The Philippine Health Insurance Corp. (PhilHealth) on Tuesday, Jan. 11, pledged to settle all the unpaid claims of private hospitals within six months amid threats of some medical facilities to disengage with the state-run corporation.
During a House Committee on Health hearing presided by Quezon Rep. Helen Tan, PhilHealth president and chief executive officer Dante Gierran said the corporation will already process the P25.45 billion unpaid claims.
"We have to pay this in six months time," he said.
This came after several hospitals threatened to disengage with the state-run insurance company by no longer lending money to PhilHealth and instead directly collecting payment from patients.
According to Eli Dino Santos, PhilHealth's executive vice president and chief operations officer, the said amount is due for payment to hospitals through its Debit-Credit Payment Method (DCPM), a mechanism adopted by PhilHealth to facilitate the settlement of accounts payable to Health Care Facilities (HCFs) during the State of Public Health Emergency due to COVID-19 to ensure continuous delivery of health care services.
Santos said Gierran already instructed its regional conciliation and mediation branches to closely and daily coordinate with its partner hospitals regarding the updates on the status of claims reimbursements and immediately address their concerns.
PhilHealth said the DCPM will allow the speedy release of funds to qualified hospitals nationwide that have signified intention to avail of the new payment mechanism while PhilHealth processed their claims.
Currently, the state-run corporation has released three waves of payments, amounting to P12.06 billion under the DCPM.
During the hearing, Gierran blamed the lack of manpower and information technology (IT) concerns on the part of PhilHeallth for causing the delay in settling the claims of its partner hospitals.
Thus, Marikina Rep. Stella Quimbo proposed House Bill 7429 or the Social Health Insurance Crisis Act of 2020 in a bid to give the President the power to revamp and reorganize any or all segments of PhilHealth in order to make them more effective, efficient and innovative in the provision of social health insurance.
If passed into law, the measure will create a joint Executive-Legislative Social Health Insurance Crisis Commission from the private sector to be tasked to carry out all steps necessary towards the reorganization of PhilHealth.
The bill was opposed by Gierran by citing there is already a mandate under the Universal Health Care Act to ensure operational efficiency of government-owned corporations.