P6.3-B hospital claims in high-risk areas released —PhilHealth exec

The Philippine Health Insurance Corp. (PhilHealth) has so far released around P6.3-billion claims of hospitals in high-risk areas in the ongoing battle against COVID-19, one of its executives said Saturday.

At the Laging Handa public briefing, PhilHealth Vice President for Corporate Affairs Dr. Shirley Domingo said they have released the funds through the debit-credit payment program to around 206 health institutions.

PhilHealth has already paid out 79 percent of the total claims, whether COVID or non-COVID, according to Domingo.

Further, PhilHealth has already paid the Philippine Red Cross around P5.5 billion for COVID-19 test claims.

Likewise, Domingo said the agency is open to a proposal of a technical working group meeting between PhilHealth and hospitals that will handle the processing of the state health insurer claims, following some data discrepancies.

"Hindi lahat ng claims na pumupunta sa atin ay binabayaran agad, kasi binubusisi talaga natin 'yon when processing the claims. Dapat lang kasi pera ng bayan ang pambayad natin diyan," she said.

[Not all claims that we are receiving are paid immediately, as we thoroughly investigate the processing because we are using people's money.]

In some cases, we returned some requests to hospitals because of several documentary deficiencies, and some claims were denied because of possible fraud.

"All of those can contribute to the difference in numbers or amounts of claims that were said to be our debts. It is important is to reconcile our data, which is what our regions are now doing," Domingo said.

The state health insurer assured the public that it has enough funds to cover the unpaid claims it owes to hospitals amid complaints that PhilHealth's obligations are heaping up to billions of pesos.

"The corporation hopes that the decision of the Ombudsman is accepted and we move on from there," Domingo said.

He was referring to the Office of the Ombudsman's dismissal of the criminal and administrative complaints filed against former and current PhilHealth executives over their supposed retaliation on fellow officers. —LBG, GMA News