Quick Guide to the No Balance Billing of PhilHealth

What is the No Balance Billing?

No Balance Billing or NBB is a privilege given to qualified PhilHealth members.  If you are covered by the NBB policy, you no longer need to pay for your hospitalization at any government hospital and selected private medical centers nationwide.  It is the government that pays for the member’s hospital expenses without prejudice to the quality of service and attention given to the patient.

Who are covered by the NBB Policy?

• Indigent members
• Sponsored members
• Kasambahay members
• Lifetime members
• Senior Citizens

What services and benefits are covered by the NBB Policy?

All services and benefits afforded to other PhilHealth members are likewise extended to those under the NBB policy, such as:

• All case rates
• Case Type Z benefits
• TB-DOTS package
• Outpatient Malaria Package
• Animal Bite Treatment Package
• Voluntary Surgical Contraception Package
• Outpatient HIV/AIDS Treatment (OHAT) Package

Which packages can be availed through NBB at both private and public hospitals?

NBB is currently offered at the following medical facilities:

Type of Facility	Government Hospital	Private Hospital	Benefits Covered by NBB
Hospital	Yes	No	All applicable benefits covered by NBB for hospitals.
Malaria – outpatient case	Yes	No	Outpatient Malaria Package
Animal Bite Treatment Centers	Yes	No	Animal Bite Treatment Package
Treatment Hubs	Yes	No	Outpatient HIV/AIDS Treatment Package
Hospitals that offer Z Benefits Package	Yes	Yes	Z Benefits Packages
Ambulatory Surgical Clinics	Yes	Yes	All applicable benefits covered by the NBB, such as: ·         Cataract extraction ·         Bilateral Tubal Ligation ·         Vasectomy
Freestanding Dialysis Clinics	Yes	Yes	Dialysis Package
Peritoneal Dialysis Center	Yes	Yes	Peritoneal Dialysis
TB-DOTS Centers	Yes	Yes	TB-DOTS Package
Lying-in Clinics (Maternity Cases)	Yes	Yes	·         Maternity Care Package ·         Antenatal Care ·         Normal Spontaneous Delivery ·         Newborn Care Package ·         Family Planning Procedures
Facilities for Primary Care Benefits	Yes	Yes	·         Primary Care Benefits ·         Family Planning ·         Procedures
Infirmaries / Dispensaries	Yes	Yes	Public Infirmaries: All applicable benefits covered by the NBB, including vasectomy.   Private Infirmaries: ·         Maternity Care Package ·         Antenatal Care ·         Normal Spontaneous Delivery ·         Newborn Care Package.

Will NBB be applied to a patient who is admitted on a private bed?

NBB is applicable only to service beds or PhilHealth beds?  If no service bed is available the time of admission, NBB can still be applied as long as the hospital guarantees that there are no service beds available.

Does the NBB Policy cover doctors’ professional fees?

Yes, that’s why doctors are not supposed to bill patients under the NBB policy; however, if the patient is admitted to a private room, doctor’s fees will still apply.

What if the hospital could not provide the needed medicines, laboratory, and diagnostic tests and the patient is compelled to transfer to a different facility?

It is the government hospital’s obligation to ensure that they have ample stocks of medicines, especially for NBB patients.

In case they are not able to provide the needed laboratory or diagnostic tests, they shall be held responsible and will have to make sure that the NBB patient is given the needed medicines and tests at their expense.

For more information on the No Balance Billing Policy, you may call the PhilHealth hotline at 02-441-7442.  They are able to take your calls, 24×7.

Source: www.philhealth.gov.ph