PhilHealth has no P86-B in unpaid claims to hospitals, says official

Katrina Domingo, ABS-CBN News

Posted at Aug 23 2021 02:28 PM

MANILA - The Philippine Health Insurance Corp (PhilHealth) on Monday denied that it owed P86 billion to hospitals since the start of the COVID-19 pandemic, saying its unpaid claims only amounted to P12.9 billion.

The P12.9-billion worth of claims is in different stages of processing, said Shirley Domingo, PhilHealth vice president for corporate affairs.

"There is no such thing as P86 billion in claims, utang (debt) in claims," Domingo told ANC's Dateline Philippines.

"They added the claims they were processing with the claims already denied," she said.

Of the P12.9 billion claims being processed, about 15 percent are COVID-19 claims, the PhilHealth vice president said.

"We are processing our regular claims, our good claims at 43 days. It's the COVID claims that's the issue," she said.

Domingo did not give the state insurer's average turnaround time for the processing of COVID-19 claims, but noted that the state insurer would never reach a "zero-zero claims processing status" as it continues to process about 1 million claims a month.

The PhilHealth official also defended an updated PhilHealth circular on the suspension of payments of claims (TSPC), saying hospitals and claimants should not be wary of the policy.

"The circular has been there since 2016. The provisions of these new circulars give them more protection... because it has a provision on due process," Domingo said.

"We will still pay for the claims pending with us. There was not much affected hospitals when we previously implemented this," she said.

The circular simple addressed "the issue of fraud and sustainability of the fund," she said.

President Rodrigo Duterte earlier told the state insurer to settle its debt to hospitals as soon as possible as facilities continue to receive more patients as the COVID-19 pandemic rages on in the Philippines.

Watch more on iWantTFC