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PhilHealth debt at P26B

Republika

Hospitals who have not received payment from state health insurer PhilHealth may have to close reduce their capacity for Covid19 cases or close down totally, according to Sen. Imee Marcos earlier this week.


According to the lawmaker, PhilHealth has an outstanding balance of P26 billion that are due to private hospitals as wells as debts to government hospitals in the range of hundreds of thousands. In response, the insurer said it had released P6.3 billion through the Debit Credit Payment Method (DCPM), a new system of settling hospital claims.


However, Marcos said that the DCPM did not include last year’s unpaid claims for Covid19 treatments. “Nor was the DCPM fully settling the 60% of hospital claims for reimbursement as directed in the government agency’s own circulars in April and May,” she added, citing a private hospital that was only paid back P430 million of P1.2 billion that it was claiming.

“[W]hich is 60% of 60%–in effect, only 36%–of what PhilHealth said it would pay through the DCPM.”


Government hospitals are also experiencing the same. The Philippine General Hospital has only received P2.56 million (0.0042%) of a P615.7 million claim; Lung Center of the Philippines was only paid 40% of its claims, leaving a P304-million balance; while the Philippine Heart Center was only paid P99.47 million (49%), leaving a balance of over P100 million.


The Private Hospitals Association of the Philippines (PHAPi), with 700 members, said that a fear of retaliation is further delaying their PhilHealth reimbursements, as many private hospitals are reluctant to be more vocal and risk waiting longer for payment.


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