State insurer Philippine Health Insurance Corporation (PhilHealth) has but to reimburse greater than P500 million value of claims filed by specialty hospitals on account of lack of paperwork, the Commission on Audit (COA) mentioned Friday.
According to Joseph Morong’s “24 Oras” report, knowledge from the 2022 COA Audit Report confirmed a number of establishments together with the Lung Center of the Philippines (LCP), National Kidney and Transplant Institute (NKTI), Philippine Children’s Medical Center (PCMC), and the Philippine Heart Center (PHC) have but to obtain their reimbursement claims.
Of the determine, the LCP has the best claims of P542.9 million whereas the NKTI has additionally filed claims.
PhilHealth additionally denied over P60 million claims from some hospitals together with the PCMC with
Citing the LCP’s response, the COA report mentioned most of its return to hospital (RTH) claims had been swab assessments from 2020 to 2021 which it didn’t file earlier than the really useful 120 days.
However, PhilHealth has but to set pointers for the posting throughout the interval.
The NKTI mentioned it coordinated with PhilHealth whereas the PCMC mentioned its claims had been additionally for the swab assessments.
More than P100 million return to hospital claims of the PHC had been likewise denied by PhilHealth.
“If it is denied with finality, hindi na nila makukuha ‘yun. The RTH they have a chance to rectify the deficiency, to fix the problem at kapag naayos nila yun eh di submit to PhilHealth again, complete and we will pay,” PhilHealth spokesperson Dr. Albert Domingo mentioned.
Domingo additionally mentioned authorities hospitals ought to by no means cost the unpaid claims to sufferers, including they produce other means for funding.
“There’s the Department of Health medical assistance to indigents, basically yung Malasakit center, meron silang one stop na nandun lahat yung possible sources,” Domingo mentioned.
“Dapat no balance billing, hindi sila dapat binibigyan ng bill,” he added.
In 2022, PhilHealth paid claims value P1.30 billion. A bulk of it had been providers availed by the casual sector, senior residents, and the personal sector.
Domingo mentioned the state insurer has sufficient funds to cowl the reimbursement even regardless of the suspension of the slated improve for PhilHealth premium contributions below the Universal Healthcare Law.
“Tayo ay umaasa sa maayos na patakbo ng finances natin. Meaning, dapat may pumapasok na pera kasi magpapalabas,” mentioned Domingo.
“When the time comes, we will have to discuss, the urgent question na where will we get the money,” he mentioned.
Source: www.gmanetwork.com
