By: Gerome Dalipe
MEMBERS of Philippine Health Insurance Corporation (PhilHealth) might be unable to avail of the services offered by the state-run healthcare provider next year.
This, as 733 members of the Private Hospitals Association of the Philippines, Inc. (PHAPI) threatened to hold back their accreditation for 2020 unless PhilHealth pays at least 80 percent of their claims.
Dr. Rustico Jimenez, PHAPI president, sent the advisory dated Nov. 25, 2019 to all the member hospitals regarding the matter.
The advisory was an offshoot of the “overwhelming response” of the PHAPI members during their meeting last Nov. 19, 2019.
The 733 private hospitals, which account for 44,700 hospital beds, agreed to hold in abeyance the renewal of their PhilHealth accreditation.
The hospitals have notified PhilHealth of their decision.
A hospital’s legal counsel, who requested anonymity, said the private hospitals came up with such decision because they were fed up with PhilHealth.
For instance, PhilHealth pays only 20 percent or less for a P5-million claim of the hospital.
“So many excuses for delay. Then, the latest strategy is to threaten filing of charges. It shows how poor our concern for health care is,” the lawyer said.
He said that all private hospitals and their employees are paying millions to PhilHealth.
“But it seems doubtful that PhilHealth can pay. What happened to the funds?” the lawyer asked.
He suspected the funds are being used during elections. PhilHealth officials and employees are also receiving high salaries, he added.
Apart from demanding the payment of 80 percent of claims on or before Dec.20, 2019, the private hospitals also asked PhilHealth to stop “baseless complaints under the guise of fraud” against hospitals.
PhilHealth should also agree that the fault of the doctor must not be the fault of the hospital.
Likewise, PhilHealth is asked to issue Certificate of Good Standing to hospitals applying for accreditation with the healthcare provider.
“At present because of the unpaid claims, private hospitals are barely surviving and are at risk
of being abandoned by their employees to look for other employment simply because their salaries are delayed or not paid at all,” the advisory read.
Some hospitals must obtain emergency loans just to be able to sustain their operations.
“But until when these hospitals can sustain their viability if PhilHealth persistently ignores their pleas under the guise that fraud could have been committed?” the advisory said.
But the private hospitals said they are open to have a dialogue with the PhilHealth officials.
“This is not to put PhilHealth down but simply a faithful manifestation of the state of affairs of private hospitals due to unpaid claims. PHAPI is willing to sit down with PhilHealth with these talking points on the table.”