November 7, 2021

Unpaid claims will be released by PhilHealth before the end of the year.

The Philippine Health Insurance Corp. (PhilHealth) announced on Thursday that it will increase its efforts to refund unpaid claims from private hospitals by the end of the year.

PhilHealth made the pledge in the wake of certain private hospitals in Metro Manila and other regions threatening to cut connections with the state insurer after it failed to satisfy hospital claims payments in October.

It also came as a result of Malacanang pressuring PhilHealth to meet its financial obligations to hospitals.

During the Laging Handa briefing, PhilHealth spokesperson Rey Balea Jr. assured that the agency is doing everything possible to speed up the payment of private hospital reimbursement claims, the majority of which are for services delivered to patients with coronavirus disease 2019 (Covid-19).

“Ang lahat po ng aming makakaya para po ma-release na po natin ‘yung mga bayad natin (PhilHealth is putting out all efforts to release the [unpaid] claims),” Balea added. “Makakaasa po ng ating mga ospital na darating na po ang mga bayad natin, especially doon sa Covid-19 claims.”

According to Balea, PhilHealth is just taking the time to verify the reimbursement claims to ensure that they are free of errors and in compliance with all program laws and criteria.

When asked if unpaid private hospital claims would be addressed before December, Balea answered, “Dapat po (It should be).”

Some hospitals in Metro Manila, Cagayan Valley, and General Santos City have stated that they will not renew their PhilHealth certification. Jose Rene de Grano, president of the Private Hospital Association Philippines Inc., stated on Monday.

More hospitals will follow suit in the next two weeks, according to De Grano.

According to Balea, some private hospitals have yet to formally notify PhilHealth that they intend to cut connections with the agency.

Nonetheless, he expressed optimism that private hospitals will reconsider their decision to leave PhilHealth.

Balea made the statement after admitting that the likely breakup of some private hospitals’ links with PhilHealth would have a “severe” impact on the country’s healthcare system.

“Wala ho po kaming natatanggap na sulat o notice na hindi po sila magpapa-accredit sa January 2022,” he said. At kami po ay umaasa na kung may mga plano man po ang ilan sa ating mga ospital na mag-disengage mula sa PhilHealth, eh sana po ay ma-reconsider po nila ito. And we’re hoping that some hospitals will reconsider their decision to leave PhilHealth),” Balea added.

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