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GENERAL SANTOS CITY - The Philippine Health Insurance Corp. (PhilHealth) is targeting to release by the end of October around PHP320 million in pending reimbursement claims by private hospitals here. Nol Valila, head of the PhilHealth-Local Health Insurance Office here, said Tuesday they are currently working on completing the processing of at least 7,200 claims by Oct. 31 based on an agreement last week with concerned hospitals. He said the amount is part of the PHP437-million "good claims" or those with complete documentation submitted by the health care providers. As of Tuesday, he said they already processed some PHP49 million worth of claims of local hospitals that will be credited to their accounts within the week. "We are currently fast-tracking the processing of these claims...Next week, we will be coping up with the remaining number of claims as promised," Valila said in a "question hour" during the city council's regular session. He was responding to a query from city councilors over a statement earlier released by the Private Hospitals Association here regarding the delayed payment of their claims that has reportedly reached PHP834,532,820.98. The hospitals said the mounting unpaid claims have already affected their operations and might eventually result in the collapse of the local health care system, which is still trying to reel from the coronavirus disease 2019 (Covid-19) pandemic. The statement was signed by officials and representatives from the Auguis Clinic and Hospital, General Santos Medical Center, Socsargen County Hospital, General Santos City Doctor's Hospital, Mindanao Medical Center, Sarangani Bay Specialists Medical Center Inc., St. Elizabeth Hospital Inc., and Diagan Cooperative Hospital. Valila said they held a consultative meeting last week with representatives of the eight private hospitals to thresh out the problems regarding the delayed payments. He said they clarified with them that only around PHP750 million of the PHP834 million claimed by hospitals is still pending. Of the PHP750 million, only PHP437 million have proper documents while the rest, amounting to over PHP300 million, were either denied or returned to the hospitals. These claims were returned by PhilHealth-Region 12 to the hospitals due to the lack of supporting documents. Dr. Hector Zenon Leonardo Malate, acting vice president of PhilHealth-Region 12 (Soccsksargen), said last week that the returned claims need to be refiled by the hospitals and are not considered as "due and demandable" pending their compliance. From January 2020 to October 9 this year, he said they have already processed and released some PHP1.159 billion in claims, including those involving Covid-19 cases, to the concerned hospitals. He said the settled amount represented 61 percent of the 136,731 reimbursement claims amounting to P1.9 billion that were submitted to the agency during the period. Meantime, aside from expediting the processing of the claims, Valila said they have agreed to immediately release the "return to hospital" claims to the concerned health care institutions in Region 12. He said the agency will also issue a regional advisory to all health care providers stating the clarificatory provisions in the implementation of Covid-19 in-patient benefit packages "for uniform guidance and application of policies." He said South Cotabato 1st District Rep. Shirlyn Banas-Nograles, whom they engaged in a separate consultation, promised to provide them with additional manpower to assist the "reconciliation process" of the returned claims. At least six workers committed by the lawmaker will start working with them within the week, he said. "We will also conduct regular dialogues with health care institutions and medical society (groups) to address the issues and concerns with regards to the payment of claims," he added. (PNA) }

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South Cotabato ,Philippines ,Sarangani Bay ,Philippines General ,Philippine ,Benguet ,General Santos ,Shirlyn Banas Nograles ,Hector Zenon Leonardo ,Sarangani Bay Specialists Medical Center Inc ,Diagan Cooperative Hospital ,Mindanao Medical Center ,Santos Medical Center ,Hospitals Association ,Elizabeth Hospital Inc ,Health Insurance Office ,Philippine Health Insurance Corp ,Philippine Health Insurance ,Philhealth Local Health Insurance Office ,Private Hospitals Association ,Auguis Clinic ,General Santos Medical Center ,Socsargen County Hospital ,General Santos City Doctor ,Diagan Cooperative ,Hector Zenon Leonardo Malate ,General Santos City The Philippine Health Insurance Corp Philhealth Is Targeting To Release By End Of October Around Php320 Million In Pending Reimbursement Claims Private Hospitals Here Nol Valila ,Ead Of The Philhealth Local Health Insurance Office Here ,Aid Tuesday They Are Currently Working On Completing The Processing Of At Least 7 ,200 Claims By Oct 31 Based On An Agreement Last Week With Concerned Hospitals He Said The Amount Is Part Of Php437 Million Quot Good Or Those Complete Documentation Submitted Health Care Providers As Tuesday ,E Said They Already Processed Some Php49 Million Worth Of Claims Local Hospitals That Will Be Credited To Their Accounts Within The Week Quot We Are Currently Fast Tracking Processing These Next ,E Will Be Coping Up With The Remaining Number Of Claims As Promised ,Uot Valila Said Ina Quot Question Hour During The City Council 39s Regular Session He Was Responding Toa Query From Councilors Overa Statement Earlier Released By Private Hospitals Association Here Regarding Delayed Payment Of Their Claims That Has Reportedly Reached Php834 ,532 ,820 98 The Hospitals Said Mounting Unpaid Claims Have Already Affected Their Operations And Might Eventually Result In Collapse Of Local Health Care System ,Hich Is Still Trying To Reel From The Coronavirus Disease 2019 Covid 19 Pandemic Statement Was Signed By Officials And Representatives Auguis Clinic Hospital ,Eneral Santos City Doctor 39s Hospital ,Arangani Bay Specialists Medical Center Inc ,T Elizabeth Hospital Inc ,Nd Diagan Cooperative Hospital Valila Said They Helda Consultative Meeting Last Week With Representatives Of The Eight Private Hospitals To Thresh Out Problems Regarding Delayed Payments He Clarified Them That Only Around Php750 Million Php834 Claimed By Is Still Pending ,Nly Php437 Million Have Proper Documents While The Rest ,Mounting To Over Php300 Million ,Ere Either Denied Or Returned To The Hospitals These Claims Were By Philhealth Region 12 Due Lack Of Supporting Documents Dr Hector Zenon Leonardo Malate ,Cting Vice President Of Philhealth Region 12 Soccsksargen ,Aid Last Week That The Returned Claims Need To Be Refiled By Hospitals And Are Not Considered As Quot Due Demandable Pending Their Compliance From January 2020 October 9 This Year ,E Said They Have Already Processed And Released Some Php1 159 Billion In Claims ,Ncluding Those Involving Covid 19 Cases ,O The Concerned Hospitals He Said Settled Amount Represented 61 Percent Of 136 ,731 Reimbursement Claims Amounting To P1 9 Billion That Were Submitted The Agency During Period Meantime ,Side From Expediting The Processing Of Claims ,Alila Said They Have Agreed To Immediately Release The Quot Return Hospital Claims Concerned Health Care Institutions In Region 12 He Agency Will Also Issuea Regional Advisory All Providers Stating Clarificatory Provisions Implementation Of Covid 19 Patient Benefit Packages For Uniform Guidance And Application Policies South Cotabato 1st District Rep Shirlyn Banas Nograles ,Hom They Engaged Ina Separate Consultation ,Romised To Provide Them With Additional Manpower Assist The Quot Reconciliation Process Of Returned Claims At Least Six Workers Committed By Lawmaker Will Start Working Within Week ,E Said Quot We Will Also Conduct Regular Dialogues With Health Care Institutions And Medical Society Groups To Address The Issues Concerns Regards Payment Of Claims ,Uot He Added Pna ,

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