MANILA, Philippines — The WellMed Dialysis Center (WellMed) on Thursday denied reports that they claimed benefits for deceased clients from the Philippine Health Insurance Corporation (PhilHealth).
The dialysis center made the denial after its former employees, Edwin Roberto and Liezel Santos, exposed that PhilHealth continuously paid for claims of the dialysis center on behalf of a client who had already died.
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“The law firm of Gargantiel Ilagan & Atanante would like to inform the public that its client, WellMed Dialysis Center (WellMed), vehemently denies the accusations of its former employees, Edwin Roberto and Liezel Santos,” the law firm said in a statement posted on the dialysis center’s page.
“WellMed and its owners did not and would not, in any way, consent to, or participate in any ‘ghost dialysis’ or fraudulent scheme as described by Mr. Roberto,” it added.
The law firm then turned the tables against Roberto and Santos, saying that the two were responsible for the fraudulent scheme.
“Mr. Roberto, WellMed’s former Assistant Manager, and overall in-charge of WellMed’s clinic, and Ms. Santos, WellMed’s former PhilHealth Officer and Cashier, connived with each other, took advantage of the trust reposed in them by WellMed’s owners, and perpetrated the fraudulent scheme, which they are now conveniently attributing to us,” the law firm said.
PhilHealth acting president and CEO Dr. Roy Ferrer said Thursday that they have filed an administrative complaint against the dialysis center.
“In relation to this case, the corporation has filed 28 counts of administrative claims for non-admitted treated patients, misrepresentations by furnishing false or incorrect information, and breach of warranties of accreditations performance against the mentioned dialysis center,” Ferrer said in a press briefing.
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The law firm, however, said they have responded to the complaints and vowed to continue coordinating with PhilHealth for the resolution of the issue.
“Our client has filed with PhilHealth its answer to the various complaints, and will continue to give its full cooperation in PhilHealth’s investigation for the true perpetrators of the fraudulent scheme to be held accountable,” the law firm said.
“As a PhilHealth-accredited health care provider, WellMed has remained and will remain faithful to its commitment to PhilHealth. WellMed wishes to assure its clients and the public in general, that it has taken positive steps to prevent a similar scheme from ever being perpetrated again,” it added.
The law firm said that WellMed will not be “intimidated by these harassment tactics” of Roberto and Santos, and it will file charges against its former employees.
PhilHealth Senior Vice President Israel Francis Pargas said the payment for claims filed by the dialysis center has been suspended since February.
The National Capital Region office of PhilHealth was also instructed to file criminal charges against the dialysis center. (Editor: Eden Estopace)
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