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Manila Bulletin devider Philippines devider National devider PhilHealth warns public anew on health insurance fraud

PhilHealth warns public anew on health insurance fraud

Published Apr 30, 2021 01:17 pm

The Philippine Health Insurance Corporation (PhilHealth) advised health care providers not to engage in unethical acts such as upcasing of claims.

Philippine Health Insurance Corporation (PhilHealth) (MANILA BULLETIN)

In a statement, the PhilHealth said it received various reports relating to health care providers colluding with patients to declare minor respiratory symptoms as COVID-19 case for higher benefit reimbursements.

In view of the increase in reports of claims manipulation, the state health insurer urged patients and their families to directly report such illegal acts to PhilHealth.

The agency also called on the public to be vigilant of such acts and fully cooperate with PhilHealth by providing proofs to support the investigation.

“We call on the public to cooperate with us to immediately curtail these wrongdoings. We should protect the National Health Insurance fund, because it is a public fund, it is your money,“ PhilHealth President and Chief Executive Officer Dante Gierran said.

The state health insurance chief stressed that he will not tolerate deceitful practices made by some providers in order to take advantage of the uncertainties brought about by the pandemic.

“PhilHealth shall not hesitate to use full force of the law to those caught engaging in these illegal practices,” said Gierran.

PhilHealth has earlier initiated collaborations with the National Bureau of Investigation to detect, deter, and prosecute fraud committed by hospitals and professionals.

Reports pertaining to the said fraudulent acts, the state health insurer said, may be sent via email at [email protected]; [email protected]; and [email protected] or by mail addressed to the Office of the Corporate Secretary, Room 1711, 17th Floor Citystate Centre, 709 Shaw Blvd., Pasig City.

PhilHealth assured whistleblowers that complete confidentiality of reports as well as their protection will be given as provided by law.

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