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PhilHealth calls claims it owes private hospitals billions ‘overly bloated,’ ‘erroneous’

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ABS-CBN News

MANILA—PhilHealth on Saturday rejected allegations by an official representing private hospitals in the country that the government corporation owes them billions.<ul class="op-related-articles">	<li><a href="http://news.abs-cbn.com/news/05/08/18/philhealth-owes-billions-to-private-hospitals-exec">PhilHealth owes billions to private hospitals - exec</a></li></ul>In a statement, PhilHealth said it owes only P183.2 million, not &quot;P7 billion to P9 billion&quot; in unpaid claims as alleged by Dr. Rustico Jimenez, president of the Private Hospital Association of the Philippines Inc. (PHAPI).&quot;Summing up PhilHealth’s payments of P3.75 billion and another P50.85 million in impending payments for &#x27;in process&#x27; claims on record, less those already denied payments and returned-to-hospital claims (7,602 + 10,714 claims = 18,316 claims x P10,000 Average Value Per Claim = P183.2 million) quickly gives us an idea how overly bloated PHAPI’s claims are against the state health insurance agency,&quot; it said.&quot;In summary, our initial data analytics shows that the allegations of Dr. Jimenez on the alleged unpaid claims are erroneous and inaccurate.&quot;It said it will reach out to PHAPI to resolve the matter.PhilHealth also denied Jimenez&#x27;s allegation that the agency&#x27;s debt ballooned after it ordered hospitals to apply for reimbursement claims through an online portal.&quot;Contrary to Dr. Jimenez’s assertion that PhilHealth is delayed in paying their member-hospitals due to the implementation of the e-Claims system in 2017, our Corporate Dashboard shows that we are paying hospital claims at an average of 50 days nationwide, with the shortest average claims processing time at 38 days for those submitted through third party solutions providers under the new system being criticized by the PHAPI,&quot; it said.&quot;By law, PhilHealth has 60 calendar days to process and pay hospital claims.&quot;The agency, meanwhile, said it will form a task force to review and expedite payments of unpaid claims.It added that it will also create a &quot;reconciliation portal&quot; for its partner hospitals, which will provide them the status of their claims.PhilHealth said it will look into the claims data of all its accredited facilities in the public and private sectors &quot;to see if there are weak areas that we need to improve on, and other areas as well to continue building our strengths on.&quot;PhilHealth also urged its hospital partners to go to its regional and local health insurance offices to check on its claims.

PhilHealth says it owes only P183.2 million, not "P7 billion to P9 billion" in unpaid claims as alleged by an official representing private hospitals in the country.

PhilHealth says it owes only P183.2 million, not "P7 billion to P9 billion" in unpaid claims as alleged by an official representing private hospitals in the country.