PhilHealth assures continuous communication with hospitals to settle unpaid claims

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Metro Manila (CNN Philippines, March 31) — The Philippine Health Insurance Corporation said on Wednesday that it is continuously coordinating with hospitals to settle their billions of unsettled debts.

Talagang may mga utang kami sa mga hospitals, private o government. As a matter of fact, lagi na kaming nagu-usap kasi itong mga utang na ito, matagal na iyong iba,” PhilHealth President Dante Gierran said during the Laging Handa briefing.

[Translation: We really have debts to hospitals, private or public. As a matter of fact, we are always talking to them because these are already from a long-time ago.]

He noted that in 2020, total claims reached ₱107 billion, but around 85% of that was already paid, while some were denied or returned. The remaining ones are still being processes, he added.

Gierran explained that they are continuously exerting efforts to pay their obligations, but the COVID-19 pandemic is causing the slow processing of claims since the agency has to operate on a limited workforce to prevent the transmission of the virus among their personnel.

“We admit, we accept that we have obligations and all of them are being processed,” he said, adding that they will again meet with a hospital group to settle the issue on reimbursement claims.

Earlier, a private hospitals group said they are seeking a dialogue with the state insurer to discuss the reimbursement of their claims amid the spike in COVID-19 cases. 

Private Hospitals Association of the Philippines President Jose Rene de Grano said on Tuesday that it would be better to have a reconciliation between their members and the state insurer to know what really are the gaps regarding the settlement of the latter’s ₱6 billion debt to them.

Solving the matter will be also helpful for them in replenishing funds to ensure unhampered operations amid rising number of infections, he noted.

In an interview with CNN Philippines, PhilHealth spokesman Rey Baleña assured that they are continuously processing clams as they come and that they are willing to coordinate with the group.