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LEAN workforce and not bankruptcy has been delaying the process of paying its billions of pesos in debt, says the Philippine Health Insurance Corp. (PhilHealth) on Friday.

At a Senate hearing, PhilHealth spokesperson Shirley Domingo also assured the public it has enough funds to cover the unpaid claims it owes to hospitals amid complaints over the state health insurer’s failure to make the necessary payment to its obligations.

PhilHealth reiterates its commitment to pay its obligations to its partner hospitals. It has sufficient funds to fulfill its obligations,” Domingo said as she read the statement issued by the agency.

Philippine Hospital Association president Dr. Jaime Almora said private and public hospitals were forced to use their savings and borrow from banks to sustain their operations due to PhilHealth’s alleged failure to pay the claims for COVID-19 cases since March 2020.

The huge amount of unpaid claims to the hospitals for COVID-19 cases, he added, has been causing severe financial distress to the medical institutions and healthcare facilities.

However, Domingo defended PhilHealth by saying that the delay in payment of claims was caused by the reduction of its workforce as some of their employees needed to be confined or put in isolation following exposure to COVID-19.

Nonetheless, PhilHealth said that being a public fund, safeguards are in place based on accounting and auditing rules and regulations prior to disbursements.

As of May 17, 2021, the state health insurer said it paid a total of P25.38 billion in claims, P4.88 billion of which are for COVID-19 related claims.

Recognizing the need of the hospitals for funds especially in highly critical areas for COVID as identified by the Inter-Agency Task Force (IATF) for the Management of Infectious Diseases, PhilHealth has introduced the Debit-Credit Payment Method  (DCPM) wherein 60 percent of good ‘in process claims’ are paid outright to qualified hospitals minus 2-percent withholding tax, while the remaining 40 percent shall  be paid after claims processing and reconciliation, minus 2-percent withholding tax,” the statement further reads.

The accelerated payment method provides hospitals sufficient cash flow to continue providing the sick with quality health care during the pandemic,” it added.

To date, PhilHealth has only managed to pay less than P6 billion in DCPM to 182 hospitals.

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