Seven private hospitals based in Iloilo City threatened not to renew their accreditation with Philippine Health Insurance Corporation (PhilHealth) if their demands especially the payment for unpaid claims are not met.
Through a letter, these hospitals which include Iloilo Mission Hospital, St. Paul’s Hospital of Iloilo, Iloilo Doctors’ Hospital, Medicus Medical Center, The Medical City of Iloilo, Qualimed Hospital Iloilo, and the Metro Iloilo Hospital and Medical Center Inc., through their respective administrators and heads, expressed their concerns and called the attention of Health Secretary Francisco Duque III.
They specifically want the DOH to have actions on immediate reconciliation and payment of the payables by the end of October 2021 as well as immediate suspension of the policies for No co-payment and No-balance billing.
If these demands are not met, the hospitals said they will seriously consider taking some steps which include non-renewal of their accreditation with PhilHealth.
“We will still accept patients with PHIC accreditation but will not process PHIC collection and reimbursement. The patient will be given their statement of accounts and they will process their reimbursement with PHIC,” the group said.
They added that they will also charge co-payment and balance billing appropriately.
“We are already on a survival mode and the conditions worsen each day. Consequently, we have decided to take drastic but necessary actions for our own self-preservation and to enable us to provide better medical care to our patients,” they lamented.
Dr. Elmer Pedregosa, hospital administrator of Iloilo Mission Hospital and president of the Private Hospital Association of the Philippines-Western Visayas Chapter, noted that even before the pandemic, the delayed and unpaid claims were already a problem with PhilHealth which until now affects their operations and financial stability.
The group further lamented that their concerns on unpaid claims were compounded with the accusations of unfounded violations of PhilHealth circulars, subjected to a barrage of investigations, denials of claims that were submitted as far back as 2010, suspension or termination of payments without due process, and empty promises and assurances that our concerns will be addressed and our claims will be paid.
Furthermore, the group stressed that the imposition of no co-payment and no balance billing are very detrimental to the cash flow of the private hospitals as the patients’ expenses exceed more than what the PHIC covers.
They added that they have to deal with operating expenses, purchases of medical supplies and equipment, payment of utilities, and more importantly the salaries of nurses, medical technologists, hospitalists and other hospital staff who have been placed under tremendous stress and seemingly unending duress as they have been dealing with the pandemic and the daily influx of COVID 19 patients.
They further wept that the actuations of PhilHealth have caused a chilling effect on the hospital and the healthcare workers, most of whom are already demoralized if not downright depressed and exhausted. (Glenda Tayona)/WDJ