Baleña belies PhilHealth remiss in paying hospitals

The Philippine Health Insurance Corporation, or PhilHealth, yesterday maintained payments had been made totaling P32.3 billion to its private and public hospital partners.

Acting PhilHealth VP for Corporate Affairs Rey T. Baleña issued the statement issued the statement in response to a threat by several private hospitals across the country to cut ties with PhilHealth over its alleged failure to settle its outstanding debts amounting to P27 billion.

In an interview with DAILY TRIBUNE, Private Hospitals Association of the Philippines Inc. president Dr. Rene de Grano said they will make a final decision by January, which is the last month for health facilities to receive PhilHealth accreditation.

"We will have to meet with our members because like before when we planned to disengage, the patients are the ones who will suffer," De Grano said.

Baleña assured the group that PhilHealth would reach out to them to thoroughly address the issues.

"Total payments made until 25 November is at P32.3 billion already. These are payments to both government and private hospitals. We are returning to the average of P2.5 billion payments made every week," the PhilHealth executive said.

He called on PhilHealth's partner hospitals to coordinate with its regional offices to reconcile their claims records accurately.

"This reconciliation (of data) is important to put things into proper perspective because there are claims we return or deny. These should not be included among their receivables unless these are refiled and or appealed," Baleña said.

De Grano said their group will meet their members like before when they planned to disengage as "the patients are the ones who will suffer."

"We have to think about what we will do. We have to plan it well. It is not just a simple thing to do because right now, the accreditation period has started up to I think the end of January," he added.

He said that some hospitals were already thinking of disengaging from PhilHealth until its debts were fully paid. De Grano claimed that private hospitals had not received any payments for unpaid claims from the state-run health insurer.

"The truth is we have not received anything, we have not received anything. We're giving them until the end of the year," De Grano told TRIBUNE.

In October, PhilHealth president and CEO Emmanuel R. Ledesma said they had settled at least P20 billion of their P27 billion debt to health facilities.

"It's been roughly 30 days since we made the announcement and already 76 percent has been paid," Ledesma had told reporters in a press briefing.

"Clearly, we are on track. We will probably be able to complete it ahead of time," he added, referring to the commitment he made before lawmakers that the state-run health insurer would settle "a bulk or majority" of its P27 billion unpaid claims to various hospitals within 90 days.

PhilHealth previously said it would utilize its Debit-Credit Payment Method to accelerate the payment of unpaid hospital claims.

'Useless'

"Hopefully, it will work but it should be 100 percent and not 80 to 20 or 60 to 40 percent because this is nonsense," De Grano said.

"It is useless because it is like you are giving us 80 percent of P100 million but without an attachment," he added.