Duterte orders PhilHealth to expedite payment of hospital claims

MANILA – President Rodrigo Duterte has directed the Philippine Health Insurance Corporation (PhilHealth) to expedite the payment of claims of hospitals, Malacañang said Thursday.

This, after the state-run medical insurer earlier acknowledged “slowness” in its processing of reimbursement claims by hospitals.

Presidential Spokesperson Harry Roque said PhilHealth has approved the application of a debit-credit payment method (DCPM) to facilitate the settlement of accounts payable to health care facilities (HCFs) during the state of public health emergency due to the Covid-19 pandemic.

“HCFs eligible for DCPM must be located in regions identified by the Inter-Agency Task Force for the Management of Emerging Infectious Diseases (IATF-EID), such as the National Capital Region (NCR), Batangas, Bulacan, Cavite, Laguna, Pampanga, and Rizal,” he said.

These HCFs must likewise have no interim reimbursement mechanism fund balance on record, he added.

Roque explained the HCFs must be attending to Covid-19 patients or providing the SARS-CoV-2 testing package and their accreditation is not suspended during the applicable period.

He also expressed confidence that the DCPM of public and private hospitals, amounting to around PHP9.7 billion, would mean “continuous” delivery of healthcare services.

“Through this measure, we are confident there would be continuous delivery of healthcare services, especially in identified areas of concern, amid the rising number of coronavirus active cases,” he said.

PhilHealth CEO and President Dante Gierran earlier said the state-run medical insurer last year received PHP107 billion in claims for the service of hospitals to its members and settled about 85 percent of these claims.

Gierran attributed the delay to some PhilHealth personnel contracting Covid-19, thus needing to reduce the workforce and temporarily lock down its office.

He also clarified reports that PhilHealth has some PHP6 billion in unpaid reimbursements to private hospitals as alleged by the Private Hospitals Association of the Philippines (PHAP).

In a statement posted on its Facebook page, the state-run medical insurer said, “Cognizant to the situation, PhilHealth ensures that it is paying its obligations to its accredited health care providers within and even way faster than what was required by law, provided that the claims comply with existing policies and guidelines, pursuant to strict auditing rules of the Commission on Audit.”