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PhilHealth Imus Branch is experiencing an average increase of

65.04% complaints on the membership system from

January 2014 to June 2014

A company study presented to the faculty of the

College of Engineering, Architecture and Technology

De La Salle UniversityDasmarias

Dasmarias, Cavite

In Partial Fulfilment of the requirements for the Degree of

Bachelor of Science in Industrial Engineering

Submitted By:

Arabe, Jan Andre

Aquino, Arvin

Gumila, Kenneth

IEE41

Submitted to:

Engr. Ma. Socorro M. Bunda

August 2014


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CHAPTER I

1.1 INTRODUCTION

PhilHealth Inc. was established in 1995 to serve as a service health sector of the

Government for the Filipinos to help their needs especially in the financial assistance

when it comes to hospitalizations. The company offers compensation and health

insurances for all the members that had been admitted in hospitals by assisting them

when it comes to financial. As long as the hospital is accredited by PhilHealth, any

person admitted to that certain hospital can reimburse payments made by them.

Philhealth Inc. vision is Bawat Pilipino, Miyembro, Bawat Miyembro, Protektado,

Kalusugan Natin, Sigurado while its mission is Sulit na Benepisyo sa Bawat Miyembro,

Dekalidad na Serbisyo para sa Lahat.

Since PhilHealth is a service health sector of the government, it is important for

all the Filipinos especially those who are incapable of paying such fees. And by

providing their service, system is very important. Implementing a good and effective

system will most likely to lead in perfect execution of the service they are providing. In

this study, case of a certain ineffective system of their process is to be undertaken to

have the idea what are the reasons behind and how do they affect the flow of the

process.


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1.2 BACKGROUND OF THE STUDY

There are a lot of factors and reasons why the system of their process is

ineffective that results in unsatisfying service. It may come from the employees,

materials, equipments, or the system itself. Ineffective system greatly affects the whole

process of their service for the Filipinos.

The researchers found out and observed that the system of their process has a

problem when it comes in the first step of their process which is the system of

membership. In this process, customers are having a lot of troubles and complaints.

Membership consists of enrollment, submission of requirement and payment. During

membership process, the researchers observed that the membership system has three

problems namely long queuing line, slow system server and lastly dissemination of

information. Long queuing line are due of multiple transactions by the customers who

have been asking questions especially when it comes to requirements and including

outside transactions. By this scenario, the customer next to them will have a long time

waiting for them. Slow system server are due by their internet system (PLDT and

Globe), PhilHealth is accommodating an average of 500 applicants a day. By having

only two back up internet system would not be enough to sustain and update the

records of the applicants and members. Lack in dissemination of information would

result into confusion of applicants regarding the procedures and passing of

requirements. This can greatly lead into customer dissatisfaction due to unclear

presentation of information.


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1.3 PROBLEM STATEMENT

PhilHealth Inc. Imus branch is experiencing an average of 65.04% of customer

dissatisfaction in their membership system process from the month of January to June

2014.

1.4 OBJECTIVES OF THE STUDY

General Objectives

Minimizing Philhealth Imus Branch in experiencing an average increase of

65.04% complaints on the membership system from January 2014 to June

2014

Specific Objectives

To eliminate multiple transactions

To improve system server

Wider dissemination of information

1.5 SCOPE AND LIMITATIONS

The study was conducted in PhilHealth Inc. located at MYP GBY Phil. Corp. bldg

Aguinaldo Highway, City of Imus, Cavite. The study focuses on a certain system of their

process where problems are occurring. The study will only consider the data gathered

from February 2014July 2014.


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1.6 SIGNIFICANCE OF THE STUDY

For the students

This study will help them to be more optimistic in dealing with problems in the

system of an industry in the near future. This study will also serve as part of their

experience as they deal in the field of Industrial Engineering. This study will help them

be enlightened and to familiarize the Systems Analysis and Design.

For the company

This study will help them to improve the system of their process and to be able to

provide satisfying service to their beneficiaries. This study will also serve as their

understandings and knowledge of their strength and weaknesses.

For the readers

This study will help them to get new ideas and concepts related to Systems

Analysis and Design. This study will also serve as their guidance whenever they want to

conduct study regarding systems analysis and may also use as their reference for

researches.


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1.7 DESIGN AND METHODOLOGY

Observation

The researchers were able to observe the algorithm of the system of their

process in membership system last August 1, 2014. Brainstorming has to be done to be

able to think for the alternatives.

Interview

The researchers were able to interview and accommodated by the Head of the

PhilHealth Inc. Imus branch, Mrs. Beng Fontanilla. She showed first the important

overviews of the technicalities of the system of their process, how it works and ends.

Mrs. Fontanilla also provided the researchers all the necessary data and information

needed.

Mrs. Beng Fontanilla, Head of PhilHealth Inc. Imus branch

Mr. Benjie Rodil, Supervisor of PhilHealth Inc. Imus branch

Some of the questions asked

1. What mostly are the common problems occur in the process?

2. How many employees do you have?

3. How do you manage problems occurring in the process?

4. How many customers do you accommodate in a day?

5. How many customers have you been not accommodated in day?


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1.8 DEFINITION OF TERMS

System ServerA program that provides services to other computer

programs (and their users) in the same or other computers.

Insurance A thing providing protection against a possible

eventuality.

HospitalizationThe act or an instance of being hospitalized.

MembershipThe state of belonging to or being a part of a group or

an organization.

DisseminationPertains of spreading a certain thing or idea.

Enrollment The process of registering or enlisting, to become a

member of an organization.

VerificationThe act or process of verifying and clarifying.


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0

5,000

10,000

15,000

20,000

25,000

Jul|Jan Aug|Feb Sep|Mar Oct|Apr Nov|May Dec|Jun

Frequency

Months

Membership

2013

2014

CHAPTER II

PRESENTATION AND ANALYSIS OF DATA

Table 2.1 Data for Comparison of Membership Records

2014 2013

Month Frequency Month Frequency

January 20,456 July 16,523

February 18,319 August 15,095

March 19,220 September 17,167

April 21,213 October 15,586

May 20,173 November 17,002

June 19,192 December 18,194

Total 118,573 Total 99,567

Table 2.1: shows the Comparison of Membership Records between the period of July to

December 2013 and January to June 2014


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Table 2.2 Data for Increase in Membership Records

July-Dec 2013 JanJune 2014 Increase % Increase

99,567 118,573 19,006 65.15%

Table 2.2: shows the amount increased from July to December 2013 to January to

June 2014 and its corresponding Percentage increase.

Source:

BenjieRodil

Social Insurance Officer III

Table 2.3 Data for Records of Complaints from January 2014 to June 2014

Type of

Complaint

Frequency

January February March April May June Total Percentage

Written 124 135 118 141 138 145 801 62.14%

E-mail 76 67 72 91 85 97 488 37.86%

Total 200 202 190 232 223 242 1,289 100%

Percentage 15.52% 15.67% 14.74% 18% 17.30% 18.77% 100%

Table 2.3: shows the data for records and complaints grouped according to its type from

January to June 2014. E-mails and written are the two types of complaints that are submitted to

PhilHealth.

Table 2.4 Data for Records of Complaints from July 2013 to December 2013

Type of

Complaint

Frequency

July August September October November December Total Percentage

Written 91 83 78 85 76 72 485 62.10%

E-mail 51 43 47 54 52 49 296 37.90%

Total 142 126 125 139 128 121 781 100%

Percentage 18.18% 16.13% 16.01% 17.80% 16.39% 15.49% 100%

Table 2.4 shows the data for records and complaints grouped according to its type from July to

December 2013.

Source: BenjieRodil



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Computation:

()

Table 2.5 Data for Concern of Complaints

Complain Frequency Percentage

Slow System Server 672 52.13%

Long Queuing Line 419 32.51%

Lack of Dissemination of

Information

198 15.36%

Total 1289 100%

Table 2.5: shows the complaints of customers and members regarding their concerns

that are submitted to PhilHealth.

Table 2.6 Data for Increase in Complaints

Complaints July-Dec 2013 JanJune 2014 Increase % Increase

Written 485 801 316 65.15%

Email 296 488 192 64.86%

Total 781 1,289 508 65.04%

Table 2.6: shows the increase in type of complaints and the total number of complaints. Also the

percentage increase is included in the table.

Source: BenjieRodil



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Figure 2.1 Process Flow Chart

Membership Process

Fill up form PMRF

application form

Fall in line for

transactions

Verification

Enrollment

Fall in line for

Payment

Payment in cashier


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Figure 2.2 Enrollment breakdown

Up

Passing of requirementsIn this scenario, customers must pass their document

that includes valid Identification Card, Photocopy of NSO birth certificate and

other required documents for them to be able to enroll in the membership.

Updating dependents and other record In this case, customers check and

update the records of their documents and the beneficiaries of their insurance.

Updating records includes changing of civil status, address etc.

Changing of membership type This case is particularly to members who are

already member then a change in their status in occurred and so they must

change their type of membership for their insurance to be applicable.

Enrollment

Passing of

requirementsUpdating

dependents and

records

Changing of

membership type


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Figure 2.3 Process Flow Chart Proposal

Membership Process

Passing of

requirements

Fill up form PMRF

application form

Enrollment and

Payment

Verification


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Problem Tree

Long queuing

line

Slow system

server

To eliminate 65.04% customer dissatisfaction in the membership system from

the months of January to June 2014

Dissemination of

Information

Opportunity loss Profit loss Dissatisfied

customer

CAUSES

EFFECTS


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Problem Tree Analysis

CAUSES

Long queuing line

Some of the people do not have the patience to wait for their turn especially if the

line is too long. By this scenario, they intend to walk out and cancel their enrollment in

membership.

Slow system server

Since system server is not updated, they cannot clearly process the enrollment

stage of their applicants during membership. By this, they cannot properly store to their

data base the information given by their customers.

Dissemination of information

We all know that almost all the members of the PhilHealth, Inc. are from low

class community and PhilHealth disseminates their information about their requirements

through common means of advertising only and their advertisement does not reach

most of their common applicants.


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EFFECT

Opportunity loss

Long queuing line can cause impatience and frustrations to customers. This can

lead to loss of the opportunity of the company to serve more applicants for membership

because of the customers long time waiting.

Profit loss

Slow system server greatly affects the process of enrollment in membership. By

having this kind of system may lead to profit loss because the claims of the company

will decrease because of the present server that they are having.

Dissemination of information

Dissemination of Information causes dissatisfaction to customers because of

their lack of disseminating their information regarding procedures, requirements and

registrations. Customers also will not be able to apply properly and clearly due this

existing problem.


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Objective Tree

Improve systemserver

Adding inquiry

station

To eliminate 65.04% customer dissatisfaction in the membership system from

the months of January to June 2014

Wider

dissemination of

information

Satisfied

Customer

Elimination of

multiple

transactions

Compliance of

requirements

MEANS

ENDS


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OBJECTIVE TREE ANALYSIS

MEANS

Improving system server

Since system server is slow, it would help the operation if the system

server will be improved to make a smoother and faster entry of all information

given by their customers not just every once in a while but constantly, and fixing

any problem there is will greatly uplift the productivity level of any system.

Adding inquiry station

In any system procedures like membership, it is unavoidable that

customers would have a lot of questions and concerns that has to be attended

more often than not, these concern require immediate response to ensure the

satisfaction of the customer and the clarity of the response given. Providing an

inquiry counter will help build a stronger connection with the customers and will

help eliminate any hesitation in them to discuss or ask anything

Wider dissemination of information

PhilHealth is one of the most known Insurance Company in our country.

By this, adding advertisements about their registrations and requirements are

needed since we all know that most of the members came from the lower class

of the society and also in order for the applicants to be enlightened what should

they do and what should they submit.


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ENDS

Satisfied customer

Since system is already faster, PhilHealth members will be satisfied

because they will be served faster and more members will be accommodated

and customers

Elimination of multiple transactions

Since additional counter is already in effect, elimination of multiple

transactions will be eliminated because counters for inquiry is already provided

and long queuing of line will also lessen.

Compliance of requirements

If most of the customers of PhilHealth are already informed about the

procedures for registrations and passing of requirements, they can already

pursue their plans of being a member of PhilHealth without any hesitations.


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CHAPTER III

ALTERNATIVE COURSES OF ACTION

ACA#1 IMPROVE SYSTEM SERVER

As you have seen in the table below, It shows the actual speed of the system

server of PhilHealth. Researchers observed that their server is not enough to process

all of its members and their applicants records in regards to the enrollment for

membership. By this, researchers proposed that improving their system server by

adding and updating their internet system would help them to avoid confusions and

improper storage of records of their members to their data base. Through this, it would

result into better customer satisfaction.

Existing

Internet Connection Internet Speed Cost

Globe Home Tattoo 7 Mbps 2,499

Proposed

Internet Connection Internet Speed Cost

PLDT Home Fibr 20 mbps 5,800 php

Advantages:

1. Increase profit

2. Will prevent improper storage of records

3. Assurance of fast and reliable online system


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Disadvantages:

1. Additional costs for meetings

2. Additional costs for the new internet system

ACA#2 ADDITIONAL INQUIRY STATION

As you have seen in figure 3.2, It shows the actual counters available for the

applicants for membership. Since it has only four counters inclusive of one special for

seniors and PWD, researchers observed that the counters are not sufficient for them to

accommodate all of their applicants including walk in customers resulting in long

queuing of line especially that most of their customers and members includes out of line

transactions. Researchers proposed that adding an additional counter for inquiries

would prevent long queuing of line caused by multiple transactions of their customers.

This would also result to have more opportunity to have applicants for membership.

Figure 3.2 Existing Counters


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Advantages:

1. Will have more opportunity to have customers

2. Elimination of multiple transactions

3. Will prevent long queuing of line

Disadvantages:


2. Additional costs for salary of the employee to be hired

3. Familiarization of their walk in customers

ACA#3 WIDER DISSEMINATION OF INFORMATION

Since most of the members of PhilHealth are from lower class of the society.

Researchers observed that PhilHealth lacks of disseminating their information regarding

their procedures and requirements to the lower communities which are not reached by

their common advertisements. Through this, researchers proposed that wider

dissemination of information through posting tarpaulins and radio advertisements in

lower class municipalities would really help most of their customers and applicants to

have information of what they should do and submit before applying for the

membership. Since the customers and applicants have already been informed, they can

already pursue of their plans of being a member of PhilHealth without any hesitations.


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Advantages:

1. Compliance of requirements

2. Will increase customer satisfaction

3. Will have smooth application

Disadvantages:


2. Additional costs for additional advertisements

3. Additional costs for transportation


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Cost Benefit Analysis

Alternative Courses of Action

ACA #1 COST BENEFITSImprove System

ServerHome Pldt Fibr

internetconnection(20mbps)

PHP 5800.00

Tangible Intangible

Profit will increaseby 151,200php

semi annually

Less hassle forthe workers and

applicants

ACA #2 COST BENEFITS

AdditionalInquiry Station

Additional InquiryStation

Tangible Intangible

Profit will increaseby 104,000semi

annually

Multiple

Transactions willbe Eliminated

Long QueuingLine will beEliminated


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ACA #3 COST BENEFITSWider

Dissemination ofInformation

Tarpaulin (6x6ft)PHP 700.00

Tangible Intangible

Profit will increaseby 120,00 semi

annually

Awareness ofwalk-in applicants


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CHAPTER IV

CONCLUSION AND RECOMMENDATION

CONCLUSION

PhilHealth Inc. was established to serve as a service health sector of the

Government for the Filipinos to help their needs especially in the financial assistance

when it comes to hospitalizations. The study was conducted in PhilHealth Inc. located at

MYP GBY Phil. Corp. bldg Aguinaldo Highway, City of Imus, Cavite. The study focuses

on a certain system of their process where problems are occurring. Researchers

observed that the system of their process has a problem when it comes in the first step

of their process which is the system of membership. The study will only consider the

data gathered from February 2014 July 2014. This study concludes that complaints

and customer dissatisfaction regarding their enrollment procedures are caused by the

following namely: Slow system server, long queuing of line and lastly lack of

dissemination of information. To minimize the complaints and customer dissatisfaction

experienced by PhilHealth Inc, researchers proposed the following alternatives:

Improving system server, adding inquiry station and wider dissemination of information.


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Recommendation

The proposed alternative courses of action can be a big help to the company, all

of these are needed to minimize the complaints and customer dissatisfaction

experienced by PhilHealth, Inc.

First is to improve their system server in order to prevent improper storage of the

records of their applicants and members also to assure fast and reliable online system.

Second is to add an inquiry station for all the applicants and walk in customers who

have questions regarding their application and updating of their records. This will

eliminate multiple transactions occurring. Last is wider dissemination of information

through posting tarpaulin advertisements regarding their requirements and procedures

for the membership to prevent customer dissatisfaction and will result into compliance of

requirements.


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CHAPTER V

DETAILED PLAN OF ACTION

Table 5.1 Detailed Plan of Action

WHEN ACTIVITY PEOPLE CONCERNED

October 23, 2014

Meeting regarding the

proposal of the new

process and methods to be

implemented

Managers and Supervisors

October 24, 2014Presentation of the

proposalManagers and Supervisors

October 27, 2014 Approval of the proposal Managers and Supervisors

October 28, 2014Implementation of proposed

alternative course of action

Managers, Supervisors and

employees

October 29, 2014 Adaptation of the alternativecourse of action to be used

Managers, Supervisors andemployees


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