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PhilHealth stops WellMed claims

The Philippine Health Insurance Corp. on Tuesday withdrew the accreditation of WellMed Dialysis Center and Laboratory Corp. due to the fraudulent claims for dialysis services filed on behalf of deceased patients.

“We reiterate that prior to this, PhilHealth has ceased paying the said dialysis center for their claims,” said Ruben Basa, PhilHealth officer-in-charge.

PhilHealth accreditation enables qualified health care providers to participate in the National Health Insurance Program.

“We advise our members and their qualified beneficiaries who are availing of WellMed’s services to transfer to other accredited facilities to ensure continuous availment of their PhilHealth benefits,” Basa said.

PhilHealth advised the public to call our Action Center at (02) 4417442or log-on to the PhilHealth website for a complete list of accredited dialysis centers.

Earlier, PhilHealth assured the public that fraud control measures and reforms had been put in place to curb fraudulent claims.

Investigations were intensified, and the regions conducted spot checks on health care providers. Benefit payment reforms to deter fraud were also set up.

Earlier, Health Secretary Francisco Duque III said he was dismayed that WellMed’s accreditation had not yet been pulled.

He said in a radio interview that he would call Basa and find out “what the heck is happening.”

Police arrested the owner of WellMed, Brian Sy, on June 10 on charges of estafa, falsification of public documents and violation of the PhilHealth law. He is out on bail of P72,000.

READ: DOJ widens probe of medical clinics

READ: Senator chimes in on PhilHealth

READ: Duque, other execs face retroactive inquiry into PhilHealth payouts

Topics: Philippine Health Insurance Corp , WellMed Dialysis Center and Laboratory Corp , Ruben Basa , National Health Insurance Program , Francisco Duque III
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