Private hospitals said Monday they are set to sever ties with the Philippine Health Insurance Corp. (PhilHealth) by the second week of November, after the state-owned insurance company missed its October deadline to make good on P20 billion worth of unpaid claims.
“As early as August, they owed us more or less P20 billion, and this is all over the country,” said Jose Rene de Grano, president of the Private Hospitals Association of the Philippines, Inc (PHAPi), which has about 700 member-hospitals.
“And it’s continuous. Let’s say that they are saying they paid P10 billion already, then where are these payments?” De Grano said, noting that some hospitals are reporting they have yet to receive any payments from PhilHealth.
He said some hospitals will be announcing their plans for 2022 by mid-November, a few weeks after the October deadline given to the agency.
Though PhilHealth had been paying recent claims of private hospitals, the agency has yet to pay for claims of COVID-19 cases in 2020, De Grano said.
The PHAPi president said some hospitals were forced to downsize to continue operating amid the agency’s non-payment of claims.
“What hospitals do is they downsize, they reduce working hours, just so operations will continue,” he said.
For months, hospitals have been consulting with their members on whether to sever their affiliation with PhilHealth.
De Grano said some hospitals in Iloilo, General Santos City, Cagayan Valley, and the National Capital Region have already signified their intention to break ties with PhilHealth.
“By this week, next week, or another two weeks, some hospitals will be announcing… what they plan to do in 2022 on whether.. to renew or stop accreditation with PhilHealth,” he added.
In October, De Grano said an estimated 5 percent to 10 percent of nurses in private hospitals in the country have left their jobs in the last two to three weeks.
“What we are doing in hospitals now is, of course, we are looking for replacements for our registered nurses. We are training under-board nurses, we are training nursing attendants,” he said.
De Grano said they are also urging nurses and health care workers to stay in the country.
“Of course, we are also trying to give them the best salary offer that we can give, but we can’t match the big offers of foreign companies or foreign hospitals,” he said.
In a Senate hearing earlier, the state insurer admitted to delays in processing of claims for COVID-19 cases. “We are so swamped with an increase in claims. Can you just imagine, in 2020, we had an average of daily claims of 31,000, and the average number of claims now is 39,000. Which means that is a job increase of 26 percent,” PhilHealth chief Dante Gierran had said.
PhilHealth is also facing a manpower shortage, he added.
“We blame it again on the pandemic because we have a limited locomotive, some of our people got sick, as matter of fact, some of our people even died. And we cannot tell everybody that we have this problem, but we are doing something about it,” Gierran said.
However, De Grano said those allegedly questionable claims being investigated by PhilHealth should not affect the reimbursement of unpaid dues to other hospitals, which they used for their day-to-day operations.