PhilHealth, hospitals groups agree to settle alleged debt mess

The Philippine Health Insurance Corporation (PhilHealth), hospitals groups and medical association have agreed to sit down and discuss ways to settle the alleged unpaid claims of hospitals from the state insurer.

Interviewed on Dobol B sa News TV on Wednesday, Private Hospitals Association of the Philippines Inc. (PHAPI) spokesperson Jhiann Natividad said the camps have discussed the matter on Tuesday.

“Nag-agree kami kahapon, napagkasunduan na gagawan ng reconciliation ang mga claims,” she said.

Aside from PHAPI, Natividad said the Philippine Medical Association (PMA) and the Philippines Hospital Associations (PHA) participated in the meeting.

PhilHealth was represented by its spokesperson Shirley Domingo.

Natividad said the reconciliation of claims will initially start for one to two hospitals, which have already been identified.   

“’Yung sinasabing ng mga hospital na hindi binabayad sa kanila, ikukumpura doon sa kung ano merong datos o report sa system ng PhilHealth,” she said.

“Titignan natin kung ano ba talaga ang nangyayari,” she added.

According to her, there might be discrepancies between the data of PhilHealth and some hospitals claiming reimbursement.

However, Natividad said some hospital members did not want to participate with the groups’ dialogue with PhilHealth. According to her, they might just want to settle the issue directly with the agency.

Of the 744 members of PHAPI, only 203 hospitals responded to the association about their issues with the state insurer, Natividad said.

On Tuesday, Domingo said the alleged unpaid claims of PhilHealth to some hospitals do not appear in the database of the state insurer.

Domingo said some forms for reimbursement were returned to hospitals due to lack of documentation, while some claims were altogether denied by PhilHealth.

She pointed out that the claims for reimbursement that were denied by PhilHealth should not be counted as unpaid claims.

Domingo made the statement after PHAPI said that around 300 hospitals are in danger of shutting down due to the alleged unpaid claims by PhilHealth.

PhilHealth denied that hospitals are facing closure due to delayed payments.

“Since January, we have paid already around P52 billion to our hospitals. Malaki po ang bayad natin kasi we process around 1 million claims a month,” Domingo said. —Joviland Rita/LDF, GMA News