PhilHealth confirms meeting with private hospitals group, says unpaid claims being reconciled

Published October 25, 2019, 3:44 PM

by Gabriela Baron & Minka Klaudia Tiangco

By Analou De Vera

The Philippine Health Insurance Corporation (PhilHealth) on Friday said that its officials have already met with their counterparts from the Private Hospitals Association of the Philippines Inc. (PHAPi), and are now in the process of reconciling unpaid claims to private hospitals.

Philhealth President, retired army general Ricardo “Dick” Morales (MARK BALMORES / MANILA BULLETIN)
Philhealth President, retired army general Ricardo “Dick” Morales (MARK BALMORES / MANILA BULLETIN)

“Nag-usap kami kahapon at nagkaayos na naman kami [We had a conversation yesterday and we’ve already made up]. So, we are working with the hospitals to reconcile,” said PhilHealth President Ricardo Morales in a media forum.

“Ang suggestion namin sa mga [Our suggestion to the] hospitals affected is to work with us and not to go to threats and intimidation. It does not work because it is putting the public in a predicament which they do not deserve,” he added.

Morales described the threat of PHAPi as “cheap stunt” and “crude attempt,” adding that the issue on unpaid claims was not only limited to its members but also involved other hospitals.

“This is an issue not only involving these hospitals… [but] the entire Philhealth ecosystem,” he said.

“Whether or not they publish that half page threat, we would still be doing the same thing [of processing the payments]. That’s not [going to] change anything. We are always working constantly,” he added.

Morales said that they were already conducting stringent measures for faster processing of hospital claims as well as to prevent possible fraudulent transactions.

“We are adopting information technology para mapadali at mapabilis yung pagbayad sa kanila at maiwasan yung pagbayad ng fraud,” he said.

[We are adopting information technology for faster payment and to avoid paying for frauds.]

“Much has been said of the criminal cases against WellMed that made headlines in June this year. We are not allowing this to happen again. We are now imposing more stringent if not uncompromising actions at the slightest sign of fraud,” he added.

Last October 21, PHAPi published an open letter addressed to Morales, saying that some of its members might not renew their accreditation with the state health insurance agency next year. Around 600 hospitals were members of the said organization.

The open letter, signed by its president, Dr.Rustico Jimenez stated that many of its members have yet to receive their reimbursements, while the accreditation of some hospitals in Mindanao have been withdrawn by PhilHealth due to pending cases, arguing that they were not “given the opportunity to be heard in a formal hearing.”