PhilHealth aminadong mabagal sa pagproseso ng hospital claims | ABS-CBN

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PhilHealth aminadong mabagal sa pagproseso ng hospital claims

PhilHealth aminadong mabagal sa pagproseso ng hospital claims

ABS-CBN News

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MAYNILA - Inamin ng pinuno ng Philippine Health Insurance Corporation (PhilHealth) na mas nahihirapan sila ngayon sa pagproseso ng claims ng mga ospital na gastos para sa mga pasyenteng may COVID-19.

Sa naging budget hearing ng Senado nitong Miyerkoles para sa pondo ng Department of Health para sa susunod na taon, sinabi ni PhilHealth chief Dante Gierran na natambakan sila ng claims dahil sa pandemya.

“We are so swarmed with increase of claims. Can you just imagine, in 2020, we have the average of daily claims of 31,000, and the average the number of claims now is 39,000. Ibig sabihin that is job increase of 26%," ani Gierran.

Kulang din aniya sila ng tao na magpoproseso ng mga ito.

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"We blame it again on the pandemic because we have a limited locomotive, some of our people got sick, as matter of fact, some of our people even died. And we cannot tell everybody that we have this problem, but we are doing something about it," paliwanag niya.

Tugon naman ni Sen. Risa Hontiveros, matagal nang problema ang mabagal na pagproseso ng PhilHealth.

“Atty. Gierran, even before you came in, in fairness inabot ko iyang problema na iyan, so it is not just COVID kasi even bago kayo pumasok andyan na rin iyang problema na iyon, maybe it is just exacerbated by COVID," saad ni Hontiveros.

Paliwanag naman ni Gierran, ipinatutupad nila ang debit-credit payment method para mabayaran agad ang portion ng claims habang isinasagawa ang validation dito.

“We block a certain period in which we get the amount to be paid to our healthcare providers and then once this is made outright, we pay but only 60%, of course subject to the regular withholding tax. And then later we reconcile, and the 40% will eventually be paid," aniya.

Bukod sa kakulangan ng tao, sinabi rin ni Gierran na problema rin ng PhilHealth ang ginagamit nitong IT system, isang bagay na pinuna naman ni Sen. Panfilo Lacson.

“Ang problema sa IT ninyo ... nag-overprice naman noong bumili kayo ng IT equipment? Di 'ba can you recall when we conducted our Committee of the Whole hearing, namili ng IT equipment, overpriced, times 4 as testified to by Col. Etrobal? Kaya paikot-ikot tayo ng problema. Nakalimutan naman, uulit na naman," ani Lacson.

Wala naman sinagot si Gierran dito.

Matatandaang napag-usapan sa pagdinig ng Senado noon ang ilang isyu sa PhilHealth kabilang ang biniling umano'y mahal na IT equipment ng ahensya sa ilalim ng pamumuno noon ni dating PhilHealth chief Ricardo Morales.

Sa kasagsagan ng isyu sa PhilHealth, nagbitiw sa pwesto si Morales at iniupo ni Pangulong Rodrigo Duterte si Gierran at inutusan itong linisan ang korapsyon sa loob ng ahensya.

— Ulat ni Joyce Balancio, ABS-CBN News


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