COA: 4.2M PhilHealth members with defective records

MANILA, Philippines – A recent report by the Commission on Audit (COA) revealed that over 4 million members of the Philippine Health Insurance Corporation (PhilHealth) have missing entries in their records.

In the 2015 COA report, an audit team learned that the following entries were missing for 4,287,546 PhilHealth members, or 6% of the 66 million total membership:

• No dates of birth – 3.037 million members
• No middle names – 1.25 million members
• No first names – 1,117 members
• No last names – 39 members

Auditors said these “deficiencies…would affect the relevance, reliability, and completeness of information” and “could adversely affect the delivery of services to members and to the operation of PhilHealth.”

A total 4,587,697 members only filled the “middle name” requirement in the PhilHealth Members Database with their middle initial, while 207,485 members were missing entries for middle name, birthday, and status – crucial for the verification of members with the same first names or last names.

Invalid or “null” entries were also found in the “status” column of 938,094 members. This column shows whether a member is active or a senior citizen. (READ: ‘Tsekap’: Philhealth has new benefits for indigents)

COA auditors found out that a total of 338,528 centenarians all born before January 1, 1901, were listed in the database as “active” instead of “senior citizens.” One “active” member’s year of birth was listed as 1752, making the person 264 years old.

Meanwhile, 7,530 members were registered after the cutoff date of December 31, 2015.

COA said “improbable” entries should be given immediate revalidation. The agency also urged PhilHealth to create a mechanism so that the system would automatically recognize a member who turns 60 years old as a senior citizen.

“The noted deficiencies, though immaterial in size relative to its database, were essentials in the determination of PhilHealth members’ identities,” COA said in its report.

These deficiencies in members’ records, according to COA, could create problems in the long run, such as the delay in the posting of contributions, or the non-availment of benefits. – Rappler.com