Palace renews call on PhilHealth to pay hospital claims

MANILA – Malacañang on Tuesday renewed its call to the Philippine Health Insurance Corp. (PhilHealth) to settle unpaid claims after seven private hospitals in Iloilo announced cutting ties with the state insurer over unpaid claims amounting to more than PHP545 million.

“Pangulong Duterte has already issued a directive in previous Cabinet meeting namin na to pay the hospitals immediately, bayaran ang mga ospital (President Duterte has already issued a directive in a previous Cabinet meeting to pay hospitals immediately),” Acting Presidential Spokesperson, Cabinet Secretary Karlo Nograles said in a Palace press briefing.

Nograles pointed out that Duterte’s directive led to PhilHealth coming up with its debit-credit payment method (DCPM), which allows hospitals to receive 60 percent of their reimbursement claims even if PhilHealth is not yet done in processing their documentary requirements.

“So because of that directive, nagkaroon nitong (we now have this) debit-credit-payment method which, again, nag-two waves na nga (had two waves). And then now, PhilHealth is already preparing everything to do the third wave,” he added.

He also urged private hospitals to avail of PhilHealth’s new payment scheme to expedite the disbursement of hospitals’ unpaid claims.

“And sabi ng (According to) PhilHealth, using this debit-credit payment method or DCPM – they have actually had two waves of this already – again to accelerate and facilitate the payment of the hospitals and they are set to release a third wave of DCPM,” he said.

The first phase of the DCPM method covers claims lodged from March 8, 2020 to April 7, 2021.

On the other hand, the second phase covered claims filed from April 8 to Aug. 9, 2021.

“So ang panawagan ng PhilHealth sa mga hospitals ay to cooperate with their DCPM method so that mas mabilis bayaran (So PhilHealth’s call to hospitals is to cooperate with their DCPM method so that payment of claims will be faster),” he added.

On Saturday, the Iloilo Mission Hospital, St. Paul’s Hospital of Iloilo, Iloilo Doctors’ Hospital, Medicus Medical Center, The Medical City of Iloilo, Qualimed Hospital Iloilo, and Metro Iloilo Hospital and Medical Center Inc., said they would not renew their accreditations with PhilHealth starting next year.

The hospitals cited the unpaid reimbursement claims amounting to PHP545 million as of Aug. 31 as the reason for their plan to disengage from the health insurer.

In a Dec. 10 letter to Health Secretary Francisco Duque III, PhilHealth board chair, and PhilHealth president and chief executive officer Dante Gierran, the heads of the hospitals said they will not renew their accreditation starting Jan. 1, 2022, because the agency “cannot comply with its legal obligations under Republic Act No. 7875 (National Health Insurance Act of 1995).”

“We have been exhausting all our efforts to provide essential health-care services during this pandemic despite the extreme challenges we face and the constant sacrifices being made by our healthcare workers and employees. Unfortunately, our hospitals cannot continue to operate with depleted financial resources caused by the nonpayment of our claims by PhilHealth,” the letter read.

PhilHealth Spokesperson Shirley Domingo, meanwhile, hoped that its DCPM payment scheme could stop the plan of seven hospitals in Iloilo from disengaging from the state insurer.