BAGUIO CITY – The City Council approved a resolution requesting the Philippine Health Insurance Corporation (PHIC) to fastrack the processing of the payment of its over P100 million unsettled obligations with different private and public hospitals in Baguio City and the Cordillera to ensure the delivery of quality health services to all the patients seeking medical attention from the said health facilities.
Further, the resolution also requested the PHIC to conduct a massive information education campaign among the management staff of the different private and public hospitals on the insurance corporation’s e-claims program for them to know how to comply with the terms and conditions of the system for payment of claims from the patients using the benefits of their membership to the corporation.
Based on the revelation of a number of administrators of private hospitals in the city, their unpaid claims from the health benefits of patients is roughly over P100 million dating back to as early as the first quarter of this year.
Sister Maria Teresa Pareño, administrator of the Notre Dame de Chartres hospital, reports the health insurance corporation owes the hospital over P63 million in unpaid claims over the past several months, while the accumulated unpaid claims of PHIC to the Pines City Doctors hospital reached over P50 million based on the revelation of Ms. Teresita Gapus.
For the Saint Louis University (SLU) Hospital of the Sacred Heart, lawyer Rodolfo Soriano, who represents the hospital management, claimed their unpaid claims reached over P50 million over the past several months primarily because of the delayed payments due to the alleged denial of claims entered through the e-claims system.
All the private hospital administrators informed members of the city’s local legislative body that since the implementation of the corporation’s e-claims system, payments of their unpaid claims have significantly decreased and also resulted to the denial of some of the claims, making them wait for a longer period of time for these accounts to be paid as they need to appeal the denied claims to the PHIC central office which takes some time in ruling on these claims.
The administrators also admitted that a huge part of their operational budget has been significantly affected by these delays in the settlement accumulated unpaid claims by the PHIC but the hospitals still continue to operate using other alternative sources of income just to make sure that quality health care services is provided to their patients.
Lawyer Jerry Ibay, PHIC-CAR regional vice president, assured local legislators and hospital administrators that efforts are being done to fastrack the settlement of unpaid claims but he emphasized the need for all hospitals to comply with the terms and conditions of the corporation’s e-claims system because manual enrolment and application of claims is no longer allowed aside from the fact that hospitals were given sufficient grace period to comply with lacking requirements in their enrollment in the e-claims system of payment adopted to guarantee the prevention of overlapping claims of benefits from the corporation.
By Dexter A. See