State insurer Philippine Health Insurance Corp. (PhilHealth) said it has paid more than P6 billion to hospitals in the NCR Plus region as need for medical care increased due the surge in the number of Covid -19 cases.
The NCR Plus is composed of the National Capital Region (Metro Manila) and the nearby provinces of Bulacan, Cavite, Laguna and Rizal.
PhilHealth Vice President for Corporate Affairs Dr. Shirley Domingo said the state insurer has instituted the debit-credit payment method (DCPM) that allows hospitals to process and receive funds equivalent to 60 percent of their currently in-process claims.
"Those hospitals need only to sign a memorandum of understanding and signify that they want to avail [of these claims], so if they submitted it, we would release the funds equivalent to 60 percent of their in-process good claims," Domingo said during the Laging Handa briefing on Saturday.
She said under the DCPM scheme, they have released a total of P6.3 billion worth of claims to 206 health institutions in the NCR Plus region while 79.6 percent of total overall claims for both Covid and non-Covid confinements, equivalent to P 231 billion pesos, have also been disbursed.
"We are processing the claims, and our turnaround time for the good claims is around 43 days," Domingo said.
She said the state health insurer is open to creating a technical working group that will countercheck and reconcile the claims made by hospitals and PhilHealth.
"We welcome that. If Congress thinks that it will be helpful in the processing of claims of PhilHealth and hospitals, then it is okay for us," Domingo said, adding their regional offices were processing and reconciling claims.
Domingo explained that hindrance to fast processing of claims were documentary deficiencies, while others were denied and investigated due to possible fraud.
She said PhilHealth has paid the Philippine Red Cross P5.5 billion for testing services.
Guidelines on the payment of claims for adverse events following immunization are now being drafted with the Department of Budget and Management, Domingo added.