Escolar Documentos
Profissional Documentos
Cultura Documentos
Unique
Member
12%
Claims
Reimbursed
Total Population Total Covered NHTS/SP
Total LGUs
Members Claims
Covered Members and Dependents
as of December 31, 2017
Sector Members Dependents Beneficiaries
Members in the 14,903,502 13,952,626 28,856,128
Formal Economy Private 12,646,606 10,361,739 23,008,345
Government 2,186,147 3,537,657 5,723,804
Household
Help/Kasambahay 69,621 51,687 121,308
Enterprise Owner &
Family Drivers
1,128 1,543 2,671
Members in the 11,077,951 11,821,151 22,899,102
Informal Economy Migrant Worker
Informal Sector
536,094
2,317,026
779,640
3,430,129
1,315,734
5,747,155 93%
Self-Earning Individual 435,824 599,814 1,035,638
Organized Group and
of 2017
Others
15,109 21,040 36,149 Projected
Informal Economy Population
Members w/o 3/6
contribution but Entitled
to Point of Service (POS)
7,773,898 6,990,528 14,764,426
excluding Foreign
Nationals
Indigents 14,329,442 17,700,855 32,030,297
Sponsored Members 1,127,692 1,452,057 2,579,749
Senior Citizens 6,899,207 1,574,258 8,473,465
Lifetime Members 1,245,993 888,947 2,134,940
TOTAL 49,583,787 47,389,894 96,973,681
Note:
- Indigent count of members and dependents was based on DSWD Listahan II database and are subject for further validation.
- 2017 Projected Population is 104,519,910 estimated from the August 2015 Census by PSA.
Covered Members (by Sector)
as of December 31, 2017
Lifetime
3%
Gov't
Private 35%
65%
LEVEL 3 51 64 115 6%
Total Amount of Claims Average Value Paid per % Distribution of Total No. of
Member Category Total No. of Claims Paid
Paid Claim Claims Paid
Number of claims paid were generated using Power BI Dashboard processed January 12, 2018 based on check date.
Claims Processing
Number and Amount of Claims Paid Per Type of Facility
January 1 to December 31, 2017
Total Amount of Claims Total No. of Claims Average Value Paid per % Distribution of Total No. of
Type of Facility
Paid Paid Claim Claims Paid
ZMORPH FOR THE FITTING OF EXTERNAL LOWER LIMB PROSTHESIS BELOW THE KNEE (BOTH) 60,000 2
ZMORPH FOR THE FITTING OF EXTERNAL LOWER LIMB PROSTHESIS BELOW THE KNEE (LEFT) 660,000 44
ZMORPH FOR THE FITTING OF EXTERNAL LOWER LIMB PROSTHESIS BELOW THE KNEE (RIGHT) 555,000 37
Grand Total 420,431,755 1,980
Note : No. and amount of claims paid as reported by BDRD.
Z-Benefit
Number and Amount of Claims Paid Per Facility
January 1 to December 31, 2017
Total Amount of Total No. of
Z BENEFITS Claims Paid Claims Paid
ANGELES UNIVERSITY FOUNDATION MEDICAL CENTER 2,975,000 6
BAGUIO GENERAL HOSPITAL AND MEDICAL CENTER 3,928,180 45
BATANGAS MEDICAL CENTER 3,075,000 33
BICOL MEDICAL CENTER 800,000 10
BICOL REGIONAL TRAINING AND TEACHING HOSPITAL 665,000 8
CAGAYAN VALLEY MEDICAL CENTER 325,000 4
CHINESE GENERAL HOSPITAL & MEDICAL CENTER 3,850,000 7
CORAZON LOCSIN MONTELIBANO MEM. REG'L HOSP. 7,300,092 66
DAVAO REGIONAL MEDICAL CENTER 1,125,000 15
DE LOS SANTOS MEDICAL CENTER 2,850,000 5
EAST AVENUE MEDICAL CENTER 400,000 5
ILOCOS TRAINING AND REGIONAL MEDICAL CENTER 75,000 1
KAPAMPANGAN DEVELOPMENT FOUNDATION, INC. 1,170,000 76
KIDNEY SOLUTIONS INC. 934,614 38
LORMA MEDICAL CENTER 1,150,000 2
MAKATI MEDICAL CENTER 436,153 13
MANILA DOCTORS HOSPITAL 4,950,000 9
MARY MEDIATRIX MEDICAL CENTER 7,950,000 15
NATIONAL KIDNEY AND TRANSPLANT INSTITUTE 114,597,857 789
NORTHERN MINDANAO MEDICAL CENTER 10,761,000 40
NOTRE DAME DE CHARTRES HOSPITAL 1,000,000 2
PHILIPPINE CHILDREN'S MEDICAL CENTER 3,710,000 19
PHILIPPINE HEART CENTER 140,980,000 362
SOUTHERN PHILIPPINES MEDICAL CENTER 34,730,000 91
ST. FRANCES CABRINI MEDICAL CENTER, INC. 1,025,000 12
ST. LUKE'S MEDICAL CENTER - GLOBAL CITY 14,400,000 25
ST. PAUL'S HOSPITAL OF ILOILO, INC. 3,048,458 20
UNIVERSITY OF THE EAST RAMON MAGSAYSAY MEMORIAL MEDICAL CENTER, INC. 90,000 6
UP-PHILIPPINE GENERAL HOSPITAL 33,260,000 163
VICENTE SOTTO MEMORIAL MEDICAL CENTER 17,425,400 78
WESTERN VISAYAS MEDICAL CENTER 1,445,000 15
Grand Total 420,431,755 1,980
Note : No. and amount of claims paid as reported by BDRD.
Indigent-NHTS/ Sponsored Program
(Number of Claims Paid)
as of December 31, 2017
not NBB
26.71%
No Balance
Billing
73.29%
Note: Level of NBB Compliance per PROs based on Exit Survey Results from October to December 2017
Support Value
January 1 to December 31, 2017
Preliminary estimates using Average Value Paid per Claim (AVPC ) for claims paid January 1 to December 31, 2017 P 9,870 over
P 17,801 the estimated average cost of In-patient care based from the 2013 NDHS by PSA with 3.2 inflation rate in 2017.