PhilHealth, hospitals to reconcile unpaid claims

THE Philippine Health Insurance Corp. ( PhilHealth) and the Private Hospital Association of the Philippines ( PHAPI) on Friday agreed to settle their dispute over billions in allegedly unpaid hospital claims.

This was after Rustico Jimenez, president of PHAPI, warned that some hospitals might shut down because of the failure of PhilHealth to pay its supposed debts worth P7 billion to P9 billion to over 60 hospitals in the country.

“We would like to inform the public that the PHAPI and PhilHealth have acknowledged the concerns of hospitals in some regions over the perceived delay and non-payment of their claims filed for their services that they have rendered to PhilHealth members and patients,” PHAPI and PhilHealth said in a joint statement.

The two sides agreed to address the issue by identifying paid claims, claims in process, and claims that have not been denied and not fit for payment, among others.

They also agreed to launch an electronic portal “to continuously update hospitals of their claims profile which will help avoid the recurrence of the problem,” and meet on a weekly basis “to see developments of reconciliation activities on the ground.”

“We hereby assure all accredited health care institutions, our members, their families, the government and the general public that we will both exert all efforts to put this issue to an end,” PhilHealth and PHAPI said.

The statement was signed by Jimenez and PhilHealth interim president Celestina de la Serna.