The Philippine Health Insurance Corp. (PhilHealth) has paid only half of the P25 billion worth of COVID-19-related benefits claims it owes various hospitals.
PhilHealth vice president for corporate affairs Shirley Domingo said COVID-19 claims included testing packages, community isolation unit benefits, and in-patient benefits.
Domingo said a huge portion of unpaid COVID-19 claims were related to testing and some hospitals were unable to submit required documents, resulting in the delay in releasing payments.
Malacañang on Thursday said President Rodrigo Duterte had asked PhilHealth to settle the billions of pesos worth of unpaid hospital claims as soon as possible.
PhilHealth last week said it was working double time in addressing P25 billion worth of unpaid claims by several hospitals “through constant dialogues and reconciliation of figures with hospital representatives at the regional level.”
Domingo said PhilHealth’s regional vice presidents were already in talks with concerned hospitals to come up with strategies on how to fast-track claims
Under PhilHealth’s Debit-Credit Payment Method (DCPM), the state health insurer pays 60 percent of total amount of applicable health care facilities’ receivables while the remaining 40 percent will be paid following full compliance to processing requirements.
The DCPM is aimed to hasten payments to hospitals.
Reimbursements through the DCPM, however, only apply to in-process claims received from March 8, 2020 to April 7, 2021 and claims returned, denied, under investigation and those approved for payment as of April 7, 2021 are not qualified under the DCPM.
Domingo said the PhilHealth is also augmenting the human resources claims processors by deploying additional personnel in regions that need augmentation.