PhilHealth eyes settling hospitals' claims before December

Jamaine Punzalan, ABS-CBN News

Posted at Nov 04 2021 12:21 PM | Updated as of Nov 04 2021 03:04 PM

Philhealth Local office at Mother Ignacia Street Quezon City, June 7, 2019. Mark Demayo, ABS-CBN News/File
Philhealth Local office at Mother Ignacia Street Quezon City, June 7, 2019. Mark Demayo, ABS-CBN News/File

MANILA — PhilHealth said on Thursday it is eyeing to settle this month the claims of some private hospitals, which have prompted some to consider cutting ties with the government medical insurer.

"Ginagawa na po ng PhilHealth ang lahat po ng aming makakaya para po ma-release na natin ang mga bayad na iyan," said PhilHealth Corporate Communications Senior Manager Rey Baleña. 

(PhilHealth is doing everything it can to release those payments.) 

"Hindi na po talaga magtatagal sapagkat talaga ini-mobilize na po ang lahat ng dapat i-mobilize dito," he said in a televised public briefing.

(It won't take too long because we have mobilized all that we need to mobilize here.)

Pressed on whether this meant PhilHealth could settle its obligations before December, Baleña said, "Dapat po." 

(That should be the case.)

The Private Hospitals Association of the Philippines Inc (PHAPI) last week said some of its members might not renew their accreditation with PhilHealth because most claims for the treatment of COVID-19 patients last year remain unpaid.
PhilHealth has "enough" funds for the unpaid claims. It has paid some P152.8 billion from January 2020 until last Oct. 8, which represents 75 percent of all claims it has received, said Baleña. 

He said the payment of some claims is delayed due to a shortage in PhilHealth's manpower, and errors and inconsistencies in hospitals' documents. 

To speed up the claims processing, PhilHealth has augmented its human resources. It also implemented a debit-credit method where 60 percent of claims are paid while they are still under review, Baleña said.

He noted PhilHealth president Dante Gierran also met recently with PHAPI president Dr. Jose Rene De Grano to resolve the issue. 

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PhilHealth has yet to receive any letter or notice from hospitals planning to cut ties with the insurer, said Baleña.

"Lubos po nating nauunawaan ang kalagayan po at iyong idinulot po nito sa ating mga partner hospitals. Humihingi po kami ng kaunti pang pang-unawa at suporta," he said. "Moving forward, matatanggap na po nila iyon pong mga bayad na nabinbin po sa mga nakaraan." 

(We fully understand the situation and how this affects our partner hospitals. We ask for some more patience and support. Moving forward, they will receive the delayed payments.) 
"Kami po ay umaasa na kung may mga plano man po ang ilan sa ating mga ospital na mag-disengage sa PhilHealth, sana po mai-reconsider po nila ito," added the PhilHealth official. 

(If some of our hospitals indeed have plans to disengage with PhilHealth, we hope they could reconsider.)