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The Palace reiterates its plea for PhilHealth to reimburse hospital bills.

Malacanang repeated its appeal for the Philippine Health Insurance Corp. (PhilHealth) to settle unpaid claims on Tuesday, after seven private hospitals in Iloilo announced they were terminating connections with the state insurer due to unpaid claims totaling PHP545 million.

“Pangulong Duterte has already issued a direction in a recent Cabinet meeting namin na to pay the hospitals immediately, bayaran ang mga ospital,” Acting Presidential Spokesperson Cabinet Secretary Karlo Nograles said in a Palace press briefing.

According to Nograles, Duterte’s directive prompted PhilHealth to develop the debit-credit payment method (DCPM), which allows hospitals to receive 60% of their reimbursement claims even though PhilHealth is still reviewing their documentary requirements.

“As a result of that direction, nagkaroon nitong (we now have this) debit-credit-payment mechanism, which, once again, works in two waves” (had two waves). Then, right now, PhilHealth is putting everything in place for the third wave,” he continued.

He also urged private hospitals to make use of PhilHealth’s new payment method, which will speed up the reimbursement of outstanding hospital claims.

“And sabi ng (According to) PhilHealth, using this debit-credit payment technique or DCPM – they’ve already had two waves of this – to speed up and simplify hospital payments, and they’re about to issue a third wave of DCPM,” he stated.

The DCPM method’s first phase covers claims filed between March 8, 2020, and April 7, 2021.

The second phase, on the other hand, included claims filed between April 8 and August 9, 2021.

“So, ang panawagan ng PhilHealth sa mga hospitals ay cooperating with their DCPM approach so that mas mabilis bayaran (So, PhilHealth’s call to hospitals is cooperating with their DCPM system so that claim payment is faster),” he continued.

The Iloilo Mission Hospital, St. Paul’s Hospital of Iloilo, Iloilo Doctors’ Hospital, Medicus Medical Center, The Medical City of Iloilo, Qualimed Hospital Iloilo, and Metro Iloilo Hospital and Medical Center Inc. announced on Saturday that they would not renew their PhilHealth accreditations beginning next year.

The hospitals said their decision to leave the health insurance was motivated by unpaid payment claims totaling PHP545 million as of Aug. 31.

The heads of the hospitals said in a Dec. 10 letter to Health Secretary Francisco Duque III, PhilHealth board chair Dante Gierran, and PhilHealth president and CEO Dante Gierran that they will not renew their accreditation beginning Jan. 1, 2022, because the agency “cannot comply with its legal obligations under Republic Act No. 7875 (National Health Insurance Act of 1995).”

“Despite the enormous problems we confront and the ongoing sacrifices made by our healthcare personnel and colleagues, we have been exerting all of our efforts to offer crucial health-care services during this pandemic.” Unfortunately, our hospitals are unable to operate with decreased financial resources as a result of PhilHealth’s failure to fulfill our claims,” the letter stated.

Meanwhile, PhilHealth spokeswoman Shirley Domingo believed that the state insurer’s DCPM payment scheme would prevent the plan of seven hospitals in Iloilo from disengaging.

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