Review of dubious claims delays PhilHealth payments

MANILA, Philippines - Amid complaints over delays in the release of payments to doctors and hospitals, the Philippine Health Insurance Corp. (PhilHealth) said yesterday that all claim documents undergo a thorough scrutiny.

“As stewards of the premium contribution of our members, it is our duty to protect the funds and ensure that only those claims that must be paid are indeed paid for,” PhilHealth president Dr. Rey Aquino said in a letter to The STAR.

From January to April this year, PhilHealth has some 717 pending cases in various stages of legal process like extending period of confinement, filing claims for unconfined patients, and breach of warranties of accreditation.

Last week, Private Hospitals Association of the Philippines (PHAP) president Dr. Rustico Jimenez complained that it usually takes PhilHealth six months to process the reimbursements of doctors and hospitals.

Jimenez said PhilHealth also owes around 60 PHAP hospitals in Central Luzon, Ilocos and Central Visayas region some P1 billion in unpaid claims.