Makati Med exec says collecting reimbursements from PhilHealth still a ‘challenge’

Makati Medical Center Facebook photo

MANILA, Philippines — Collecting claims reimbursements from the Philippine Health Insurance Corp. (PhilHealth) remains a “challenge” for the Makati Medical Center (MMC), the hospital’s president and chief executive officer said Wednesday.

This despite earlier assurances from the state insurer that nearly 80 percent of claims from 2019 to 2021 have already been paid.

Atty. Pilar Nuneca Almira said the delay in processing reimbursements at PhilHealth has been going on for quite some time especially when the leadership was changed last year amid allegations of corruption in the agency.

“On PhilHealth, it is a challenge. The collection is really a challenge because PhilHealth has been delayed in reimbursing and paying the hospital, and this has been going on especially when they had this controversy in the way PhilHealth organization was managed and leadership in Philhealth was somehow shuffled,” she said in an online discussion with the media.

According to Almira, many of the PhilHealth staff have also resigned, affecting the processing of claims submitted by the MMC.

“Even up to now, we have quite a challenge in collecting from them. They admitted to us that they also were experiencing attrition. They have been losing their employees and that their people are also adjusting on how to manage this processing of PhilHealth claims in view of their computerization,” she added.

Almira said PhilHealth has been trying to pay them “but of course not the way they have committed that they will pay the hospital.”

According to the hospital official, PhilHealth recently provided a P230-million fund to MMC for the liquidation of future claims, but this would not cover the previous claims.

“That would answer for claims in the future rather than settling the claims that had been in arrears during the past years,” Almira said.

“So that is the situation with PhilHealth and that is the same experience that all hospitals have presently. We look forward that maybe this 2021 and 2022 they would be able to fix the concerns on PhilHealth and they would be able to pay even the accounts that have been in arrears for so long. We can just sympathize also with them,” she added.

PhilHealth has yet to give its response or comment on this matter. But on Saturday, its spokesperson and Vice President for Corporate Affairs Shirley Domingo said that the agency has paid 79.6 percent of all the P259 billion worth of hospital claims since 2019. https://newsinfo.inquirer.net/1448204/phihealth-spox-nearly-80-of-hospital-claims-paid

Domingo also assured that processing is ongoing for the rest of the unpaid claims.