PhilHealth XII hastens KONSULTA implementation

KORONADAL CITY - In support to the Universal Health Care (UHC) Program, PhilHealth 12 has accelerated the implementation of “Konsultasyong Sulit at Tama” (KONSULTA) implementation in the region.

To date, the office has already accredited 48 health facilities ready to provide free check-up including initial and follow up consultation, targeted health screening and assessment with digital rectal exam and breast exam, provision of drugs and medicines including rendition of laboratory services.

Recently, the South Cotabato Provincial Hospital and Kidapawan City Hospital have undergone simulation activity.

The PhilHealth 12 KONSULTA Team took charged of the activity for every other newly accredited facility for them to adopt the system from enrolment, benefit availment to PhilHealth payment of the services provided for the members.

“Ït is important that our (health) facilities (workers) know the entire process for them to appreciate that our system and our program really works. Our Information Technology and Management Section will take charge of the system installation,” Dr. Hector Zenon Leonardo P. Malate, PhilHealth 12 Regional Vice President during his speech in one of the orientation activities.

PhilHealth 12’s accredited facilities serving the provinces of South Cotabato are the Rural Health Units of Surallah, Norala, Sto Nino, Tupi, Tboli, Banga, Polomolok with South Cotabato Provl Hospital and Howard Hubbard Memorial Hospital. In Sarangani Province are the Rural Health Units of  Malungon, Glan, and Sarangani Provincial Hospital, St Elizabeth Hospital, Inc., St. Elizabeth Hospital Inc.- Alabel satellite; Sultan Kudarat Province are Tomboc Salayog Hospital, RHU Bagumbayan and North Cotabato Province is Kidapawan City Health Office

The member’s facility of choice serves as the initial point of contact and navigator of the beneficiaries’ needs to a higher level of care whenever needed.

To have their KONSULTA benefits availed of immediately, PhilHealth members are encouraged to start picking out their facility of choice, have themselves registered, secure their confirmation slip for the issuance of authorization transaction code (ATC).

This KONSULTA benefits as UHC has committed shall also provide drugs and medicines that may be dispensed depending on the need of the members are anti-microbial to control the spread of bacteria and other microorganisms that may cause certain illnesses and fluid and electrolytes for rehydration.

It includes anti-asthma to counteract symptoms of asthma; antipyretics to reduce fever; anti-dyslipidemia to prevent coronary heart disease; anti-diabetic to relieve diabetes, anti-hypertensive to lower high blood pressure, anti-thrombotic meds to reduce the formation of blood clots and antihistamine for allergies.

On the other hand, KONSULTA laboratories that may be requested for the need of the beneficiaries include CBC with platelet count to check and detect a wide range of disorders including anemia, infection and leukemia.

It also covers urinalysis to detect and manage a wide range of disorders, such as urinary tract infections, kidney disease and diabetes, fecalysis to help diagnose certain conditions affecting the digestive tract, sputum microscopy to determine whether abnormal cells are present in sputum samples, fecal occult blood test to check stool samples for any indication of colon cancer or polyps in the colon or rectum — though not all cancers or polyps bleed.

Also included are Pap smear to check whether one has a cervical cancer or cell changes that may lead to cervical cancer, lipid profile to measure the amount of cholesterol and triglycerides in the blood, fasting blood sugar to check sugar and to diagnose prediabetes, diabetes or gestational diabetes.

It also includes oral glucose tolerance test to measure our body's response to sugar; ECG to check the heart's rhythm and electrical activity, chest x-ray to look at the structures and organs in our chest, creatinine to measure how well our kidneys are performing their job in filtering waste from our blood including Hemoglobin A1C test to measure the average blood sugar levels over the past 3 months can likewise be requested depending on the need of the beneficiaries.

“Since PhilHealth shall pay for the free services to be provided for the members, said beneficiaries are reminded to fill out electronic KONSULTA availment slip o EKAS upon check-up and availment of their laboratory services and ePress upon receipt of their drugs and meds,” Nevin L. Hallegado, Membership Section Head in one of the radio interviews.

“This is PhilHealth’s way of validating benefit claims on KONSULTA filed by the facilities,” Hallegado added.

Health Care Providers that are interested to apply for accreditation may visit PhilHealth 12 and coordinate with the Accreditation and Quality Assurance Section for the orientation, accreditation requirements and the necessary simulation.

Facility accreditation requirements include its service capability to provide preventive care /screening services and health education; capability to provide the required laboratory and radiologic services and capability to dispense the required drugs and medicines as enumerated above.

Said accreditation requirements include the facility’s technical standards for the general infrastructure, infection control and prevention during pandemic and equipment supplies.

In pursuit of a holistic medical-surgical intervention as committed by the UHC, members enrolled in the program will have their personal data and information encoded in the system for the necessary access in case they are referred to a higher level of care.