PhilHealth holds employers forum to tackle erroneous claims

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KIDAPAWAN CITY — The Philippine Health Insurance Corp. (PhilHealth) 12 (Soccsksargen) has taken steps to reduce erroneous claims, which often result in losses and inefficiencies, through a series of forums for employers in the region.

Friday’s forum here also tackled ways to improve compliance with corporate policies, understand the implication of underpayments or selective reporting vis-à-vis recovery of unwarranted claims, and address the Employer/PEERs issues and concerns on PhilHealth premium contribution-related policies.

PEERs stands for PhilHealth Employers Engagement Representatives who serve as point persons responding to employers’ queries and concerns with PhilHealth.

This year’s forum for employers will also take place in the cities of General Santos, Cotabato, and Koronadal, and Isulan, the capital town of Sultan Kudarat province.

The common issues taken up during the first round of the forum fixated on unwarranted claims, which compelled the employers to settle their obligations with PhilHealth.

Unwarranted claims refer to properly filed claims by employed members but without qualifying contribution prior to the date of confinement.

To date, the collection section of PhilHealth-12 has received 114 settlements amounting to PHP1.1 million out of 1,933 issued billing notices.

Lorelie Bonilla, collection section head of PhilHealth-12, said the forum served as a venue for the agency to help employers and PEERs carry out their duties and obligations.

“You must understand that your primary obligation is to remit the premium contribution of your employees on time, submit a report to get rid of interest charges and inconvenience in time of benefit availment,” she added.

Employers are bound by law to collect the premium and remit them to PhilHealth. Newly hired employees must be reported within the first 30 days upon their assumption to their post and must be deducted and reported for their monthly contribution to the corporation.

“We are here to provide technical support in case you need to know more about the system that we employ to make your work easy in terms of submitting your report and remitting your contribution to PhilHealth,” Bonilla said during the forum.

In addition to the information dissemination on collection policies and guidelines, PhilHealth-12 also provided employers with penal provisions and strict rules governing non-compliance.

“We do not want to litigate you inasmuch as we wanted you to be amenable with our corporate policies,” PhilHealth-12 legal service office representative Sharon Ysmael said.

“Let us just be honest in our dealings because PhilHealth as an institution is here to help you in times of your hospitalization need,” she added.

Employers were given the opportunity to clarify their issues and concerns.

As stakeholders of the corporation, they were likewise updated on the salient points of the Universal Health Care Program. =PNA

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