Iloilo hospitals decide not to renew PhilHealth partnership in 2022

Seven private hospitals in Iloilo have decided not to renew their contracts with state-run Philippine Health Insurance Corp. (PhilHealth), citing some P545 million in delayed claims payments.

According to Katrina Son's Sunday "24 Oras Weekend" report, the hospitals that will not renew their contracts with PhilHealth in January 2022 are St. Paul’s Hospital, Iloilo Doctors Hospital, Iloilo Mission Hospital, The Medical City - Iloilo, Medicus Medical Center, Qualimed Hospital, Iloilo and Metro Iloilo Hospital and Medical Center Inc.

According to Private Hospital Association of the Philippines Inc. (PHAPI) Western Visayas Chapter President Elmer Pedragosa, hospitals have been waiting for the payments to be made, but have yet to receive the full amount.

“We waited for October 31 for payment. We were expecting like 70% to 80% to be paid by Philhealth, but we only got an average of 15% to 20% payment,” said Pedragosa.

With the non-renewal of the contracts, patients will have to process their claims and will have to pay in advance before they are reimbursed by PhilHealth.

Under its mandate, PhilHealth is tasked to administer the National Health Insurance Program which aims to provide health insurance coverage and ensure affordable, acceptable, available, and accessible health care services for all citizens of the Philippines.

PhilHealth Spokesperson Dr. Shirley Domingo said that among the unpaid claims are those involving COVID-19 cases, which takes time to validate.

“It’s the COVID claims that are delayed and we are already addressing the issue through our DCPM — debit credit payment [method]. Dati (Previously,) we were giving 60% of the amount of claims, good claims that are with us already, and we reconcile and then we give the remaining 40% if ever,” she said in the same report.

PhilHealth last month said it is seeking to settle unpaid claims to private hospitals by December, as it blamed the lack of manpower amid the COVID-19 pandemic. — Jon Viktor Cabuenas/DVM, GMA News