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Hospitals reset ‘holiday’ action vs. PhilHealth

The Private Hospitals Association Philippines (PHAPI) announced on Wednesday that the plan for a “PhilHealth holiday” has been suspended.

PHAPI president Dr. Jose de Grano said the plan to protest the non-payment of claims by the state-owned Philippine Health Insurance Corp. (PhilHealth) was put on hold after patient groups sought advice on what they could do during such a holiday.

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PHAPI had earlier encouraged its members to not accept PhilHealth deductions for their services from Jan. 1 to 5, 2022.

PhilHealth said on Tuesday it was still checking the unpaid claims of seven Iloilo hospitals that will no longer renew their accreditation with the state insurer come January.

“Actually, we are reconciling the figures, because they gave us a figure which is more than our actual in-process claims,” said PhilHealth spokesperson Dr. Shirley Domingo, in an interview with ANC’s “Rundown.”

“They have included figures or amounts that were, of claims that were returned to hospitals and denied. And, on our side, we cannot pay for claims that are returned to the hospital unless they refile it with us,” Domingo said.

“So we’re still hoping that this reconciliation of figures will be recognized and will push through,” Domingo said.

Earlier, Metro Iloilo Hospital & Medical Center Inc., Iloilo Doctors’ Hospital, Iloilo Mission Hospital, Medicus Medical Center, Qualimed Hospital Iloilo, St. Paul’s Hospital of Iloilo and The Medical City of Iloilo said they are severing ties with PhilHealth over unpaid claims amounting to P895 million.

Metro Iloilo Hospital & Medical Center president Dr. Danny Encarnacion said they had a meeting with the state health insurer on Dec. 20 but nothing came of it.

Domingo said PhilHealth’s ability to disburse claims has been affected by the COVID-19 pandemic.

“Philhealth has been affected by this pandemic in terms of human resources. We followed IATF guidelines of 30 percent in office, and then 50 percent in office,” she said.

However, Encarnacion told ANC’s “Headstart” that the unpaid claims of several hospitals date back to 2010.

“This bill has amounted to — this situation goes back to 2010,” Encarnacion said.

PhilHealth, meanwhile, announced that it will extend the validity of all currently accredited health facilities (HFs) until Jan. 31, 2022.

PhilHealth president and CEO Dante A. Gierran said the extension would be made as long as the hospitals have submitted their complete applications for accreditation to the concerned PhilHealth regional office on or before Jan.31, 2022.

The PhilHealth chief also reminded hospitals that applications received for continuous or renewal of accreditation beyond Jan. 31, 2022 may result in a gap in a facility’s accreditation.

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