PhilHealth vows to pay 60% of hospital claims next week

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THE Philippine Health Insurance Corp. (PhilHealth) on Thursday vowed to pay 60 percent of hospital claims next week.

In a hearing of the House Committee on Good Government and Public Accountability, PhilHealth President and CEO Dante Gierran said hospital claims will be paid through the Debit-Credit Payment Method (DCPM).

“Next week, we will pay our debts…and this would be through the DCPM. This means around 60 percent. The amount that we need to pay to healthcare institutions would be settled outright 60 percent,” he said.

“So by next week, we could wipe out 60 percent [of our debts to hospitals],” he added.

PhilHealth, in its Circular 2021-0004, provides for the use of the DCPM to facilitate the settlement of accounts payable to health-care facilities during the State of Public Health Emergency brought about by the Covid-19 pandemic.

Currently, Gierran said the PhilHealth has P21.1 billion unpaid claims to its accredited hospitals. Of the P21.1 billion, P10.6 billion unpaid claims are from private hospitals.

“We will really pay for that [debt] because we know how the hospitals have suffered. We already have this expanded DCPM. [And we will pay] something like P17 billion. So with P17 [billion] out of P21 [billion worth of unsettled debts], there would be P4 billion left,” he said.

According to Gierran, the payment of P17 billion is already in the pipeline.

“In fact, we are just waiting for the documentation,” he added. “However, we have a hearing tomorrow [Friday], that’s why the work would be disrupted.”

Meanwhile, Gierran admitted that PhilHealth officials are hurting from the issues involving unpaid hospital claims.

Ito sasabihin ko na po: bugbog na po kami. I open my heart, bugbog na po kami, [This I have to say: we are so beaten. I open my heart: we are so beaten],” said Gierran.

Gierran also said Philippine Hospitals Association (PHA) President Dr. Jaime Almora called him to apologize for “overreacting” on the circular on the temporary suspension of payments on claims (TSPC).

The PhilHealth Circular 2021-013 imposes a temporary suspension of claims for potential fraudulent cases.

But PHA’s Almora had earlier expressed “strong doubt” on the timing of the release of the circular on TSPC.

Almora said the PhilHealth circular was released amid mounting pressure for them to pay hospitals.

With this,  Almora said the Board of Directors and Officers of the PHA, the Private Hospital Associations of the Philippines, and the President of the Philippine Medical Associations and other healthcare providers, decided to review their engagement with PhilHealth.

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