State insurer Philippine Health Insurance Corporation (PhilHealth) has modified its payment scheme for hospital claims in COVID-19 cases treatment by increasing the initial amount from 60 percent to 80 percent.
PhilHealth spokesperson Gigi Domingo, in a Palace briefing on Wednesday, said the move is meant to hasten settlement of unpaid dues with hospitals.
Domingo cited that the Debit Credit Payment Method (DCPM) wherein PhilHealth will pay 80 percent of hospital claims while the remainder will be paid for upon completion of processing requirements.
Domingo made the announcement in reaction to reports regarding PhilHealth’s delayed payments, which got hospitals into thinking of severing ties with the agency.
“From 60 percent, this will be raised to 80 percent [initial payment] so as to expedite the payment process because we know this is much needed by hospitals,” she added.
Likewise, Domingo said they are yet to receive formal notice from any hospital that they intend to disengage with PhilHealth starting next year due to PhilHealth’s delayed payment for treatment of COVID-19 cases.
Domingo also assured hospitals and the public that PhilHealth is working on addressing the delays amid the challenges posed by the pandemic.
On Sunday, seven private hospitals in Iloilo have decided not to renew their contracts with PhilHealth, citing some P545 million in delayed claims payments.
Opposition Senator Leila M. de Lima meanwhile cited the continued failure by PhilHealth and the Department of Health (DOH) to release payments to accredited hospitals and health care workers.
De Lima reiterated the need for Congress to investigate the recurring and longstanding issue which poses threats to DOH and PhilHealth’s capacity to provide essential health services to the public.
“We cannot ignore serious allegations of mismanagement which affects hospitals and healthcare professionals, which are relied upon by our country as we continue to battle a pandemic,” she added.
What is more alarming, De Lima said, is that more hospitals are reportedly eyeing disengagement from PhilHealth too.
She said that anomalies still marred this government, especially the health sector despite the pandemic that has been here for almost two years.
Notably, Private Hospitals Association of the Philippines Inc. (PHAPi) president Jose Rene de Grano said more hospitals in General Santos, Quezon province, Isabela and Metro Manila are expected to disengage from PhilHealth.
It may be recalled that as early as Oct. 24, 2019, PHAPi revealed PhilHealth’s failure to settle its financial obligations to its members and notified the government that these hospitals may cut off their PhilHealth accreditation due to unpaid financial obligations of the state’s firm.
Last year, De Lima filed Proposed Senate Resolution (SR) No. 461 urging her colleagues to investigate the alleged failure of the
PhilHealth to release insurance claims to its accredited hospitals. With Macon Ramos-Araneta
