PhilHealth, private hospitals group agree to work together in resolving claims row – Go

Published October 25, 2019, 12:22 PM

by Francine Ciasico

By Mario Casayuran 

The Philippine Health Insurance Corporation (PhilHealth) and the Private Hospitals Association of the Philippines Inc. (PHAPI) have committed to work together in reconciling outstanding claims of private hospitals, as well as in cracking down on alleged fraudulent claims.

Senator Christopher Lawrence “Bong” Go (Photo from Bong Go / Facebook / MANILA BULLETIN)
Senator Christopher Lawrence “Bong” Go (Photo from Bong Go / Facebook / MANILA BULLETIN)

 

This came after officials of these two agencies met Thursday night in an undisclosed place based on the request of Senator Christopher Lawrence ‘’Bong’’ Go that they sit down and settle alleged ‘’sham’’ claims of some hospitals in their treatment of PhilHealth members.

He told PhilHealth President General Ricardo Morales and Rustico Jimenez, PHAPI president, that his communication lines remain open to help in the early resolution of the row.

Some PHAP hospital-members have reportedly threatened to leave PhilHealth coverage.

Go informed Senate reporters that the holding of the meeting was aimed at reconciling outstanding claims of private hospitals, as well as in cracking down on alleged fraudulent claims.

“Naiintindihan ko mga hospital na dapat sila mabayaran. Ang concern ko lang dapat hindi mapabayaan ang mga pasyente. Dapat hindi ma-hamper ang serbisyo,” Go said. (I understand that private hospitals have to be paid. My concern is that patients should not be victims of this PhilHealth-PHAP row.

On the part of PhilHealth, it explained that the management wanted to make sure the outstanding claims were not denied or fraudulent claims. They appealed for cooperation from private hospitals in order to settle outstanding accounts.

The leadership of PhilHealth also assured private hospitals that it will be ready to hear their concerns.

PhilHealth will have their regional office officials sit down with the management of various hospitals to reconcile the claims, it said.

PhilHealth also noted that they would conduct quarterly regional “reach-out” forums wherein hospitals are invited to raise their issues and concerns, it added.

Go, for his part, reiterated that it was important to ensure that funds of PhilHealth are not wasted and are utilized properly to benefit patients in need of medical attention.

Go, Senate health committee chairman, said failure of the two groups to settle their differences might force him to call them to appear before the committee and explain their side in a public hearing.

Go said he had called Morales to settle the financial claims of private hospitals.

‘’And last month ako ang nag arrange ang meeting between Rustico Jimenez and General Morales at nagkasundo na aayusin angd apat ayusin babayaran ang dapat bayaran,’’ Go said. (Last month, I arranged a meeting between Morales and Jimenez. Morales said he would settle the payment claims of hospitals.

Go said there is no truth to reports that some PHAP members would pull out of PhilHealth.

 
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