The Far Eastern University-Dr. Nicanor Reyes Medical Foundation (FEU-NRMF) has cut its ties with state insurer Philippine Health Insurance Corporation (PhilHealth) after its receivables from the agency rose to P200 million by the end of November.
In a statement, Chief Operating Officer Juan Enrique Reyes said the hospital would no longer deduct PhilHealth benefits from the hospital bills of members.
“It was a very difficult decision, but given the circumstances, altruism must give way to pragmatism. We simply cannot treat our patients or help our students if we are not financially viable,” Reyes said in an advisory to members.
Earlier on, PhilHealth said it would expedite hospital payments through the Debit-Credit Payment Method as it released P165.8 billion in claims from January 2020 to date.
This, as hospitals in the National Capital Region, Quezon province, northern Luzon and General Santos City said they would follow the lead of seven hospitals in Iloilo and are also planning to cut ties with
state health insurer PhilHealth over unpaid claims.
Dr. Jose Rene de Grano, Private Hospital Association of the Philippines Inc. national president, said the private hospitals that cut ties with PhilHealth would still serve the firm’s members — but the patients or their families would be the ones who would directly transact with the state insurer.
At present, PhilHealth has released two waves of payments amounting to P11.04 billion under the DCPM.
It will release more funds for the third wave through its Circular 2021-0023 which took effect immediately upon publication on December 8, 2021, officials said.
Under the third wave, hospitals nationwide are qualified to apply as long as they are managing Covid cases and are offering the PhilHealth testing packages, have fully liquidated their IRM, and have no legal cases with PhilHealth.
Despite this, Reyes gave assurances they would provide all the necessary forms that would allow patients to apply for reimbursements on their own.
At the start of the year, Reyes said its receivables from PhilHealth stood at P114 million before increasing to P200 million by November 30, 2021.
Reyes said their receivables had increased by P8 million every month.
“As you can see, the claims paid are far less than our claims submitted, despite the Interim Reimbursement Mechanism and Debit Credit Payment Mechanism liquidations,” Reyes said.
Reyes said the FEU-NRMF would continue working with PhilHealth to reach an amicable settlement.
“Rest assured our goal is to reach an understanding with PhilHealth, but we must take this opportunity to fight for necessary reforms. We are making it clear that we can no longer accept the current situation. We must make changes, or hospitals will close,” he said.
Meanwhile, PhilHealth spokesperson Gigi Domingo said the agency was meeting with FEU to reconcile the data and discuss their issues.
“We are still hoping that the implementation of DCPM 3 will provide the much-needed funds to the hospitals. In coordination with PHA, we have been meeting with hospitals nationwide to discuss DCPM 3,” she said.
Earlier this month, seven private hospitals in Iloilo decided not to renew their contracts with PhilHealth, citing some P545 million in delayed claims payments.