Private hospitals warn cutting ties with PhilHealth over unpaid 2020 COVID claims


Posted at Oct 29 2021 09:41 AM | Updated as of Oct 29 2021 10:02 AM

MANILA—A group of private hospitals on Friday warned that some of its members might not renew their accreditation with Philippine Health Insurance Corporation over unpaid claims of COVID-19 cases from last year.

Dr. Jose Rene De Grano, president of Private Hospitals Association of the Philippines Inc, said a number of private hospitals, including in Metro Manila, would release in November a position paper on whether or not they were cutting ties with the state insurer if the issue remained unresolved.

"Karamihan po diyan ay siguro hindi na magre-renew ng kanilang PhilHealth by next year dahil po sa narasanan nila na wala pong kongkretong solusyon na ibinibigay ang PhilHealth sa nakaraang mga 2 o 3 buwan," he told TeleRadyo.

(Many of them may not renew with PhilHealth next year because of what they have experienced, which is there is no concrete solution from PhilHealth from the last 2 or 3 months.)

Most COVID-19 claims from 2020 remain unpaid, he added.

Last week, in a Laging Handa press briefing, De Grano said PhilHealth still owed at least P834 million to some private hospitals in General Santos, Iloilo and Northern Luzon.

At a Senate hearing, the state insurer also admitted to delays in processing of claims for COVID-19 cases.

“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 (Which means) that is job increase of 26 percent," PhilHealth chief Dante Gierran had said.

PhilHealth was also facing a manpower shortage, he added.

"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," Gierran had said.

However, De Grano said those allegedly questionable claims being investigated by PhilHealth should not affect the reimbursement of unpaid dues to other hospitals, which they used for their day-to-day operations.

"Kung talaga meron silang pruweba dito sa mga supposedly na fraudulent claims, then i-file po nila. Pero 'yun nga po, napakaliit pong porsiyento niyan," he said.

(If they have proof of these supposedly fraudulent claims, then file a case. But still, that's still a small percentage.)

"Ang ibig sabihin po namin, kung meron mang ganung ilan na mga cases o claims na sa tingin nila ay hindi maganda, bakit naman po nasasakripisyo 'yung iba, 'yung kalahatan na mga iba pang claims na hindi nila bayaran?"

(If there are fraudulent cases or claims, why let others suffer?)

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