Some private hospitals mull PhilHealth non-renewal as unpaid claims hit P21.1 billion

ABS-CBN News

Posted at Sep 29 2021 12:14 PM | Updated as of Sep 29 2021 12:29 PM

MANILA - Patients in some private hospitals may soon need to pay upfront for admission to several private hospitals after these medical centers said they are looking to not renew their accreditation from the Philippine Health Insurance Corp (PhilHealth).

A private hospital group said this was due to unpaid PhilHealth reimbursements reached P21.1 billion.

At least 7 big hospitals from the provinces have said they won't renew their accreditation with PhilHealth if reimbursements are not paid by the end of October, Private Hospitals Association of the Philippines Inc president Dr. Jose Rene De Grano told ANC. 

"That is the sentiment of most private hospitals, not only them. It is just they probably have the courage to tell PhilHealth about their plight but the majority of private hospitals are contemplating on doing the same thing," De Grano said.

"For the past year, more than 1 year actually, and PhilHealth still owes us around P21.1 billion and that has not been reduced still," he added.

De Grano said a moderate case of COVID-19 entitles a patient to a benefit worth P143,000. If there are 10 moderate patients in 2 weeks that's P1.4 million shouldered by the hospital.

Due to losses, majority of hospitals have resorted to downsizing, reducing work hours, or borrowing from the bank in order to sustain operations, he said.

"The only solution then is to stop the bleeding and when we mention stopping the bleeding, then who is causing the bleeding? It’s PhilHealth," De Grano said. 

"That is probably the solution that we are thinking right now, to not to reaccredit first from Philhealth and we will see. We were able to survive last year almost without PhilHealth, so what’s another year, really, without PhilHealth in 2022?" he added.

Patients will still receive health care even if some private hospitals opt to forego their PhilHealth accreditation. However, they will have to pay for the services upfront and then reimburse directly from PhilHealth, De Grano said.

The group has submitted a position paper to the agency but they are yet to receive a response.

In August PhilHealth said unpaid claims amounted to P12.9 billion, denying reports it owed P86 billion to hospitals since the start of the pandemic. 

 

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