ARTA tells PhilHealth: streamline processes

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The Anti-Red Tape Authority (ARTA) urged the Philippine Health Insurance Corp. (PhilHealth) to streamline processes and then shift to automation to resolve the slow release of hospital claims.

In a statement, ARTA director-general Jeremiah Belgica reminded PhilHealth the agency can impose sanctions on those who will delay the processing of such financial claims.

Belgica made these statements at a dialogue last Monday between PhilHealth and Philippine Hospital Association (PHA) on the latter’s call for the timely reimbursement of their claims.

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“There seems to be a mounting request from the hospitals to reimburse immediately specifically those hospitals, the smaller ones that are really dying to continue their operations for their people,” Belgica said, noting this has been relayed to him during the recent meeting of the Inter-Agency Task Force (IATF) against COVID-19.

“Anyone who is holding up their processes whether unwittingly or with negligence will not be tolerated,”he added.

At the dialogue, PHA president Dr. Jaime Almora expressed support to a proposal to automate the filing of benefit claims to resolve the current problem.

But Belgica said PhilHealth’s processes must be streamlined first before shifting to full automation.

“ARTA have offices that help come up with more rational solution and in reengineering systems. One of the things that we encountered with other government agencies is that some would jump to automation without first seeing the most rational and simplified process. But we cannot automate without first removing redundancies and streamlining the process,” Belgica said.

Previously, ARTA had formed a special task force to monitor PhilHealth’s services in relation to the health insurer’s Citizen’s Charter and their streamlining efforts. ARTA had also asked PhilHealth to explain previous complaints for supposedly violating the Ease of Doing Business law.

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