Senator Grace Poe (Office of Sen. Grace Poe/MANILA BULLETIN File Photo)
In a statement on Monday, May 24, she said the PhilHealth “must do all to address hospital claims it refuses to pay as well as the so-called ‘return-to-hospital (RTH) claims’ which threaten the viability of these hospitals.”
She cited a Commission on Audit (COA) 2020 report on the Philippine Children’s Medical Center (PCMC), which supposedly stated that the state health insurer denied a total of 1,641 claims from the government-run hospital amounting to P22.98 million as of September 30, 2020, while RTH claims amounted to P11.60 million representing 683 claims.
RTH claims were sent back to hospitals as PhilHealth deems they still “lack certain requirements.”