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PhilHealth No Balance Billing (NBB) Policy for Sponsored Program Members Admitted in Government Hospitals

Published/Updated on: 27-September-2011

PhilHealth recently announces that the No Balance Billing (NBB) policy pertaining to the availment of benefits under the new case rates is applicable to Sponsored Program members and / or their dependents admitted in accredited government hospitals due to any of the following medical conditions and surgical procedures:

MEDICAL CASES
Dengue I	P8,000.00
Dengue II	P16,000.00
Pneumonia I	P15,000.00
Pneumonia II	P32,000.00
Essential Hypertension	P9,000.00
Cerebral Infraction	P28,000.00
Cerebro-vascular accident with hemorrhage	P38,000.00
Acute Gastroenteritis	P6,000.00
Typhoid Fever	P14,000.00
Asthma	P9,000.00
Newborn Care Package	P1,750.00

SURGICAL CASES
Radiotherapy	P3,000.00
Hemodialysis	P4,000.00
Maternity Care Package	P8,000.00
NSD, Level 1	P8,000.00
NSD, Levels 2-4	P6,500.00
Caesarean Section	P19,000.00
Appendectomy	P24,000.00
Cholecystectomy	P31,000.00
Dilatation and curettage	P11,000.00
Throidectomy	P31,000.00
Herniorrhaphy	P21,000.00
Mastectomy	P22,000.00
Hysterectomy	P30,000.00
Cataract Surgery	P16,000.00

Sponsored Program members refer to indigent families whose enrolment into the National Health Insurance Program (NHIP) is made possible through the sponsorship of the local government units, private companies and individuals. Also included under the Sponsored Program are families listed under the National Household Targetting System for Poverty Reduction of the Department of Social Welfare and Development (DSWD) whose annual premium has been paid for by the National Government.

Accredited government hospitals must refer to the validity period stated in the Sponsored Program member‘s ID card to ascertain that availment of benefits is within the said validity period.

The NBB policy also applies when the Sponsored Program members avail themselves of outpatient surgeries, hemodialysis and radiotherapy in accredited non-hospital facilities that includes free-standing dialysis centers (FSDCs) and ambulatory surgical clinics (ASCs). It also applies when they are availing themselves of our existing outpatient packages for TB-DOTS, Malaria and HIV/AIDS.

At the same time, all other member-types are entitled to the NBB policy when availing themselves of the Maternity Care Package (MCP) and the Newborn Care Package (NCP) in accredited MCP (non-hospital) providers.

Posted by: khen | Category: Health | Tags:: for, (NBB), no, Program, members, balance, Policy, Sponsored, Billing, PhilHealth

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PhilHealth No Balance Billing (NBB) Policy for Sponsored Program Members Admitted in Government Hospitals

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