PhilHealth will pay a large portion of the hospitals’ in-process claims to their agency next week, according to the government health insurer on Thursday.
PhilHealth President and CEO Dante Gierran told the House Committee on Good Government and Public Accountability, they plan to pay 60 percent of the hospitals’ in-process claims.
They said they would pay it through the debit-credit payment method.
Of PhilHealth’s P21.1 billion debt to hospitals as of Aug. 24, P10.6 billion is in private hospitals, according to Dr. Benjamin Pague, acting senior manager of the agency’s information management system.
The House hearing also examined the recurring claims of the hospitals and the alleged misdiagnosis of the doctors at the hospital.
Marikina Rep. Stella Quimbo tried to ask PhilHealth for a list of unpaid claims, but Gierran did not answer. Instead, he passed the ball to his staff.
“Hindi ba dapat meron kayong baon na… ng unpaid claims…. With all due respect, is that information readily available now?” Quimbo asked.
But Gierran explained that there might be a lack of documentary requirements, so benefit claims are returned, and claims are denied.
PhilHealth to pay next week 60 pct in debt to hospitals
Pague said the benefit claims process usually takes 44 days for 2020 and 2021.
“Yung pagbalik ng claims is not about wrong diagnosis… It’s about documentary requirements… Kaya mayroong [return to hospital claims at] mayroong denied claims. Upscaling will always be there…It doesn’t mean na mayroong upscaling… we mistrust our hospitals,” said Gierran.
Quimbo also asked Gierran which of its regional offices is the fastest to process benefit claims. However, they have no records of it.
But based on Quimbo’s question, he said it appears that PhilHealth offices here in the National Capital Region can process benefit claims in just two days.
The hearing officer also said that Private Hospitals Association of the Philippines Inc. Dr. Jaime Almora admitted to her that he only overreacted to his statements to the media regarding PhilHealth’s unpaid debts.
“I open my heart, bugbog na po kami. Si Dr. Almora, tumawag sa’kin, umamin siya na he was just overreacting… It’s unfair na kami lahat ang mali,” said Gierran.
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