The PhilHealth local office on Mother Ignacia Street, Quezon City. Photo taken on June 7, 2019. Mark Demayo, ABS-CBN News/File

MANILA — A lawmaker again grilled officials of the Philippine Health Insurance Corp over the agency's delays in paying hospitals, which reportedly caused some medical establishments to shut down completely.   

Batangas 2nd District Rep. Gerville Luistro expressed concern over the "huge" amount of unpaid claims, which she said has reached P59.6 billion.

Luistro said she there are reports of hospitals that have stopped services or had fully closed because PhilHealth had yet to pay their claims due to strict documentary requirements.

"I feel disturbed that the purpose of our UHC [Universal Healthcare Law] is being defeated by the issues of documentary requirements and minor discrepancies when these are legitimate claims I would like to believe," she said.

Luistro said a private hospital in her hometown of Mabini, Batangas closed down supposedly because of unpaid PhilHealth claims.

"Nakasandal ang iba sa claims. If they will be suffering delay from payment of claims, chances are baka ma-derail ang services like certain hospitals," she explained.

PhilHealth Senior Vice President for Fund Management Renato Limsiaco Jr. meanwhile said the state health insurer's turnaround time for processing claims has already improved to an average of 23.4 days in 2024 from 41 days in 2018.

PhilHealth President and CEO Emmanuel Ledesma Jr. said they have been engaging hospitals for claims reconciliation, and have a project to improve claims processing to minimize the number of denied and deficient or return-to-hospital claims.

AMNESTY BILL

A lawmaker has filed a bill seeking to grant amnesty for pending cases involving hospitals and healthcare providers and payment of denied claims due to late filing. 

AGRI Party-list Rep. Wilbert Lee said he filed House Bill No. 11298 last Wednesday amid the large number of hospitals that have been blacklisted by the PhilHealth or which have shut down supposedly due to late payments.

"Dito sa amnesty na finile natin, maraming kasama dito. Una sa lahat yung mga denied claims due to late submission. Ibig sabihin, bayaran na po ang ospital dito. Pangalawa, ito pong mga return to hospital claims dahil sa mga discrepancy tulad ng nagkamali lang sa pangalan," he said.

"Nilalaban natin itaas yung mga benepisyo, itaas yung mga coverage. Eh kung wala namang mga ospital, ano mangyayari?" Lee added.