The Philippine Health Insurance Corporation (PhilHealth) on Friday admitted that it still owes billions of pesos to public and private health facilities due to the delay in the processing of “hundreds of thousands of [Covid-19] claims.”
Earlier, the Philippine Hospital Association said the state health insurer still owes P20 billion in claims to hospitals.
In response, PhilHealth Vice President of Corporate Affairs Dr. Shirley Domingo says a total of P12 billion has already been paid. However, she did not specify how much the agency still owes the hospitals.
“Nakabayad na po tayo ng 12 billion ng claims. 50% po ito ng total claims that we received. [The] rest ay pino-process po natin,” she said.
(We already paid 12 billion pesos in claims, which is 50% of the total claims we received. We are still processing the rest.)
Testing comprises the most significant portion of the claims, followed by community isolation unit benefits and in-patient benefits. But failure to process these claims promptly, she said, was due to manual processing of the claims and the non-compliance of testing centers to submit the required documents.
“Pero yung malaking portion is in the testing [claims]. ‘Yung mga required documents ay hindi po nasasubmit ng testing centers. Kailangan [pa] po i-encode… [since] we agreed to receive claims manually.”
(Testing [claims] consists the biggest portion. Testing centers fail to submit the required documents. They still have to be encoded… [since] we agreed to receive claims manually.)
Measures such as the deployment of human resources to regions that need them and the streamlining of PhilHealth’s processes are being eyed to expedite the payments, she said.
Last Thursday, President Rodrigo Duterte directed PhilHealth to immediately settle the billions it owes to hospitals in the country. Dunston Chi Esquivel