PhilHealth: PRC claims for P320 million debt deficient

Mark Ernest Villeza - The Philippine Star
PhilHealth: PRC claims for P320 million debt deficient
Individuals continue to avail services as face-to-face operations and transactions continue at the Philippine Health Insurance Corp. (PhilHealth) in Quezon City on September 26, 2023.
STAR / Michael Varcas

MANILA, Philippines — The Philippine Health Insurance Corp. is acknowledging it owes the Philippine Red Cross P320 million for its COVID tests, but this is due to deficiencies in the documents the PRC submitted for its claims, a PhilHealth official said yesterday.

Since 2020, PhilHealth has paid PRC a total of P8.278 billion for 2,476,566 tests, Philhealth acting vice president for corporate affairs group Rey Baleña told The STAR.

However, the processing of 66,024 PRC claims amounting to P221.561 million has been halted due to the non-submission of duly accomplished Case Investigation Forms (CIFs) and inconsistencies in the validated line list or summary of test results, he said.

These deficiencies, Baleña said, mean the claims do not conform to the provisions of a memorandum of agreement between PhilHealth and PRC.

He added that another set of claims amounting to P99.011 million is on hold due to missing CIFs.

Baleña said that PhilHealth is awaiting the results of a Commission on Audit special audit on the appropriateness of paying these claims submitted with deficiencies.

During the Kapihan sa Manila Bay forum last June 5, PRC chairman Richard Gordon said that PhilHealth owes the humanitarian organization around P320 million for COVID tests.

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