ILOILO CITY—Private hospitals in Iloilo may cut off their accreditation with the Philippine Health Insurance Corp. (PhilHealth) if the agency fails to pay P545 million in hospital claims by next month.
In separate letters to PhilHealth President and Chief Executive Officer Dante Gierran, and Health Secretary Francisco Duque III dated Sept. 22, the heads of seven private hospitals called for an “immediate reconciliation and payment of the payables by the end of October 2021.”
The hospitals demanding payments were Iloilo Mission Hospital, St. Paul’s Hospital of Iloilo, Iloilo Doctors’ Hospital, Medicus Medical Center, The Medical City of Iloilo, Qualimed Hospital Iloilo, and Metro Iloilo Hospital and Medical Center Inc.
The heads of the hospitals said they would still accept patients with PhilHealth accreditation if the agency fails to settle P545,094,532.45 in hospital claims by the end of next month. But the hospitals are “seriously considering” not processing PhilHealth collection and reimbursement and directly bill the patients.
They said the nonpayment of claims amounting to P545,094,532.45 as of Aug. 31 “has greatly affected our operations and financial viability.”
Finances depleted
They also lamented being “accused of unfounded violations of PhilHealth circulars, subjected to a barrage of investigations, denials of claims that were submitted as far back as 2010, suspension or termination of payments without due process, and empty promises and assurances that our concerns will be addressed and our claims will be paid.”
“The hospitals cannot continue to operate with their depleted financial resources caused by the nonpayment of claims by PhilHealth. We have to deal with operating expenses, purchases of medical supplies and equipment, payment of utilities and more importantly the salaries of nurses, medical technologists, hospitalists and other hospital staff who have been placed under tremendous stress and seemingly unending duress as they have been dealing with the pandemic and the daily influx of COVID 19 patients,” they said.
The Iloilo City government earlier filed administrative and criminal complaints against officials of PhilHealth in Western Visayas over the alleged failure to settle unpaid claims of nine hospitals and the city-run Uswag Molecular Laboratory amounting to P932 million.
Mayor Jerry Treñas earlier said hospitals were unable to add more COVID-19 wards and intensive care unit beds due to the nonpayment of these claims.
In earlier statements, PhilHealth in Western Visayas said it “has not been remiss in its duty to facilitate the payment of good claims within the time provided by law.”
It also said some claims were returned because they lacked requirements, including documents or signatures. Some had also been denied for various reasons, including exhaustion of benefits, but these could be appealed. INQ