PhilHealth vows to settle some P17-B of hospital claims

MANILA – The Philippine Health Insurance Corp. (PhilHealth) vowed on Thursday to pay 60 percent, or around PHP17 billion, of in-process claims it owes to hospitals through the Debit Credit Payment Method (DCPM) by next week.

PhilHealth President and CEO Dante Gierran made the commitment during the hearing of the House Committee on Good Government and Public Accountability into the non-payment of health care facilities’ claims by the state medical insurer.

Gierran said PhilHealth will settle around PHP17 billion out of the PHP21 billion worth of unpaid claims to hospitals, leaving a balance of PHP4 billion.

“So itong 17 billion nasa pipeline na ito. In fact, hinihintay nalang po, Mr. Chair, ang dokumentasyon ([The payment of] PHP17 billion is already in the pipeline. In fact, we are just waiting for the documentation, Mr. Chair),” he said.

“Next week, babayarin ito, Mr. Chair at doon parin sa DCPM. Ang ibig sabihin niyan 60 percent. Kung magkano ang amount na dapat bayaran namin doon sa mga health care institutions ay babayaran kaagad yan outright 60 percent (Next week, we will pay our debts Mr. Chair and this would be through the DCPM. This means around 60 percent. The amount that we need to pay to health care institutions would be settled 60 percent outright),” he added.

Gierran also lamented the criticism the agency is facing due to the unsettled hospital claims.

“Bugbog na po kami. I open my heart, bugbog na po kami (We are battered. I open my heart, we are really wrecked),” Gierran said.

On Monday, Malacañang appealed to PhilHealth to pay the claims of private hospitals, emphasizing that failure to do so would “significantly” affect the country’s healthcare system amid the prevailing coronavirus pandemic.

Presidential Spokesperson Harry Roque made this remark after hospitals and physicians organizations announced their decision to disengage from PhilHealth over its circular suspending payments to hospitals and healthcare providers whose claims are under investigation.

Roque, the primary author of Republic Act (RA) 11223 or the Universal Health Care Law (UHC) Law in the 17th Congress, reminded the state insurer of their mandate.

“Ang panawagan ko po sa PhilHealth, magbayad kayo ng dapat bayaran. Dahil as author of the law, the intent of the law, is kayo po, ang gobyerno through PhilHealth (My appeal to the PhilHealth is to pay what needs to be paid. Because as the author of the law, the law intends that the government, through PhilHealth), will become the sole purchaser of all goods and services,” he said.

In a virtual Palace press briefing on Thursday, Roque said Duterte has directed Gierran to pay the claims of private hospitals as soon as possible.

“Inulit ni Presidente ang kautusan niya kay Atty. Gierran, bayaran niya nang bayaran dahil sa panahon ng pandemya (The President reiterated his directive to Atty. Gierran to pay the hospitals’ claims because amid the pandemic), we cannot afford to lose the cooperation of the private hospitals,” Roque said.