PhilHealth owes Iloilo hospital up to P93 million


Posted at Dec 13 2021 10:53 AM

MANILA — The head of a private hospital in Iloilo City said Monday the Philippine Health Insurance Corp. (PhilHealth) still owed it some P93 million, part of a larger issue of unpaid claims that has prompted several hospitals to cut ties with the state health insurer.

"We still have a balance of about P93 million... this is cumulative amount which started since 2018," said Metro Iloilo Hospital and Medical Center President and CEO Danilo Encarnacion.

In 2018, PhilHealth owed the hospital some P136 million but the insurer was able to gradually pay, Encarnacion said.

"Pero malaki pa rin ang balance na natira kasi 'di naman, it's not being honored, ang lahat ng mga claim," he said.

(But the balance that remains is still big because not all claims are being honored.)

Encarnacion said the PhilHealth returns many claims to his hospital, often with unclear reasons.

"Hindi maganda 'yong mga evaluation, mga explanation [ng PhilHealth]. Kadalasan hindi namin alam talaga kung bakit kasi wala kami masyadong communication na makuha sa kanila dahil hindi naman puwedeng mag-direkta sa kanila. Ang gusto nila through email... eh ang hirap-hirap noon," he told ABS-CBN's Teleradyo.

(PhilHealth's evaluation, explanation is unclear. Most of the time, we don't know why they are returning the claims because we don't have much communication because we can't directly contact them. What they want is to correspond through email... which is very difficult.)

Metro Iloilo Hospital and Medical Center is only one of seven private hospitals in Iloilo that have threatened to disengage with PhilHealth for failing to pay a total of P545 million in hospital claims.

Private Hospitals Association of the Philippines Inc. President Dr. Jose Rene de Grano said hospitals in the National Capital Region, Quezon province, northern Luzon and General Santos City are also planning to cut ties with the state health insurer over unpaid claims.

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In a separate Teleradyo interview, De Grano said private hospitals that cut ties with PhilHealth would still serve the firm's members but the patients or their families would be the ones who would directly transact with the insurer.

"Pagbibigyan din naman po sila ng parehong serbisyo ng ating pribadong ospital," De Grano said.

(Our private hospitals will still give them the same service.)

"Magbabayad nga lang sila at bibigyan sila ng kaukulang statement of account para iyon po ang kanilang ma-refund directly sa Philhealth para sa kanilang benefits," he explained.

(But they will have to pay and we will give them a statement of account, which they will refund directly to PhilHealth for their benefits.)

Last month, PhilHealth Spokesperson Shirley Domingo appealed to hospitals to rethink their plans of disengaging with the firm.

The PhilHealth also earlier said it was working to settle the unpaid claims.


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