MANILA, Philippines — Some hospitals have been forced to dig into their savings or borrow from banks in order to continue operating amid a “huge amount of unpaid” claims owed by the Philippine Health Insurance Corp. (PhilHealth), with P1.2 billion supposedly still to be paid to one hospital.
Concern over these unpaid claims, which are causing “severe financial distress” to hospitals and date back to the start of the pandemic in March 2020, was raised by Philippine Hospital Association (PHA) president Dr. Jaime Almora during Wednesday’s Senate hearing on the status of government measures to help pandemic-hit sectors.
“They have to dig into their savings and they have to borrow from the bank. Some hospitals who have called already informed me that they have borrowed from the bank for their operating budget,” Almora told senators.
“They have to somehow sort from their other assets that they have and also from the bank. But remember, that if the hospitals are not paid, the doctors, the professional component is not also paid. So here are doctors working for the COVID patients but they are not being paid,” he added.
He noted that while non-COVID claims are being processed, claims for the treatment of COVID-19 patients are not being paid.
This, according to him, “aggravates” the problem of hospitals, which he said have faced a 50 to 70-percent decrease in non-COVID patients.
“There is already a decrease in the income of the hospitals from the non-COVID [cases] and they are treating COVID-19 cases that are not being paid. It is a compounded problem,” he said.
Asked how much claims remain unpaid by PhilHealth, Almora cited a case of some hospitals.
“We are not able to get the total number but there’s a hospital that has a P1.2-billion claim. Merong P700 million. And the smallest for the COVID centers would be about P50 million,” he noted.
‘Totally unacceptable’
Senator Francis Pangilinan found this “totally unacceptable.”
“At this point parang ‘Wala kaming pakialam sainyo, magtiis kayo.’ Ang dating sa atin dito dahil you are the frontliners and yet this is how you are treated by government in terms of government support in terms of funding, this is totally unacceptable,” Pangilinan said.
Almora at this point clarified that the PHA had reached out to PhilHealth president and CEO Atty. Dante Gierran to raise the concerns of hospitals.
“Atty. Gierran was sympathetic and accommodating and he promised that they are going to pay,” Almora said, noting they met with the PhilHealth chief last April 8.
“Three days after our meeting, they came up with PhilHealth circular 2020-004 creating the debit-credit payment mechanism for the NCR (National Capital Region) bubble cities for partial payment of 60 percent of the in-process claims,” he added.
However, Almora said private hospitals were made to apply for the said mechanism.
“The hospitals were surprised why they had to apply,” he noted.
“Somehow, may pakunti naman [na nag-apply]. So in the NCR, many hospitals applied and received some amount which they consider small,” he added.
Senator Imee Marcos, who is leading the hearing as chairperson of the Senate economic affairs committee, said PhilHealth will be given a chance to explain their side on the matter in succeeding hearings.