Health Care Merry-Go-Round ( 2nd Scene)

      December 16, 2009 was the day when I was able to submit two filled-out application forms. Together with it are the itemized hospital bill, the hospital's waiver, death certificate, funeral receipts, and father's SSS certification of membership. Plenty, isn't it? Not sufficient, I think. That's because I've been required to submit some more by Philhealth head office. These were copies of my parent's marriage certificate, my mother's two id-size photos, my birth certificate and that of my siblings, our waiver of right and a letter of request from mother as claimant. January 19 this year, I forwarded the second set of papers to them. A clerk reviewed it and again more were asked of me to submit. These are baptismal certificates of  my brother and mine, and an ID. That ID I couldn't remember anymore what for or what it was. Most probably due to the sheer amount of paper or documents I had to work on and produced; and most of it had to be notarized and certified. A couple of days after, with the certificates and an id in hand, I was finally told to come back in a month's time to follow up on our claim's progress.

      Came back to Philhealth around the second week of following month. Still in process. Third week. "Good for payment", they say. Even showed me the workstation's monitor linked to their file server. As clear as daylight, "Good for Payment". Finally it would be over, or so I thought and was led to believe. Came back last week of February, still "good for payment". No sign a checque being issued though. March 11, still the same. It seemed to hit a plateau several more days after. March 23, "payment withheld"??? Reason a certain form 3 or a clinical abstract was being asked by some wise guy upstairs. Is this some kind of  a big joke! After all the time and effort I made not to mention the money spent on everything(viz., transport fares, notarial fees, certification fees, and other charges). The clerk could not even explain why. 
      In fact, one of the application form that was submitted to them at the very outset contains already the information found in the clinical abstract/F3 form being required(again!) such as the attending physician's diagnosis, time of death, etc.  Also attached to it was the hospital's final billing reflecting items used- cotton swabs, syringes, medicines, ventilator,...medical procedures, tests, fees, and so forth and so on. Obviously, all those were overlooked or were deemed insufficient.
     So I had to ask her to tell me who to talk to. It's on the 12th floor of the building. Room 1209 or something. Look for Maricel. 1209, lots of office people busy on their desks. Had a little talk with Maricel and she tried explaining. (Irking me a bit was a nosy security guard by my side and who was supposed to be manning his post instead.) Well in any case, Maricel did not have any satisfactory explanation to give either way. What on earth or rather why the "good for payment" thing for so long a time and, from out of the blue, it was withheld? That was mainly my question. Wasn't it supposed to be evaluated and re-evaluated by them before approval of any claim for that matter? All she could do was give me back all those papers I had submitted to them and suggested that I refile it as soon as I can get the clinical abstract. 

      Taking with me the papers, I went back down the elevator and out the building. Took a ride back to the hospital. There I went straight to the medical records section and asked for the clinical abstract. I was told to come back for it in two days. Got it exactly two days after and immediately went as fast back to Philhealth that same day. The whole receiving office was packed with clients. There's practically no room to move about. Also there only so little time left before closing time. So I decided just to go back next day.    
     Following morning, today. I had to sit and wait for my cue. In less than half an hour, I had all papers including the clinical abstract refiled.

         One more strange thing. Philhealth representatives in the hospital were even wondering why the head office needed a form 3 or abstract. Form 3, they said, were only needed when the patient involved stayed for less than a day. Father was hospitalized for two full days. That actually the representatives had not been issuing it anymore. Even they find it odd when I told them of our claim being on a "good for payment" status for several weeks and suddenly it reverted to being withheld. I myself smells something amiss and almost realizing it when, upon refiling at the head office, I was told it would take another two months to process my papers. And also furthermore, I was informed in so many times by their own people at the head office that there was a change of management a few months before. What sort of seeming sinister event is unfolding? That will be seen when election period comes! That's exactly "two months" from today. Now what could possibly be the connection. Your guess can only be as good as mind.