“We expect the same quality service [from the hospitals]. That balances [matters] off. That is what the COA does not understand, although we have oriented them several times that that’s the characteristic of the case rate provider payment,” she said.
In May last year, PhilHealth officials, led by then acting president Celestina dela Serna, told reporters that the corporation would review claims made by hospitals, especially on pneumonia, as it appeared that some institutions may have been “upcasing,” or submitting claims to the company even if their patients only had the garden-variety cough and cold.
While Domingo acknowledged the surge in the number of pneumonia cases, she said PhilHealth could not say just yet the cause of the increase. She assured the public though that the corporation’s finances remain “robust,” pointing out that last year PhilHealth posted an P11-billion net income and a benefit payout of P120 billion.
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