..ang blog ni Yeyen.

Outpatient Care

To Cagayan de Oro City and back within twelve hours.

My mom, my brother and I were at the Cagayan de Oro Medical Center for my mom’s monthly biphosphonates infusion yesterday. It was tiring, yes, but it went well, so thank God.

Despite the land travel of three and a half hours (7 round trip by private car), I prefer getting her infusions there because all we ever prepare for is only to pay for the medicine (which is not cheap) and then we proceed to the chemotherapy room (though my mom’s not on chemo) and that’s about it. Our doctor’s secretary just let her sign the Philhealth forms and get my mom’s MDR (this is a member’s record issued by PHIC) and we go home free from other financial concerns immediately after (the new medicine now only takes 15 minutes).

The professional fees of her medical oncologist is only that paid by PHIC. I think this is because of the fact that my sister is a fellow doctor (and her former student) and it’s in their law on ethics (daw) that doctors should not charge professional fees on the immediate families of fellow doctors.

The hospital charges for the use of the facilities of the chemotherapy room as well as all the other incidental expenses thereto (like supplies – gloves, dextrose, etc.) are all paid for by PHIC.

Sadly, this is not the scenario in Manila. Whenever my mom is in Manila, she gets her infusions at the hospital where her primary medical oncologist holds clinic (who is likewise the teacher of my mom’s medical oncologist in CDO). It may be because her doctor does not know that my sister is a fellow doctor, (currently a resident in PGH where he is also the head consultant in Oncology) that he charges exorbitant professional fees for my mom every time he sees her during infusions (on top of the amount PHIC pays him). Of course, he should be paid for his services. As my mom says, it’s better to pay well so that she’ll be healed, hehehe. I really don’t care about the fees but he only stays there for a maximum of ten minutes and leave (when the process is two hours long), so that’s why I feel that the P 3,000.00 we paid him is too much. Oh well, maybe not, considering his standing in his field. Whatever.

But that’s not the point of this entry.

In that hospital in Manila, they don’t allow outpatient services to avail of the PHIC benefits. We have to pay for the chemotherapy facility services and the incidental supplies (no problem with the medicine as it is the same policy with CDO). If we want PHIC to shoulder the costs, we file for REIMBURSEMENT ourselves before the PHIC office here.

If I had the time (and if I could only express myself well in Filipino, hehehe), I would have complained and insisted on the law but what the heck, it’s not even that substantial an amount (er, not so since it’s less than P 2,000.00…). Nevertheless, the policy is anti-outpatient – it’s like luring the patients to “check in” instead so that they don’t have to file for reimbursement.

There’s nothing wrong with reimbursement if the latter would be a swift process, but it’s not. Apart from the ping-pong instructions and requirements given in tidbits by a PHIC employee, one has to wait at least 90 days to be paid. Ninety days is not short — in my mom’s case, she would have incurred additional three months worth of treatments again before she receives the reimbursement for the one she got four months ago. Aigoo.

In fairness to that hospital, it must also be because of this reason that they don’t allow outpatient services to avail of the PHIC benefits. I’m assuming it takes about the same time to collect their charges from PHIC for the in-patients, and disallowing out-patients on availing PHIC benefits would make a difference — it’s cash versus accounts receivable and cash is certainly better because it’s liquid. This is on the hospital’s perspective.

In my point of view, it’s outpatient welfare versus hospital interest and I need not write which should prevail between the two because it’s so glaringly obvious.

It would be nicer if that hospital would be a little less selfish and patient friendly, like the ones here in the provinces.


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