Hospitals hit difficulty in processing PhilHealth claims

MANILA, Philippines — Private hospitals have lamented what they described as “costly and time-consuming” requirements set by the Philippine Health Insurance Corp. in processing reimbursements for claims earlier denied by PhilHealth.

The Private Hospitals Association of the Philippines Inc. (PHAPI) said that although they welcomed the move of the state health insurer to compensate claims that were earlier denied, it would be difficult for hospitals to comply with the requirements.

“We appreciate the fact that claims dating back from 2018 that were denied due to late filing will finally be paid. However, some hospitals said that obtaining requirements is difficult,” PHAPI president Jose Rene de Grano said.

“The process is tedious and will cost the hospital additional expenses, manpower and time,” he added.

He said the information required is already with PhilHealth, but hospitals are still required to refile the data.

De Grano cited small hospitals that have five claims per month consisting of at least 10 pages per chart.

“For one year, that is 600 pages. From 2018 to 2024, that is seven years. That will be 4,200 pages, or 8.5 reams of paper for just a small hospital,” he noted.

“Can you imagine those documents written not just in plain sheets of paper. Scanning 4,200 pages would require much time,” he said.

Earlier, PhilHealth announced that it would reimburse P8.8 billion worth of hospital claims previously denied for late filing.