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UPDATES ON OUR HMO PROVIDER

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UPDATES ON OUR HMO PROVIDER

Post by Admin on Mon Jul 13, 2009 7:59 pm

Magandang araw kapwa ko landbankers. During our 3 days meeting with all Regional Governors, Vice Govs and the NEB officers, the following agenda had been discussed.
1st day.
Terms of Reference (TOR).
The LBPEA presented the new TOR to the Body for evaluation/approval on the next hmo provider for the coverage of year 2010 (as well as the remaining months if present provider worsen the scenario).
under the new TOR, ang mga changes are the Extended family member coverage which decided to be a separate package, from the principal and immediate family members. malaki po kasi masyado ang utilizations ng ating extended family member enrollees per records. Kaya sa mga members na may extended family enrollees expect a higher premiums.

the rest ay medyo pareho pareho sa lang sa previous TOR. Isabay po ang presentation ng TOR with the middle management sa mga interested HMO providers for the 2010 coverage and a negotiation to include the remaining months of the year 2009. (August-December 2009).

Ang maganda lang po sa LBPEA, intact po ang ating premium on the said remaining months dahil po may addemdum po tayo na monthly basis na ang payment natin sa MEDSERV. Bayad na po tayo hanggang end of July, kaya wala pong reasons ang medserv to deny our claims. At yong mga hindi nabayaran ng medserv ay mag pa file ng case ang lbpea together with the middle management. kaya kung meron man sa inyong lugar na may violations on coverage, paki report lang po sa lbpea for proper domentation.

ang side naman ng medserv, just like any other insurance company, sila po ay na apektuhan sa financial crisis ng ating bansa, may problema sila sa liquidity sa ngayon but they are positively to overcome their problems due infusion of fresh capital by their investors sabi nila. The manners of Medserv on their payment is on a cash to cash basis na po. Medserv also promise by july 20 ma normalize na ang kanilang operations.

Action naman ng lbpea neb and governors, end of the month i terminate na ang contract pag walang improvement sa services ng medserv. Pinaubaya na po ng LBPEA sa ating lawyer ang mga kaukulang documentations in filing charges against our hmo provider.
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