The Philippine Health Insurance Corporation (PhilHealth) said it would expedite hospital payments through the Debit-Credit Payment Method (DCPM) as it had 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. (PHAPI) 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.
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.
Philhealth reported that it continued to pay hospital reimbursements.
Due to the challenges brought about by the pandemic in its operations, Philhealth has implemented the DCPM for the fast release of funds to qualified hospitals nationwide.
These hospitals, Philhealth said, have signified intention to avail of the new payment mechanism while it processes their claims.
Philhealth said hospitals in Iloilo City had been qualified to avail themselves of the said mechanism ever since they started experiencing a surge in Covid cases early this year.
It called on the seven hospitals to avail themselves of the DCPM so as to expedite payments, thereby ensuring and protecting the welfare of the members in the said region.
Meanwhile, Malacanang urged hospitals who might not renew the accreditation with PhilHealth because of unpaid claims to avail themselves of the debit-credit payment method (DCPM).
Cabinet Secretary and acting presidential spokesman Karlo Nograles said Philhealth’s new payment mechanism will fast-track the payment of hospital claims.
Under the DCPM, only 60 percent would initially be paid to hospitals while the 40 percent would be paid upon the completion of processing requirements.
Nograles issued the offer after seven hospitals in Iloilo decided to cut ties with the state insurer due to the accumulation of unpaid dues amid the COVID-19 pandemic.
“The call of PhilHealth to all hospitals is to avail (themselves) of this DCPM payment method, especially since they are now going through and preparing for the third wave,” according to Nograles.
He added President Rodrigo Duterte had directed PhilHealth to immediately pay what it owes to hospitals.’
Last month, PhilHealth Spokesperson Shirley Domingo appealed to hospitals to rethink their plans of disengaging with the firm as it was working to settle the unpaid claims.
But with the non-renewal of the contracts, patients will have to process their claims and will have to pay in advance before they are reimbursed by PhilHealth.
The president of a private hospital in Iloilo City said Monday PhilHealth still owed it some P93 million, which is part of the P545 million in unpaid hospital claims that has prompted seven hospitals in Iloilo province to cut ties with the government health insurer.
“We still have a balance of about P93 million… This is a cumulative amount which started in 2018,” said Metro Iloilo Hospital and Medical Center President and CEO Danilo Encarnacion.
According to “24 Oras Weekend” report, the hospitals that will not renew their contracts with PhilHealth in January 2022 are St. Paul’s Hospital, Iloilo Doctors Hospital, Iloilo Mission Hospital, The Medical City – Iloilo, Medicus Medical Center, Qualimed Hospital Iloilo, and Metro Iloilo Hospital and Medical Center Inc.
Elmer Pedragosa, president of the PHAPI Western Visayas Chapter, said hospitals have been waiting for the payments to be made, but have yet to receive the full amount.