PhilHealth urged to simplify process of payment claims

Roque said Duterte requested the processing of claims “to be simplified and just let the indigent patient sign so he will be able to go home after his treatment.” (File Photo: Philippine Health Insurance Corporation/Facebook)

MANILA – President Rodrigo Duterte has urged Philippine Health Insurance Corp. (PhilHealth) to simplify the process of payment claims in hospitals to 60 days following reported delays.

In a Palace press briefing, Presidential Spokesperson Harry Roque said Duterte made this directive during Monday night’s Cabinet meeting where PhilHealth CEO and President Dante Gierran was present.

“Pagdating po sa filing of claims, binibigyan ang PhilHealth ng 60 araw na sa pagproseso ng mga dokumento. Pero bagamat mahaba po ang eksplanasyon ng PhilHealth, pinag-utos po ng Presidente ang pagpapaikli, pagpapa-reconfigure, pagsi-simplify ng mga requirements para sa settling ng claims. Kasama rin ang pag-stretch ng limit ng late filing (When it comes to filing of claims, the PhilHealth was given 60 days to process documents. Despite PhilHealth’s long explanation, the President ordered them to shorten, reconfigure, and simplify requirements for the settling of claims. This includes stretching the limit for late filing,” he said.

Roque said Duterte requested the processing of claims “to be simplified and just let the indigent patient sign so he will be able to go home after his treatment.”

“Yung ideal po (What is ideal) is to compress the process more and not bring more hardship to the sick and indigent Filipino patient and not have to worry about the process,” he said.

Roque said Gierran vowed to meet members of the PhilHealth board to implement the President’s directive.

Meanwhile, Roque said the inter-agency task force investigating irregularities in PhilHealth has submitted to Duterte a new report that includes plans to file complaints against PhilHealth officials and medical practitioners involved in anomalies.

“Naisumite na nila ang kanilang report kay Presidente at sang-ayon po kay [Justice] Sec. Meynard Guevarra kagabi, e magpa-file po ang expanded task force ng ilang mga complaints sa Ombudsman laban sa ilang opisyal ng PhilHealth pati ilang medical practitioners na mga kasabwat sa anomaly (They submitted their report to the President and according to Secretary Meynard Guevarra last night, the expanded task force will file complaints before the Ombudsman against officials of the PhilHealth and some medical practitioners who are accomplices in anomalies),” he said

The task force submitted its 177-page initial report to Duterte last September.

Formed last August 7, the task force conducted seven hearings where it received the testimony of 14 witnesses, reports and summaries of cases, and reports and recommendations of other bodies including the Senate.

The task force called out the state firm’s alleged “foot-dragging” in going after thousands of fraud cases involving its employees and some healthcare institutions and has flagged the low and slow rate of prosecution of cases by PhilHealth’s legal office.

Duterte earlier ordered Gierran to find the officials and persons responsible for irregularities in PhilHealth and has directed a reshuffle of the state firm’s regional vice presidents.