THE Private Hospitals Association of the Philippines, Inc. (PHAPI) yesterday said the decision of the Philippine Health Insurance Corporation (PhilHealth) to increase majority of its case rates could become a double-edged sword if it is not implemented properly.
In a phone interview, PHAPI president Dr. Jose De Grano said while they are happy that PhilHealth members stand to benefit more, they are equally concerned that claims may not be immediately reimbursed to hospitals.
“It is a double-edged (sword). It means the benefits of the members will be higher, but, at the same time, if they are not paid, our receivables will be bigger,” he said.
“The most important factor is that the claims are paid. Whatever the claims are, they must be paid so that the increase in benefits will really be felt by the members,” he added.
Asked how much is the current pending claim, he said, “Our estimate is between P7 billion to P10 billion more or less. It is a continuous process since they pay regularly but claims are also made daily.”
De Grano, though, expressed confidence in the leadership of PhilHealth president Emmanuel Ledesma Jr. and in the agency’s capability to properly implement the increases in the case rates.
“We think it’ll be okay because PCEO Ledesma talks to us (private hospitals). We hold a dialogue whenever there are issues,” he said.
Earlier, PhilHealth announced that the increase in the case rates of most of its benefit packages will take effect on February 14. Under PhilHealth Circular No. 2024-001, the state-run health insurer will adjust majority of its case rates by 30 percent.
According to De Grano, they were actually expecting a higher adjustment of case rates. — Gerard Naval
