Metro Manila (CNN Philippines, January 26) — State health insurer PhilHealth has acknowledged there has been a slight delay in the processing and release of claims, and has offered causes behind it.
Among the reasons PhilHealth President and Chief Executive Officer Dante Gierran cited are healthcare providers who hand over applications with deficiencies.
“In effect, not all claims are good claims kasi kulang ang signature, kulang ang data [they lack signature, they lack data], these are one of the causes, noh,” Gierran said during the Palace’s regular virtual presser.
PhilHealth then has to return the concerned applications to the healthcare providers, effectively causing a delay in the process, the official explained.
Gierran also admitted lapses in PhilHealth’s IT system.
“Medyo kulang pa rin tayo, kasi kung napakaganda ng IT natin sana, mabilis ang pagbayad,” he said.
[Translation: We are still lacking in this aspect. If our IT (system) was very good, payments would have been faster.]
PhilHealth’s IT system has previously been under scrutiny amid alleged irregularities in the agency, with the Presidential Anti-Corruption Commission flagging its lack of validation mechanism. The Commission said this makes it vulnerable to fraud committed by hospitals and employees.
The reasons Gierran mentioned come atop of the COVID-19 pandemic, which he emphasized has been affecting everyone, particularly their mobility. This, he initially noted, has been affecting other government offices as well.
PhilHealth was slated to implement an increase in member contributions this 2021, but President Rodrigo Duterte ordered its postponement early January. Gierran said the contributions rendered prior to the hike’s delay will be considered as advance payments on the members’ end.
The PhilHealth chief also assured the public it has sufficient funds for the year, and that the liquidation of the allegedly missing ₱15 billion funds is already close to completion.
