Oct 1, 2020

Local PhilHealth office claims no involvement in ‘anomalous practices’

According to Wilfred Hernandez, local PhilHealth branch chief, assured their office is not involved in any anomalous practices that are currently being investigated.

None of the hospitals in Palawan have availed of the controversial interim reimbursement mechanism (IRM) with PhilHealth, seen as a vehicle for corruption in the scandal-rocked government health insurance program.

According to Wilfred Hernandez, local PhilHealth branch chief, assured their office is not involved in any anomalous practices that are currently being investigated.

Appearing at the provincial board hearing, Hernandez explained that the rejected claims by their office are caused mainly by these claims having been filed by hospitals with lacking documents.

“Halimbawa, sa Aborlan, ang main reason na binabalik naming sa ospital ang mga claims ay dahil hindi kumpleto ang mga documents ng mga pasyente,” he said.

Hernandez added that private hospitals in the province have fewer returned claims but assured that no special favors are being given to these hospitals.

“Mas efficient ang mga private hospitals, mas kaunti ang RTH (return-to-hospital) nila keysa sa public. But when it comes to compliance, wala naman silang pinagkaiba sa mga provincial hospitals,” he said.

“Sa issue na IRM, in fairness sa mga boss ko, wala namang ganoon sa Palawan,” he said.

The IRM is an emergency cash advance measure of PhilHealth that is disbursed in times of crisis and calamities. In the ongoing corruption investigation of the agency, members of the Senate pointed out that the agency has been giving IRMs to allegedly favored private hospitals.

Hernandez could not give information on whether hospitals in Palawan are making false claims for cases of pneumonia, as their office has no access to each hospital’s records. This refers to a recent concern raised in the Senate investigation, where doctors have allegedly been “upcasing” colds to pneumonia so hospitals can make PhilHealth claims.

“Wala naman akong concrete na basehan, kasi taon-taon nag-iiba ang data. Pero dahil ang data ng mga hospitals ay fino-forward sa regional office. Ang mandate ng office naming ay to manage collections, memberships, and relations sa ospital,” he said.

 

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