The Philippine Health Insurance Corporation (PhilHealth) has appealed for understanding during dialogs with hospitals while reconciling their data on the supposed billions in unpaid claims to various medical institutions—but offered no timeline on when the claims would be paid.
According to Shirley Domingo, PhilHealth’s vice president for corporate affairs, to date, the state health insurer had paid P152.8 billion or 75 percent of the total claims of hospitals.
“We are having a dialogue with hospitals to reconcile the data that they are saying we owe, because some of these are returned to hospitals and denied claims,” Domingo said in an interview with dzBB.
Earlier, the Private Hospitals Association of the Philippines Inc. (PHAPi) said PhilHealth owed private hospitals about P20 billion as of August this year.
Due to this, the affected hospitals were forced to downsize to continue operations amid the agency’s non-payment of claims.
Domingo said they got delayed on the COVID-19 claims because of several issues such as the lack of human resource due to the pandemic.
Domingo said around 43 percent of the total paid claims of PhilHealth are for COVID-19 expenses.
“PhilHealth is doing a lot of things to be able to fast-track all these claims because we know hospitals really need this,” she added.
Domingo also said PhilHealth president Dante Gierran had coordinated with PHAPi president Jose Rene de Grano twice to explain their side and the ways they were doing to hasten the processing of all the hospital claims.
Meanwhile, several private hospitals in the National Capital Region, General Santos City, Iloilo City, and northern Luzon plan to announce their cutting of ties with PhilHealth this week over the delayed claims, de Grano said.
“I’m not at liberty to name the hospitals of the NCR but right now actually there are big hospitals from NCR, the group from General Santos city, the group from Iloilo City, a group from northern Luzon or the Cagayan valley, they are already contemplating on announcing their non-renewal this week,” De Grano said in an interview with ANC.
“But then I asked them to just stay on hold first because we’re trying to get the president of PhilHealth to talk with the different hospitals so that we can work on a solution for this so this disengagement won’t push through and we’re looking at it within the week,” he added.
De Grano said he is still hopeful an agreement could be reached with PhilHealth this week.
“Let’s hope that this is going to be a good week and that we won’t have hospitals announcing their non-renewal of accreditation with PhilHealth,” he said.