Malacañang on Wednesday urged hospitals to submit complete records as the Department of Health (DOH) and the Philippine Health Insurance Corp. (PhilHealth) continue processing claims, following reports of delayed reimbursements.
This, after the Commission on Audit warned that persistent deficiencies in the processing of over PHP1 billion Return-to-Hospital (RTH) claims could affect the financial stability and operational efficiency of DOH-retained hospitals.
In a press briefing, Palace Press Officer Clarie Castro said the DOH has been directed to organize and submit the necessary documentation.
“Sinabi po diyan na ayusin ang kanilang mga records at nakausap po natin mismo ang pamunuan ng DOH at iyan po ay kanilang inaayos at ibinibigay ang sapat na dokumento (They were instructed to organize their records. We have also spoken directly with the DOH leadership, and they are working on providing the necessary documents),” Castro said.
On delayed PhilHealth claims, Castro explained that hospitals have a 60-day period to submit supporting documents, but many fail to do so promptly.
Castro said claim delays have been linked to incomplete hospital documentation and procedural deadlines.
“At dahil dito po ay ipinag-utos din po ng Pangulo na i-extend po ang maaaring period para makapag-claim ang ibang ospital. Na-extend po ito up to 120 days, ito po iyong tinatawag na Claim’s Flexibility (The President has also ordered that the claims period for hospitals be extended up to 120 days. This is called Claim’s Flexibility),” she said.
Castro said the extension of the claims submission period to 120 days is intended to address delays while ensuring hospitals can still access reimbursements.
She stressed that the goal is for hospitals to submit complete documents on time to facilitate proper processing and payment of claims.
“Dahil dito po ay natutugunan po ng DOH, ng PhilHealth ang kanilang mga obligasyon (This ensures that DOH and PhilHealth can fulfill their obligations),” she said.
RTH claims are reimbursements filed by hospitals for covered services provided to PhilHealth members. (PNA)