Hospitals shelve move vs PhilHealth

by Sheila Crisostomo, The Philippine Star

Posted at May 25 2014 11:31 AM | Updated as of May 25 2014 07:31 PM

MANILA - The Private Hospitals Association of the Philippines (PHAPi) has decided to shelve its plan of not honoring the PhilHealth membership of patients as the state-run health insurance firm promised to settle its obligations by the end of June.

“PhilHealth has promised to pay us by the end of June so we will wait for that. For the meantime, we decided not to do anything yet,” PHAPi president Rustico Jimenez said.

Earlier, PHAPi was considering not honoring the PhilHealth membership of patients because of the delayed release of reimbursements.

PHAPi complained that PhilHealth was taking at least six months to pay private hospitals for their services, severely affecting their operations.

Jimenez said that in Bulacan alone, around 50 private hospitals have complained about unpaid services for PhilHealth members, many amounting to millions of pesos.

PHAPi was considering letting patients pay for PhilHealth’s share in their hospital bills and directly apply for reimbursements with the state health insurance firm.

PhilHealth president and chief executive officer Alexander Padilla admitted the delay and attributed it to “connectivity problems” caused by the implementation of the “case-based payment” system this year.

Jimenez said PHAPi would see if PhilHealth keeps its promise.

“If we don’t give in now, we would be the one to be faulted. As much as we want to serve patients, we cannot do so if we run out of funds to pay our staff, our electric or water bills and our suppliers. So let’s see what will happen,” he added.

Palace: PhilHealth made several payments

Meanwhile, Malacañang said yesterday there were inaccuracies in the accusations of delayed reimbursements, adding that PhilHealth has made payments to several hospitals.

Deputy presidential spokesperson Abigail Valte said over radio dzRB that contrary to the allegations of Jimenez, PhilHealth has no payment backlogs in some hospitals being mentioned.

She cited the P15 million in alleged unpaid claims in San Juan de Dios Hospital in Pasay City when there was none. PhilHealth has paid 1,712 claims equivalent to P26.72 million.

She noted that the normal “minimum turnaround time” for claims in San Juan de Dios Hospital is 13 days for processing.

In Calamba Doctors Hospital in Laguna, there was allegedly P15 million in unpaid claims but based on records there were only 719 claims returned for incomplete documentation amounting to P6 million, Valte said.

She also cited other hospitals like the Western Visayas Medical Center where there was reportedly P13 million in alleged unpaid claims but PhilHealth found it had no payment backlog in the hospital.

Valte said these data must be put out as a matter of record to correct the inaccurate accusations. – With Aurea Calica