PhilHealth-Davao belies 'unpaid claims' as reason for Davao del Sur hospital closure

SunStar Davao file
SunStar Davao file

STATE-OWNED Philippine Health Insurance Corporation (PhilHealth) in Davao Region belied claims of a health group that the unpaid claims resulted in the shutdown of a private hospital in Davao del Sur.

Lawyer Harvey Carcedo, Philhealth-Davao acting regional vice president, said in a virtual presser on Friday, September 10, 2021, that the closure of Dominican Hospital in Digos City was not due to the unpaid claims.

This was in response to the statement of the Private Hospital Association of the Philippines (PHAP), Philippine Medical Association and Private Hospitals Association, who threatened to “disengage” from PhilHealth over trust issues and unpaid claims.

The threat was made after Philhealth issued a circular suspending the payment of claims filed by private hospitals that are undergoing investigation over "fraudulent, unethical acts, and/or abuse of authority."

In a television interview, PHAP President Jose Rene de Grano said two of their hospital members, one in Samar and one in Davao, have shut down and declared bankruptcy because of unpaid claims with Philhealth.

He said some hospitals have also reduced work hours or decreased their workforce while others have taken out bank loans to sustain operations.

Carcedo named the hospital that de Grano referred to since it was mentioned during a Senate hearing.

The official said the Dominican Hospital sent them a letter that they intend to stop operations due to difficulty of management since they were affected by the pandemic.

"They acknowledged sa letter nila na (in their letter that) they had experienced financial difficulties due to the occurrence of the Covid-19 pandemic," Carcedo said.

"But as to the saying na hindi sila nababayaran, nababayaran po sila Right now, still nababayaran pa rin ang Dominican on services rendered prior to the stop of operations nila . I cannot say na hindi nababayaran ang Dominican kaya sila nag-close kasi we have the data here," he added.

(But as to the saying that they weren’t paid with their claims, they were actually paid. Right now, the Dominican Hospital is still being paid for services rendered prior to the stop of its operations. So I cannot say that the hospital wasn’t paid because we have the data here.)

The Philhealth official said Davao Region was eligible to have advance payment for Covid-19 claims through the Debit-Credit Payment Method (DCPM) that would cover the pending Covid-19 claims of the hospital. The DCPM covers advance payment from April 7, 2020 to April 6, 2021.

Aside from the DCPM, Carcedo said they also release regular Covid-19 claims.

“Patuloy pa rin itong binabayaran natin kasi (We are continuously paying these claims because) we acknowledged there's already surge of Covid-19 cases in Davao Region. That's why we are doing our best to release regular Covid-19 claims sa mga (to our) hospital to at least alleviate the expenses made by these hospitals in treating Covid-19 patients sa members sa PhilHealth (that are PhilHealth members),” he said.

Davao del Sur information officer Sherwin Cesar confirmed in a previous SunStar Davao phone interview that Dominican is one of the hospitals that shut down while the entire province was on a surge. However, he did not disclose the reason during the time of its closure.

Cesar also said another hospital in the province shut down due to undisclosed reasons.

He said the closure of two hospitals in the province caused a shortage of bed capacities in the area.

Cesar said some patients are forced to undergo home quarantine due to the decking of patients needing critical care treatment. (With reports from SunStar Philippines)

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