A House leader asked the national health insurer to reimburse public hospitals for delivered services as soon as possible, noting the delayed claims payment of PhilHealth to government hospitals.
Rep. Zaldy Co of Ako Bicol party-list made the statement during a briefing on the 2025 budget of the Department of Health (DOH) where it was learned that PhilHealth’s unpaid claims have accumulated to nearly P14.8 billion, of which P6.7 billion have been pending for over two years.
“It is problematic to deny payment of services already performed. It’s as if we’re saying, don’t get treated. Once the government hospital accepts the patient, PhilHealth should automatically pay because the people’s contribution has already been paid, the subsidy has already been given,” Co said.
In the same budget briefing, Co also asked Health Secretary Teodoro Herbosa about the inclusion of doctors’ professional fees under the Medical Assistance for Indigent and Financially Incapacitated Patients (MAIFIP) program.
Herbosa, who had committed to resolve the issue in a meeting with Co and Speaker Martin Romualdez last week, said he has already released a department memorandum on the matter.
“Our DOH doctors’ professional fees should be automatically approved, not denied. Their salaries are already pitifully low. They should not have to worry about their fees,” Co said.
Responding to Co’s concerns, PhilHealth president Emmanuel Ledesma vowed to expedite the processing and payment of the claims that have either been returned to hospital (RTH) for fulfillment of unmet requirements or outrightly denied.
Co said PhilHealth should help ensure that government hospitals, which cater to massive numbers of poor patients, deliver proper health services by paying their claims promptly. He said cash flow problems seriously impact the public health care system.
“Ghost claims must be denied. But if the claims documents are missing just a period or a comma, don’t let the hospitals sweat…This is for the people, and it’s supported by Congress and the budget, and there is money for the services,” he said.
