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PhilHealth promises to pay out P25.4 billion in hospital claims.

Dante Gierran, president of the Philippine Health Insurance Corp. (PhilHealth), said on Tuesday that the current in-process claims totaling PHP25.45 billion would be paid to private hospitals within six months.

During a virtual hearing of the House Committee on Health on the latest developments surrounding the agency’s reimbursements and payments to hospitals based on its numerous circulars linked to coronavirus illness (Covid-19) benefits package claims, Gierran provided the assurance.

He explained that the payment will be made using the Debit-Credit Payment Method (DCPM), which was created by PhilHealth to help with the settlement of accounts payable to healthcare facilities during the public health emergency caused by the Covid-19 pandemic in order to ensure that healthcare services are not interrupted.

The DCPM, according to PhilHealth, will enable the quick flow of monies to qualified hospitals around the country that have expressed an interest in using the new payment system while PhilHealth processes their claims.

According to Gierran, the agency has released PHP12.05 billion to 444 hospitals through the DCPM as of January 7, 2022.

Meanwhile, Marikina City Representative Stella Luz Quimbo questioned PhilHealth officials about the typical processing time for Covid-19 claims.

PhilHealth can only resolve 21% of unpaid claims in two years, according to Quimbo, and the agency lacks accurate statistics on the average number of days it takes to process unpaid claims.

Meanwhile, PHAPI president Dr. Jaime Almora noted that the planned “disengagement” of hospitals from PhilHealth over billions of pesos in outstanding claims means that private health care providers will no longer lend money to PhilHealth to pay for Filipinos’ medical expenditures.

PHAPI, on the other hand, indicated it was willing to help PhilHealth members who would directly incur the costs of claiming reimbursement from the agency, according to Almora.

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