P6.3 billion released under PhilHealth debit-credit reimbursement system: acting spox

ABS-CBN News

Posted at Jun 19 2021 02:39 PM

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State medical insurer PhilHealth has released around P6.3 billion in hospital claims under their Debit-Credit Payment Method (DCPM), which is said to speed up reimbursements to hospitals.

Around 206 health institutions have received the disbursements, PhilHealth acting spokesperson Dr. Shirley Domingo said in a public press briefing Saturday. 

“Nag-implement tayo ng tinatawag na DCPM (debit credit payment method. Ang ginagawa natin do'n 'pag na-identify ng IATF as a high risk area and nagsu-surge ang cases of COVID ay tinitingnan natin ang 60 percent of in-process good claims at nire-release natin 'yon sa hospitals,” Domingo said. 

(What we do is that if IATF identifies a high risk area and a surge of COVID-19 cases, we look at 60 percent of the in process good claims and immediately release this to hospitals.) 

[PLS EMBED WHOLE INTERVIEW: https://www.youtube.com/watch?v=ECStxCHyJSQ&list=PLogMBc7vOosEJJL3lEZyw4ZKbIpNPnoHo&index=9] 
Courtesy: PTV

The DCPM was institutionalized as a response to President Rodrigo Duterte’s call to expedite the reimbursement of claims by hospitals as unsettled debt allegedly hit facilities battling the COVID-19 pandemic last April. 

Domingo also said they have paid around P231 billion in total claims for COVID-19 and non-COVID-19 cases. 

“That’s around P231 [billion]. So ito ang total amount na sinubmit natin is P259 billion,” Domingo said. 

“As of the rest tulo- tuloy nating pinoprocess and ang turnaround ng claims is around 43 days,” she added. 

(As of the rest, we are continuing to process them, and the turnaround of claims is around 43 days.) 

However, Domingo noted that delays are expected in reimbursing some funds, as they ask some health care institutions to address deficiencies in some documents. 

“Hindi lahat ng claims ay binabayaran agad. Kasi binubusisi 'yan kasi pera ng bayan ang pinag-uusapan,” Domingo said, adding that the state medical insurer has sufficient funds for the year. 

(Not all claims are paid right away. We still cross-check this because this is the country’s money we are talking about.) 

PhilHealth also noted that it has paid some P5.5 billion of their debt to Red Cross for COVID-19 testing. 

PhilHealth was earlier hit by corruption allegations over alleged irregularities in its system of reimbursing medical expenses to hospitals.