Philippines: 600 private hospitals threaten to cut ties with PhilHealth over unpaid claims

Around 600 members of the Private Hospitals Association of the Philippines Inc. (PHAPi) threatened that they will not renew their PhilHealth accreditation in 2020 due to unpaid claims amounting to billions of pesos.

According to Maki Pulido’s Monday report on 24 Oras, PhilHealth owes PHAPi around P2.5 billion in reimbursements.

“It’s very risky na accredited ka nga, bigay ka nang bigay ng serbisyo [pero] at the end of the day hindi ka naman babayaran. So where will you get funds?” PHAPi President Dr. Rustico Jimenez said.

On Monday, PHAPi published an open letter to PhilHealth president and chief executive officer Ricardo Morales in a newspaper that cited incidents where the state health insurer withdrew the accreditation of some hospitals for unclear reasons.

“The Association could not understand why the respondent hospitals are not given the opportunity to be heard in a formal hearing,” the letter read.

PHAPi also said there have been cases where claims are marked “Return to Hospital” for unspecified reasons.

“We are afraid that because of these developments, many of our members are alarmed that they may experience the same fate and are now signifying their intention not to renew their accreditation for the next year,” the association added.

However, Morales said they have already paid around P75 million in claims as of August this year.

“Some hospitals have difficulty in processing the forms; it has something to do with the information system. We’re trying to computerize, but we are resolving that. As a matter of fact, as of August we have paid around P75 million,” he said.

The PhilHealth chief also warned PHAPi that they will force patients to “pay out of pocket” if they refuse to apply for accreditation next year.

“Magiging mabigat financially for the patients. Both sides ang talo dito,” he said.

While Morales said PhilHealth will not speak with PHAPi, he said they are open to speaking to the hospitals individually. —Julia Mari Ornedo/LDF, GMA News