MANILA, Philippines – The Philippine Health Insurance Corporation (PhilHealth) on Tuesday, May 29, suggested the creation of an online portal that will consolidate all unpaid claims of hospitals.
PhilHealth argued that not all hospitals registered under the Private Hospitals Association of The Philippines Incorporated (PHAPI) are validated. Also, the agency said lapses in accounting and errors in the system of releasing claims are highly possible that’s why many hospitals remain unpaid for the services they have rendered to PhilHealth members.
PhilHealth and PHAPI on Friday, May 25, examined the details of all allegedly unpaid hospital claims and the figure reached P700 million. It was also discovered that their respective records do not match.
“Mayroon kaming mga bayad na pero as per their record hindi pa rin nababayaran. So baka kailangan talaga ng reconciliation on the data,” said Dr. Israel Francis Pargas, PhilHealth’s head executive assistant.
The online portal, which is likely to begin operation in June, will be installed in all PhilHealth accredited hospitals in the country.
“Automatic na iyon, they can see already and they can check the status of the claims that they have filed,” Pargas explained.
Health Secretary Francisco Duque III supports the proposal saying it is in line with the Health Information Data Analytics System that the Department of Health (DOH) wants to improve together with their partner agencies.
“So that the issues on the pending claims are addressed more systematically,” Duque said.
However, PHAPI said the portal may still be ineffective in some hospitals especially those without internet access. For now, the group said they will have regular meetings with PhilHealth to check and verify all unpaid health benefits.
“Basta ang usapan namin kailangan within 60 days babayaran nila iyong hindi fraudulent claims,” said Dr. Rustico Jimenez, President of PHAPI.
PHAPI also decided to suspend hospital holidays over the issue. — Aiko Miguel / Marje Pelayo