April 16, 2021
THE Philippine Health Insurance Corp. (PhilHealth) announced that it will investigate alleged incidents of upcasing or any form of health insurance abuse related to the coronavirus disease 2019 (Covid-19).
The agency noted a proliferation of video posts showing incidents of health care providers allegedly colluding with patients to declare minor respiratory symptoms, such as asthma, as Covid-19 symptoms to claim higher benefits.
“If found true, the incidents described in the video posts refer to upcasing or claiming for a related illness or procedure of higher severity or complexity to gain higher benefit payment,” said PhilHealth.
According to the state health insurer, upcasing is a form of health insurance fraud with a penalty of P200,000 for each count or suspension of contract of the health care provider up to three years or both.