Hospital group’s threat ‘crude blackmail attempt’: PhilHealth

The PhilHealth chief also said he has talked to Jimenez and his group and agreed to work directly with each hospital to reconcile the backlog of insurance claims. (File Photo: Philippine Health Insurance Corporation/Facebook)

MANILA — The Philippine Health Insurance Corp. (PhilHealth) on Friday tagged the threat of a group of private hospitals to sever ties as a “crude blackmail attempt”.

PhilHealth President and Chief Executive Officer Ricardo Morales said based on their talks with members of the Private Hospitals Association of the Philippines (PHAPi), its president Dr. Rustico Jimenez’s threat of separation from the agency was devoid of truth.

“There is no truth to that threat that there will be 600 hospitals that will pull out, all the hospitals we have talked to denied that they were going to pull out,” Morales said in a press conference at Luxent Hotel in Quezon City.

The PhilHealth chief also said he has talked to Jimenez and his group and agreed to work directly with each hospital to reconcile the backlog of insurance claims.

“We will reconcile our figures. Kasi minsan yung kanila, iba rin yung amin (Because sometimes, our numbers differ from theirs),” Morales said.

In an open letter released on Monday, PHAPi —with its 600 member hospitals— threatened to cut ties with PhilHealth through non-renewal of their accreditation by 2020 due to the state health insurance firm’s alleged non-payment of some PHP2.5-billion in claims.

From January this year until Sept. 30, Morales said PhilHealth has paid a total of PHP75-billion to claimants.

“So, that is what we have to reconcile, ‘yung figures nila and our figures tally. Lahat naman ito ginagawa namin (their figures and ours tally. We’re actually doing this) with all hospitals—not only limited to this group,” Morales said.

When asked how much was left unpaid to PHAPi, PhilHealth official Arnel de Jesus said their numbers were broken down per hospital which required individual reconciliation with each establishment.

“Kung ano yung numero ng ospital, pumunta sa amin at ipapakita natin din with full transparency kung ano ang numero namin para makapag-reconcile kami (Whatever number the hospital came up with, they just need to approach us and we’ll show with full transparency our numbers so that we can reconcile),” de Jesus said.

He acknowledged there is a backlog of unpaid claims but said these can be addressed through direct talks with PhilHealth.

“Kailangan lang namin ipaliwanag nang maigi kung meron dapat ipaliwanag at kung bakit hindi nababayaran (We just need to explain clearly if there’s something to be explained and why it’s not yet paid),” De Jesus said.

“Talaga namang may backlog kasi hindi perfect yung system,” he added.

Morales also acknowledged that there were issues with payments stemming from their efforts to modernize the PhilHealth system which they hope would eventually speed up their transactions as well as minimize fraud.

“This is an issue that is not only confronting only these hospitals but the entire PhilHealth information system. Kasi we are adopting information technology (IT) para madali ang pagbayad sa kanila (Because we are adopting IT to ease transactions),” Morales said.

He stressed that affected hospitals, instead of issuing threats or intimidations, should approach PhilHealth and have their issues directly addressed.

“Work directly with us and not to go to threats and intimidation. It will not work because it is putting the public in a predicament which they do not deserve,” Morales said.