Delays in PhilHealth payment of COVID-19 claims cripple private hospitals: PHAPI

ABS-CBN News

Posted at Aug 14 2021 12:06 PM

MANILA— The Private Hospitals Association of the Philippines Inc (PHAPI) on Saturday said delays in state insurer PhilHealth's reimbursement of claims for COVID-19 patients have gravely affected private hospitals in the face of a fresh surge due to the highly contagious Delta variant.

PHAPI president Jose Rene de Grano said private hospitals advance the payment for COVID-19 cases and expect to be reimbursed the cost at least 2 or 3 months after the filing of claims.

“Ngayon, kung hindi po ito mabayaran kaagad katulad ng nangyari nitong mga nakaraang taon medyo mapipilay ang pondo na ginagamit ng mga private hospitals. Hindi sila katulad ng government facilities na may budget lagi buwan-buwan na dumarating,” he said.

(Now if these are not paid just like what happened in the past it would cripple the funds that private hospitals are using. They are not like government facilities where the budget is allotted every month.)

PhilHealth on Friday acknowledged that it has yet to settle billions in pesos of hospital claims. 

“Nakapag-usap kami with [PhilHealth] president [Dante] Gierran nitong last Tuesday and sinabi nila pinafast-track nila 'yung amount na around P25.6 billion na payment para sa mga hospitals. These are both government and private hospitals at sana po maayos kaagad 'yun nang sa ganun maibalik ang pondo ng ating mga different hospitals,” he said.

(We had a meeting with president Gierran last Tuesday and he told us that they are fast-tracking the amount of around P25.6 billion for payment for hospitals. These are both government and private hospitals and hopefully this goes well so that funds are returned to our different hospitals.)

PhilHealth said it would augment its staff in some COVID-hit offices to speed up payment of hospital claims. it will also extend the debit-credit mechanism through which PhilHealth pays 60 percent of hospital claims while they are still in-process. 

De Grano assured the public that private hospitals would still provide service as best as they could.

“Tuloy-tuloy po ang serbisyo ng mga private hospitals. Hangga’t kaya po ng mga ospital, tuloy-tuloy po ang kanilang operasyon,” he said.

(Private hospitals will continue to provide services. They will continue with their operations as long as they can.)

He said the only limitation of private hospitals is manpower.

“Kahit gusto naming mag-expand ng number of beds, 'pag wala po kaming nurses na mag-aalaga naman sa ating mga COVID patients ay hindi namin magagawa,” he said.

(Even if we want to expand the number of beds we can’t do so because there are no nurses to care for our COVID patients.)

Meanwhile, he estimates that half of their members are already in critical level as COVID-19 cases continue to soar.

“Hindi ko masabi ang tunay na data, siguro more than 50 percent ng mga miyembro namin nandoon na sa high risk, critical occupancy,” he said.

De Grano said cases in Metro Manila, which is under enhanced community quarantine until August 20, continue to increase.