PHILHEALTH has committed to address delayed payments to hospitals after Senator Christopher “Bong” Go, chairperson of the Senate Committee on Health, pressed the agency during a public hearing on September 10 to fulfill its commitments.

Go raised concerns about the long-standing issue of unpaid claims to both government and private hospitals, which have significantly impacted healthcare operations in concerned hospitals.

During the hearing, Go highlighted the critical problem of PhilHealth’s available yet unused funds and the agency’s delayed payments to hospitals, saying that these inefficiencies are detrimental to the healthcare system.

“In the past two hearings, we questioned the transfer of PhP89.9 billion excess funds of PhilHealth to the national treasury that remains unutilized despite the growing number of poor patients seeking help from the government,” Go stated.

Go called on PhilHealth to act quickly, stressing that the agency’s role is not to accumulate funds but to use them to protect the health and lives of Filipinos.

“Hindi naman sila bangko na dapat mag-ipon lang po ng pondo. Gamitin po ito para maproteksyunan ang kalusugan at buhay ng bawat Pilipino ayon sa kanilang mandato, at alinsunod din sa Universal Health Care Law,” Go emphasized.

One of the primary concerns raised during the hearing was the significant unpaid claims owed by PhilHealth to hospitals, particularly government facilities. According to data from the Department of Health (DOH), these unpaid claims amount to approximately Php 14.8 billion, further exacerbating the financial burden faced by public hospitals.

In response, PhilHealth President Emmanuel Ledesma assured the committee that the agency is actively working on resolving the payment delays. He clarified that the widely reported Php15 billion in unpaid claims is likely an overestimate, with the actual amount to be finalized after the ongoing reconciliation process.

“We’re currently doing reconciliation on those, and I’m confident after the reconciliation po, yung 15 billion na yan, siguro magiging mga PhP3 to 4 billion na lang ‘yan,” Ledesma explained during the hearing.

He further elaborated that many claims were either denied or returned to hospitals (RTH) for further processing and validation, significantly reducing the total amount owed.

Go, in response, reminded PhilHealth of its responsibility to ensure that valid claims are processed and paid on time, stressing that the financial health of both government and private hospitals depends on timely reimbursements.

The senator also stressed the importance of maintaining these improvements and ensuring that private hospitals, like their public counterparts, receive their reimbursements without unnecessary delays.

“Wala naman silang pang-sweldo sa mga medical workers kung wala silang pondo. So, dapat hindi matagalan ‘yung kanilang claims. Not only sa mga government hospitals, including private hospitals din,” Go reminded Ledesma.

Ending the discussion, Go renewed his appeal to PhilHealth to utilize its funds as intended and avoid further delays in reimbursing hospitals.