4 billion worth of claims paid by Philhealth amidst the threat of "Philhealth Holiday"  

4 billion worth of claims paid by Philhealth amidst the threat of “Philhealth Holiday”

4 billion worth of claims paid by Philhealth amidst the threat of “Philhealth Holiday”

 

Amidst the threat of “PhilHealth Holiday” from private medical institutions, the National Health Insurance Company (PHILHEALTH) has decided to pay 4 billion worth of unpaid claims to local hospitals. 

This “PhilHealth Holiday” threat was a plan urging members of the Private Hospitals Association of the Philippines (Phapi) not to accept claim deductions from Philhealth starting from the 1st day to the 5th day of January to support hospitals in Ilo-Ilo who threatened to cut ties with PhilHealth. 

On January 1, 7 hospitals in Ilo-ilo City deferred their plan after PhilHealth committed to a still unspecified portion of unpaid claims reaching more than P895 million. 

The regional office of Philhealth stated that worth P268.122 million was paid for inpatient benefit. They also added that it took them 57 days to process the claims with complete documentation. 

The group’s President, Dr. Jose Rene Grano said on Wednesday, “No. Postponed muna (It is postponed for now) per request of concerned citizens and patient groups so they can be informed well and advised on what to do during the holiday,”. 

“In the spirit of human consideration and with the prevailing Yuletide season as well as for the welfare of the Filipino people which the seven hospitals serve, we agreed to suspend our planned disengagement … and give PhilHealth one more chance to fulfill its commitment,” based from a joint statement of the hospitals red by the administrator of Iloilo Mission Hospital and Phapi President in Iloilo himself Dr. Elmer Pedregosa. 

They gave Philhealth 90 days to reconcile and settle the claims during their online meetings on December 29 and 31. Giving them time to fulfill their commitment does not mean they will forget their move. The said plan was still expected to push through on February 2022. 

Pedregosa did not specify the exact amount Philhealth shall pay, but they are looking forward to the settlement of at least 80% of the claims worth P895 million as of November 30, 2021. 

PhilHealth noted that 442 healthcare facilities and 1,890 professionals in Davao were accredited as of November 19 last year, with 19 facilities also accreditated to provide a program launched last year 2020 but was only implemented in 2021. Allowing members to avail of outpatient services defined under the Universal Health Care Act, a law that mandates health insurance coverage for all Filipinos.

Not only the hospitals in Iloilo threatened to cut ties but also those hospitals in Metro Manila, for they have been accusing Philhealth of sitting on their claims for such a long time. 

Despite the “PhilHealth Holiday” threat, PhilHealth reassured its members that they would still provide services and benefits amidst the pandemic. They also said that they are still committed to providing quality, accessible and affordable healthcare benefits to its member. They also urged private hospitals to reconsider their plans about the “PhilHealth Holiday” because it may affect the patients negatively.

 

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