PhilHealth owes hospitals P7 million each on average: group

ABS-CBN News

Posted at Aug 24 2021 09:02 AM | Updated as of Aug 24 2021 12:07 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 - PhilHealth owes members of the Philippine Hospital Association an average of P7 million each, its president said Tuesday.

The embattled state insurer had said it only owed P12.9-billion worth of claims in different stages of processing contrary to the P86 billion claim of hospitals.

The P86 billion is the total amount that hospitals spent on patients without reimbursement from PhilHealth, said PHA president Dr. Jaime Almora. The PHA has some 1,100 members, he added.

"In-add together lang 'yun, 'yun ang ginastos ng ospital as of June 20," he told ABS-CBN's Teleradyo.

PhilHealth owes hospitals some P13.6 billion in denied claims, with P13 billion to P16 billion in-process claims, and P46 billion Return to Hospital (RTH) claims, according to Almora.

The state insurer had imposed policy after policy that posed problems for hospitals such as the payment recovery policy, where PhilHealth would reimburse claims but later take them back, he said. This was followed by the alleged fraudulent claims that PhilHealth said it was investigating, he added.

"Nag-alma sila. Ito ba ay strategy para hindi tayo bayaran na? Hindi na nga tayo binabayaran, tatawagin pa tayong manloloko," he said.

(They complained, is this a strategy to not pay us? They're not paying us and also calling us frauds.)

"Parang isang kalabaw. 'Yung kalabaw pinagtatrabaho mo, di mo na pinapakain, di mo na pinapainom tapos pinapalo mo pa. Kami po ang beast of burden natin."

(We're like carabaos. They are hit while not being fed. We're the beast of burden in this situation.)

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