Overpayments not tantamount to fraud, says state insurance company

  • 📰 inquirerdotnet
  • ⏱ Reading Time:
  • 36 sec. here
  • 2 min. at publisher
  • 📊 Quality Score:
  • News: 18%
  • Publisher: 86%

United States News News

United States United States Latest News,United States United States Headlines

Domingo said it was wrong to equate the supposed overpayments to hospitals since 2013 with the amount lost to fraud given that the ACR payment mechanism it employed was working under the principle of “efficiency gains.” | jovicyeeINQ

“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.

 

Thank you for your comment. Your comment will be published after being reviewed.
Please try again later.
We have summarized this news so that you can read it quickly. If you are interested in the news, you can read the full text here. Read more:

 /  🏆 3. in US

United States United States Latest News, United States United States Headlines

Similar News:You can also read news stories similar to this one that we have collected from other news sources.

China to release details on blacklist of 'unreliable' companies
Source: ANCALERTS - 🏆 26. / 50 Read more »