The Philippine Health Insurance Corp. (PhilHealth) assured Friday that its funds are enough to pay for the hospitals’ claims which already reached billions of pesos.
“PhilHealth reiterates its commitment to pay its obligations to its partner hospitals,” the agency said in a statement.
“It has sufficient funds to fulfill its obligations,” it said.
PhilHealth’s failure to pay is already forcing private and public hospitals to use their savings and take out loans, according to the Philippine Hospital Association (PHA)
PHA President Dr. Jaime Almora revealed the Senate Committee on Economic Affairs’ hearing on the status of industries affected by the COVID-19 pandemic.
“They have to dig into their savings, and they have to borrow from the bank. Some hospitals who have called already informed me that they have borrowed from the bank for their operating budget,” he said.
Almora said the unpaid claims for COVID-19 cases are already “causing severe financial distress” to hospitals.
He said PhilHealth is paying for claims for other diseases, but other hospitals are mainly accepting COVID-19 cases.
Funds enough to pay hospital claims: PhilHealth
PhilHealth explained Thursday why the agency is having delays in processing claims for COVID-19 cases of private and public hospitals.
According to PhilHealth spokesperson Shirley Domingo, the virus has also affected the agency’s employees.
“May delay po talaga sa ating processing ng claims kasi pati PhilHealth po ay naapaektuhan din ng pandemic na ito,” she said, adding that some of their employees needed to be confined or put in isolation following exposure to COVID-19.
As of May 17, 2021, the state health insurer said it paid a total of P25.38 billion in claims, P4.88 billion of which are for COVID-19 related claims.
“Recognizing the need of the hospitals for funds especially in highly critical areas for COVID as identified by the Inter-Agency Task Force (IATF) for the Management of Infectious Diseases, PhilHealth has introduced the Debit-Credit Payment Method (DCPM) wherein 60% of good ‘in process claims’ are paid outright to qualified hospitals minus 2% withholding tax, while the remaining 40% shall be paid after claims processing and reconciliation, minus 2% withholding tax,” it said.
“The accelerated payment method provides hospitals sufficient cash flow to continue providing the sick with quality health care during the pandemic,” it added.
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