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HPMR backs patient referrals to Manila
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Posted on Nov 22 2004
Hawaii Pacific Medical Referral vice president Thomas Cannon agrees that referring patients to Manila would be much cheaper for the CNMI government.
“Compared with Hawaii, it’s definitely cheaper in the Philippines,” he said, noting that health care cost in Manila is about a fifth of the average price in Hawaii.
HPMR, the third party administrator for the NMI Retirement Fund’s group health insurance program, said it would in fact be advantageous for Saipan to have a liaison office in Manila.
Cannon was on Saipan last week to report on its claims processing work for the Fund. Cannon said that for three years beginning Aug. 1, 2001 to July 31, 2004, HPMR saved the CNMI over $8 million in earned discounts from health providers in Hawaii.
HPMR recorded total charges of $53.6 million. Of this, $39.3 had been processed and paid out. Of the $39.3 million, the Fund only paid $14.1 million due to $12.5 million in ineligible charges, $8.3 million in HPMR discount, $2.7 million in coordination of benefits, and $1.7 million paid by co-insurers.
Of the total charges, $29.8 million was for off-island claims, while $9.5 million was for local claims. Of these amounts, the Fund only paid $7.4 million for off-island claims and $6.7 million for on-island claims.
Earlier, Lt. Gov. Diego T. Benavente, who took part in negotiations with a Manila hospital for the CNMI referral program, said the government can save a lot of money if it refers its patients to the Philippines due to its close proximity and relatively low health care cost.
Under the referral program, the CNMI government guarantees patients’ hospitalization in offshore hospitals and charges the patients either through their insurance or personal credit.
Records showed that since 1999, majority of patients referred for off-island treatment were sent to Guam. Of the 2,515 medical referral patients, 1,321 of them sought medical care in Guam-based health care facilities.
The next highest number of patients—1,149—were referred to Hawaii. The Philippines received 45 patients during the same period.
The DPH medical referral program has listed 15 accredited health care providers on Guam, 12 in Hawaii, and three in Manila.
