12/ Amor Sequito, PRO 12)