PhilHealth-6 denies delaying settlement of claims

ILOILO City – As far as the “payment of good claims within the time provided by law” is concerned, it has not been remiss, according to the Philippine Health Insurance Corp. (PhilHealth) in Western Visayas.

The regional office issued an official statement on Aug. 26 a day after Mayor Jerry Treñas mulled legal action against officials of PhilHealth in Region 6 over the unpaid claims of nine hospitals and the city government-run molecular laboratory.

But according to Atty. Valerie Anne Hollero, PhilHealth regional vice president, they have “processed the most number of claims among regions”.

So far this year, a total of 591,148 claims were processed, she stressed.

Hollero also emphasized that PhilHealth-6’s average Turn-Around Time (TAT) for payment of “good claims” is 27 days from the time it is filed by the healthcare institutions (HCIs), making it the “second fastest” among all regions in terms of TAT.

PhilHealth-6 considers “the HCIs as partners and strives to pay the claims as soon as possible”, balancing this with their duty to protect public funds, Hollero added.

Treñas last week instructed the City Legal Office to study the filing of criminal and administrative complaints against the state insurer.

He said complaints against PhilHealth may be filed with the Office of Ombudsman and the Anti-Red Tape Council.

The non-payment of claims is preventing hospitals from adding more beds for moderate and severe cases of coronavirus disease 2019 (COVID-19), he lamented.

“We can no longer keep track of how many times we have sent communications and conducted meetings with PhilHealth representatives,” said Treñas.

On Aug. 24, the mayor once again wrote the secretaries of Health, Local Government, National Task Force Against COVID-19, and the Inter-Agency Task Force for the Management of Emerging Infectious Diseases about the “extremely delayed settlement of charges”.

The hospitals and their unpaid PhilHealth claims were the following:

* The Medical City Iloilo – P88.052 million

* West Visayas State University Medical Center – P49. 998 million

* Metro Iloilo Hospital and Medical Center – P190.756 million

* QualiMed Hospital – P30.393 million

* Iloilo Doctor’s Hospital – P58.114 million

* St. Paul’s Hospital Iloilo – P95.205 million

* Western Visayas Medical Center – P112.714 million

* Iloilo Mission Hospital – P99.645 million

The Medicus Medical Center also has unpaid claims with PhilHealth (for updating yet) while the Uswag Molecular Laboratory has P207.441 million./PN

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