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PHAPI: Unpaid PhilHealth claims with private hospitals reach P10 billion

The state-run Philippine Health Insurance Corporation (PhilHealth) has yet to pay over P10 billion in claims with private hospitals, according to the Private Hospitals Association of the Philippines, Inc. (PHAPI).

"Yung pung aming dating estimate niya siguro 3 to 4 months ago, mahigit P10 billion na po yon sa mga pribadong ospital," said PHAPI President, Dr. Jose Rene De Grano in a super radyo dzBB interview on Saturday.

(Our estimate is from three to four months ago, over P10 billion with private hospitals.)

"'Yung sinasabi nilang additional na mahigit pa 10 billion, 'yan 'yung tinatawag nilang in-process claims. More or less ang kalahati niyan ay galing sa mga pribadong ospital," he added.

(What they called an additional of over P10 billion, those are what they call in-process claims. More or less, half of that comes from private hospitals.)

He said that the unpaid claims continue to increase as patients keep coming every day. Also, private hospitals can't refuse to accept patients nor can they not grant PhilHealth benefits as patients might suffer.

"Mas kawawa po ang ating mga kababayan kung hindi natin sila taganggapin sa ating mga hospital," Dr. De Grano added.

(Our countrymen will be in a bad spot if we don't admit them to our hospitals.)

On Wednesday, PhilHealth vowed to pay a "high percentage" of the P27 billion in hospital dues within 90 days. These include unpaid claims from private hospitals.

PhilHealth President and CEO Emmanuel Ledesma Jr. announced that Agri party-list Representative Wilbert Lee pointed out that it was baffling that PhilHealth had accumulated billions of unpaid hospital claims when the state-run corporation had P466 billion in investible funds and P68.4 billion worth of net income so far.

"Napakalaking dagok sa operasyon ng ospital [ang utang ng PhilHealth]. Simula pa ng 2019 or before the pandemic, mayroon na pong mga hinihintay kami na babayaran sa amin," De Grano said.

(The unpaid PhilHealth claims are a major blow to hospital operations. From 2019 or before the pandemic, we have been waiting for payments.)

He noted that during the past months, PhilHealth had been paying on time, but there were months with pending payments.

"Ang problema, sinasabi nila babayaran nila. Sa tagal na nung ilang pagkakautang, ang gusto nila (PhilHealth), tingi-tingi pa ang pagbabayad," he stressed.

(The problem is they say that they will pay for it. But some of the debts are so old, and PhilHealth wants to pay for it bit by bit.)