FILE PHOTO. PhilHealth
MANILA, Philippines — The Philippine Health Insurance Corp. (PhilHealth) on Thursday appealed to private hospitals not to sever ties with it as it assured them it was fast-tracking the processing of their payment claims, which it hopes to complete before December.
PhilHealth corporate communications senior manager Rey Baleña said the state health insurer was committed to heed President Duterte’s call for it to promptly reimburse its partner hospitals.
“It would not be long because we have mobilized all that we should. We have augmented our human resource and [PhilHealth president] attorney [Dante] Gierran focused on our regional offices to hasten the process. We are doing all we could for the release of their payments,” Baleña said at the Laging Handa briefing.
Asked if the payments would be completed before December, he replied that they should.
According to Baleña, PhilHealth has enough funds to pay the claims but its processing of the reimbursement applications had slowed down due to the COVID-19 pandemic, which affected its personnel and operations.
But it has already addressed the issues that affected the payments and has augmented its human resources, he said.
“We ask for some understanding and support and, moving forward, they would receive the payments that had been previously delayed,” he added.
PhilHealth is supposed to pay claims within 60 days, and it has been able to pay “good claims” after 42 days on average, Baleña said.
But it also gets questionable claims as well as claims that are not supported by sufficient documents, he said.
PhilHealth has to return these defective claims to the hospitals, which means their payments could not be processed, he added.
On average, 7 percent of all claims are returned to hospitals, he noted.Baleña appealed to medical institutions to make sure their claims are backed by the necessary documents so there would be no problems in processing them.
Baleña also said that despite constraints, PhilHealth was able to pay out P152.8 billion in from January 2020 to Oct. 28 of this year, which represents 75 percent of all claims it received.