A LAWMAKER at the House of Representatives on Tuesday urged the Philippine Health Insurance Corp. (PhilHealth) to settle at least PHP18 billion in unpaid reimbursement claims of accredited hospitals across the country.
In filing House Resolution 970, Cagayan de Oro City Rep. Rufus Rodriguez stressed the need for PhilHealth to immediately pay up pending claims to private hospitals amid the coronavirus disease (Covid-19) pandemic.
“This is very urgent especially because we are still facing this Covid 19 pandemic and we all need the full operations of our hospitals with the necessary medical personnel. We don’t want our hospitals to close down, scale services nor lay off medical personnel because of non-payment of claims by PhilHealth,” he said.
Rodriguez quoted claims by the Philippine Hospitals Association of the Philippines (PHAP), composed of 733 hospitals, that PhilHealth owed its members PHP14 billion as of December 2018 and PHP4 billion at the end of 2019.
“One of the reasons why many private hospitals are struggling to respond to the Covid-19 pandemic is because they are running out of funds. Many of them have had to obtain emergency loans to sustain their operations,” Rodriguez said.
He noted that hospitals “are retrenching some of their employees to ensure their sustainability” due to financial difficulties.
He said the University of Sto. Tomas Hospital has reduced its manpower and implemented cost-efficiency measures following “significant losses” inflicted by the Covid-19 pandemic and the delay in PhilHealth payments.
He quoted UST Hospital medical director Marcellus Francis Ramirez as saying the delay is “an average of 5-6 months” and that the hospital’s receivables from PhilHealth stood “at more than PHP180 million and counting.”
“As a result of unpaid claims, PHAP members have signified their intention ‘to hold back or hold in abeyance’ their accreditation with PhilHealth, which would be very detrimental to the Filipino people,” Rodriguez said.
PhilHealth has denied claims that hundreds of private hospitals are facing closure due to delayed payments.
The state firm said it has already disbursed some PHP52.53 billion in claims payment this year.
“Payment of claims amounted to PHP38.6 billion, which includes PHP4.74 billion paid through its accelerated return to hospital (RTH) initiative, with PHP13.93 billion released under IRM. Of the claims paid, PHP21.8 billion ((56.5 percent) were paid to private facilities,” PhilHealth said.
It added that reimbursements were processed at an average turnaround time of 41 days with a denial rate of 2 percent.
The increase in turnaround time is due to adjustments for the Covid-19 pandemic, it said. (By Filane Mikee Cervantes)
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