Makati Med confident PhilHealth to settle arrears in reimbursement claims


Makati Medical Center (MMC), one of the country’s premier medical services facilities under the MPIC Group of businessman Manny Pangilinan, expressed confidence that PhilHealth will pay up arrears in reimbursement claims saying this has been among the major challenges the hospital faced during the pandemic. 

At the virtual “Innovations in Healthcare, Solution that Address a Post Covid Future”,  MMC Medical Director Dr. Saturnino Javier listed “PhilHealth reimbursements” as one of the challenges the hospital encountered during the March-April 2021COVID-19 surge. 

MMC President and CEO Atty. Pilar Nenuca P. Almira said that very recently PhilHealth had given them  advance funds in the amount of P230 million. 

Photo credit: https://www.facebook.com/IamMakatiMed/

But Almira noted that the funds were not to settle their claims for reimbursements that had been in arrears for the past years but to answer for future claims and subject for liquidation. 

Without divulging total arrears from PhilHealth and overall claims, Almira hopes that maybe this year 2021 and 2022 the government agency would be “able to pay even the accounts that have been in arrears for so long.”

In the meantime, Almira said they could only sympathize with PhilHealth following the controversy involving its management and leadership resulting in the shuffling of personnel and the resignation of leaders and some staff. The PhilHealth situation has affected the processing of claims submitted by hospitals to them. 

“Even up to now, we have quite a challenge in collecting from them,” she said. 

In addition, Almira said that PhilHealth admitted to them that they also were experiencing attrition, they have been losing their employees, and that their people are also adjusting on how to manage this processing of PhilHealth claims in view of their computerization. 

But, she said, PhilHealth is committed to pay up. 

Meantime, Javier said that other challenges faced by MMC during the March-April 2021 COVID-19 surge include manpower availability, COVID-19 bed capacity allocation, emergency room overflow, and case mix.

To address these challenges, Javier sad that MMC’s Human Resource department doubled efforts to hire more healthcare personnel and pursued vaccination efforts now at 98-99 percent vaccination rate of all staff. They also expanded COVID-19 beds capacity to 30 percent; conversion of 8 circular t negative pressure area, telemetry to critical care unit, cohorting of patients; and conversion of CPM male ward area to critical care unit, among others.

To address patient overflow, MMC put up “full capacity” signage but did not close its emergency department.

Part of the strategies is to build vaccine confidence by demonstrating the willingness of leaders and movers of the hospital to get vaccinated thereby creating a bandwagon effect as more individuals got inoculated, said Javier.

Since March 2020, MMC has seen more than 95,000 COVID-19 suspects with very low mortality cases.

“We see a decline in the number of COVID-19 cases in the Emergency Department as well as COVID-19 admissions daily. 

Javier said that the MMC’s key strategies against the COVID-19 surges is sustained preparedness and heightened readiness. 

“Despite massive surge, MMC posts excellent clinical outcomes,” he said.  MMC also continued its various corporate social responsibility programs, including vaccination efforts in Makati City.