Philhealth Ready to Implement Universal Health Care Law

The Philippine Health Insurance Corporation (PhilHealth) on Tuesday said it is ready to fully implement the Universal Health Care (UHC) law, adding that it has adequate funds to sustain its financial obligations to all its members.

In a press briefing, PhilHealth executive vice president Ruben Basa said the corporation netted an income of PHP11.6 billion in 2018.

He said the increased income resulted from their intensified premium collections, aggressive investments and prudent spending without compromising their commitment to health care providers.

“This is a complete turnaround from our 2017 net income of PHP237 million. We recorded a total of PHP32.5 billion in premium income, earned solid returns in our investments as evidenced by PHP5.1 billion windfall from government securities, and our total investment portfolio is at PHP149 billion while our reserve fund is at PHP97 billion at the close of 2018,” he added.

With the introduction of the e-Claims system, Basa said PhilHealth was able to reduce its turnaround time for claims to 20 days from their 68-day average last year.

“The e-Claims also enabled our hospitals to electronically check the benefit eligibility of members, electronically verify the status of claims and do away with the costs for physical transport and supplies in claims submission,” he said.

Meanwhile, PhilHealth acting president Roy Ferrer clarified that PhilHealth only lacks PHP22 billion and not PHP170 billion for the funding of the UHC law implementation.

“There had been an appropriation of PHP 18 billion, this is additional to the GAA[, so there’s only PHP22 billion lacking, most likely we’ll get this from the sin taxes on tobacco and alcohol,” he said.

Ferrer also belied statement of some private hospitals that PhilHealth still owes them, noting the corporation has already released PHP121-billion payment to these hospitals.

“Noong early part of 2018 we released PHP2 billion benefits payouts weekly at noong latter part po PHP3 billion, so I don’t think may utang sa private hospitals at ang turnaround time ngayon (During the early part of 2018 we released PHP2 billion benefit payouts weekly and during the latter part PHP3 billion, so I don’t think there’s debts to private hospitals now and our turnaround time now) is just 20 days,” he added.

Ferrer said the private hospitals could be referring to their “bad claims which PhilHealth cannot pay”.

“Alam mo, mayroon tayong reconsideration summary module, kung may sinisingil sila na bad claims ay impossible na ibigay natin iyon. So, return to hospitals kapag ang required PhilHealth documents ay hindi na-submit (You know, we have reconsideration summary module, if they’re requesting payment for bad claims, it’s impossible for us to provide them. So, return to hospitals if the required PhilHealth documents are not submitted),” he added. (PNA)