PhilHealth owes hospitals some P20-B in COVID-19 claims

ABS-CBN News

Posted at Aug 08 2021 10:50 AM | Updated as of Aug 08 2021 05:31 PM

Philhealth Local office at Mother Ignacia Street. Quezon City. Taken on June 7, 2019. Mark Demayo, ABS-CBN News
Philhealth Local office at Mother Ignacia Street. Quezon City. Taken on June 7, 2019. Mark Demayo, ABS-CBN News

MANILA - State-insurer PhilHealth owes private and public medical facilities some P20 billion in COVID-19 claims, the Philippine Hospital Association said Sunday.

PhilHealth’s unpaid reimbursements to certain hospitals run from hundreds of millions to a billion pesos, said the group's president Dr. Jaime Almora, citing data as of July 5.

"Yung mga non-COVID claims, nababayaran naman. May slight na delay lang. Ang problema talaga na malaki yung mga COVID claims," he told ABS-CBN's TeleRadyo.

(Non-COVID claims are being reimbursed even though there's a slight delay. The huge problem really are COVID claims.)

"Tinitingnan natin ang figures ngayon, more than P10 billion, nasa vicinity ng P20 billion, ganun na... Tumataas pa rin."

(We're looking at figures, it's estimated at more than P10 billion, it's in the vicinity of P20 billion. It continues to rise.)

This resulted in the hospitals' "lost of trust and confidence" in its transactions with PhilHealth, Almora said.

"Nagkaroon ng demoralization sa mga ospital dahil 'pag hindi nabayaran ang mga ospital, kasama d'yan ang professional fee, mga doctor na sinasakripisyo ang mga buhay nila, 'di rin nila natatanggap yung bayad nila," he said.

"Ultimately, they (hospitals) will find ways and means para 'di sila malugi. Ang magsa-suffer d'yan, mga pasyente."

(Ultimately, the hospitals will find ways and means so they won't suffer losses. But it's the patients who will suffer.)

The group is set to meet with PhilHealth president and CEO Dante Gierran on Tuesday, Almora said.

The health department has also been informed of the issue causing the delay of special risk allowance to health workers in private hospitals, he said.

Beneficiaries of the SRA must be frontline personnel who are directly in contact with virus patients, according to Almora.

"Kasi yung direct contact, maraming interpretation yan... Kagaya sa laundry, security guard, hindi nga sila dun sa bedside pero in contact pa rin sila sa pasyente, so pwede sila mahawa," he said.

(Direct contact has many interpretations... Laundry personnel and security guards might not be at the patient's bedside, but they still have contact with them and may contract the illness.)

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