Malaca±ang: Malaca±ang 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 call to action follows a warning from the Commission on Audit regarding persistent deficiencies in processing over PHP1 billion worth of Return-to-Hospital (RTH) claims, potentially impacting the financial stability and operational efficiency of DOH-retained hospitals.
According to Philippines News Agency, in a press briefing, Palace Press Officer Clarie Castro emphasized the need for the DOH to organize and submit necessary documentation. Castro stated, '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).'
On the issue of delayed PhilHealth claims, Castro explained that hospitals have a 60-day period to submit supporting documents. However, many institutions fail to meet this deadline promptly, resulting in claim delays linked to incomplete hospital documentation and procedural deadlines.
In response to these challenges, Castro announced that President has ordered an extension of the claims submission period to 120 days, referred to as Claim's Flexibility. '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 highlighted that the extension aims to address delays while ensuring hospitals can access reimbursements. The ultimate 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),' Castro added.
RTH claims are reimbursements filed by hospitals for covered services provided to PhilHealth members, and the timely submission and processing of these claims are crucial for the financial health of healthcare institutions.
