Hospital group blasts 1-year delay in PhilHealth COVID claims

ABS-CBN News

Posted at May 20 2021 11:32 AM

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MANILA - A group of hospitals on Thursday asked the regional offices of state insurer PhilHealth to follow instructions of their chief and expedite the processing of COVID-19 claims.

Dr. Jaime Almora, president of Philippine Hospital Association, said some COVID-19 claims have not been paid for more than a year. 

The process initially set out was that hospitals should submit the claims within 60 days and PhilHealth would pay within 60 days as well.

"Obviously, there’s a problem with the processing of the claims. What we would like is for PhilHealth to tell us what is the problem and if they cannot resolve it by themselves, then call for us to help them," he told ANC's Headstart.

Almora said their group--composed of both private and public hospitals--believes PhilHealth President and Chief Executive Officer Dante Gierran is sincere in his wish to pay the hospitals their dues, "but he is not the one processing the claim, it is the regional offices."

"We believe he is sincere, he wants to pay. All they have to do, for regional offices, is to follow, to obey their superior. That’s all we are asking for," he said.

"We do not want to go into causing more problem because they have more problems than they can handle. We also have more problems than we can handle in the hospitals. We do not want to make a mess out of this. We just want to talk, to reconcile and to find a solution to the problem. That’s all we want to do," he added.

Almora said these offices should expedite the process, similar to the pace they pay non-COVID-19 claims which are done "on time."

He said the claims are "small" but the process of treating patients infected with the coronavirus is "evolving."

"Therefore, there is no such thing as clinical pathway guideline or standard of management. It keeps changing and they should not assess our claims based on standard of care because every doctor manage their patient according to their understanding and depending on how these imminent experts [are] advising them," he said.