The Anti-Red Tape Authority (ARTA) has reiterated its call for the Philippine Health Insurance Corporation (PhilHealth) to actively find solutions to address the backlog in the payment of coronavirus disease (COVID-19) claims, reminding them that the pandemic was not an excuse for delays.
ARTA Director-General Jeremiah Belgica made the statement as PhilHealth drew flak for the delays in its payment of COVID-19 reimbursement claims from both public and private hospitals.
In a meeting with PhilHealth's top management officials and regional directors and private stakeholders last this week, Belgica reminded PhilHealth officials to strictly observe their 60-day period to liquidate its cash advances to the Commission on Audit (COA) after distribution to regional hospitals and offices. This is in accordance with a special law of the state insurer.
Some PhilHealth officials claimed that prior to the pandemic, they could process claims within 40 days. However, their backlog began to accumulate after parts of the country were placed under lockdown at the onset of the COVID-19 pandemic.
The ARTA chief added that while he could sympathize with PhilHealth for its difficult work, they must also actively find solutions to move forward and ensure that their agency remains at full operational output capacity even during a global health crisis.
"Lahat tayo ay nasa pandemya. Matagal na tayong nandito. Hanggang kailan natin gagamitin na rason 'yan (We are all under the pandemic. It's been a while. Until when we will use it as an excuse)?" he said.
"Kailangan hanapan natin ng solusyon ito, otherwise, 'yung private hospitals ang siyang titirik (We need to find a solution, otherwise, our private hospitals will be at a standstill)... I think we're looking for a solution moving forward," he added.
Belgica reiterated that there should be "lasting solutions" to allow the agency to process claims much faster.
"What we want here siguro (perhaps) is more lasting solutions para makita po natin, para mas matulungan ang PhilHealth para mapabilis ang processing (so we can help PhilHealth expedite the processing of claims)," he said.
In a House hearing on the state insurer's unpaid hospital claims last week, PhilHealth President and CEO Dante Gierran admitted that the agency owes hospitals a total of P21.1 billion worth of unpaid claims.
Belgica said they will continue to closely monitor PhilHealth to ensure that they are acting upon President Duterte's directives.
Duterte has again ordered PhilHealth to pay for the COVID-19 reimbursement claims of hospitals, especially those that are struggling amid the pandemic.
Last week, ARTA identified three reasons behind PhilHealth's delayed payment of claims. These included issues with PhilHealth's Information and Communications Technology (ICT), wrong diagnoses and faulty documentation in its Return-to-Hospital (RTH) applications, and Medical Prepayment Review (MPR).
The agency likewise found that PhilHealth continues to struggle with its lack of manpower amid the pandemic, a common problem among government agencies.