Duterte directs PhilHealth to expedite claims payments

Published December 15, 2020, 5:55 PM by Genalyn Kabiling In a bid to promote more efficient public service, President Duterte has directed the Philippine Health Insurance Corporation (PhilHealth) to simplify and shorten the process of filing hospital claims amid concerns about the reported delays in payment. President Rodrigo Roa Duterte (TOTO LOZANO / PRESIDENTIAL PHOTO / FILE PHOTO / MANILA BULLETIN) The President wanted PhilHealth to hasten the process of availing benefits so the patient would not worry about the matter and instead focus on recovery, according to Presidential spokesman Harry Roque. The latest order was issued the President following the discussion on the reported delay in PhilHealth payment of claims made by health care providers during the Cabinet meeting Monday. PhilHealth officials were asked to explain the reason behind such delay in the meeting with the President and the Cabinet, Roque said. “My plea that this be simplified and yung magawa ng hospitals sila na, at yung sa facility kung maaari, — na lang sila. The ideal thing really, it’s almost near impossible but the ideal really is yung facility, yung pobreng Pilipino, I feel for the human being na pag-alis niya, pipirma na lang siya… really what should happen na pag galing na siya, di pirmahin lang siya (My plea that this be simplified and the hospitals, the facilities should address the matter. The ideal thing really, it’s almost near impossible, but the ideal really is the poor Filipino will simply sign a document before he leaves the hospital. I feel for the human being. Once he recovers, he should simply affix his signature),” Roque said, quoting the President during the Cabinet meeting. “And all of these things, can be compressed more so that it would not really — hardships on a Filipino who is sick and recuperating and have to do all of these things. Nakakaano sa, nakakasakit sa puso ‘yan (It’s heartbreaking). I feel for the human being,” Duterte said. At present, claims for payment of hospital service must be filed before PhilHealth within 60 days from the date of discharge of the patient. Such claims must then be acted upon within 60 days from receipt of PhilHealth. Roque said the PhilHealth must “reconfigure” the process as well as extend the deadline of filing claims based on the President’s directive. “Bagama’t mahaba po ang eksplanasyon ng PhilHealth, pinag-utos po ng Presidente ang pagpa-ikli at pag-reconfigure at pagsi-simplify ng mga requirements para sa settling ng claims (Even though PhilHealth made a lengthy explanation, the President ordered them to shorten, reconfigure and simplify the requirements for settling claims),” Roque said during a televised press briefing Tuesday. “Kasama rin ang pag-stretch ng limit ng late filing kasi kapag na-late filing po, hindi na nababayaran (Also ordered is the stretching of the limit of late filing because if there’s late filing, it is not immediately paid),” he said. He said the President wants the processing of hospital claims simplified “and just let the indigent patient signs so he will be able to go home after his treatment.” “Yung ideal po is to compress the process more and not bring more hardship to the sick and indigent Filipino patient and not have to worry about the process,” he added. He said PhilHealth president Dante Gierran promised to meet with the board to implement the President’s latest directive. On the investigation by the Department of Justice-led task force on the alleged anomalies in PhilHealth, Roque said a report has been submitted to the President. He said Justice Secretary Menardo Guevarra told the President about the planned filing of complaints before the Office of the Office against some PhilHealth officials and medical practitioners allegedly involved in irregularities.

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