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Alexis Romero - The Philippine Star
December 18, 2025 | 12:00am
President Ferdinand “Bongbong” Marcos Jr. inspects the zero balance billing program at the Dr. Jose Fabella Memorial Hospital in Manila on September 20, 2025.
PPA Pool Photo by Mike Alquinto and Toto Lozano
MANILA, Philippines — President Marcos has tasked the Department of Health (DOH) to lengthen the period of filing of hospital claims with the Philippine Health Insurance Corp. from 60 to 120 days and to fix its paperwork following concerns over outstanding PhilHealth claims worth more than P1 billion.
According to a Commission on Audit (COA) annual report for 2024, a total of 13 DOH-retained hospitals are encountering challenges in ensuring the accuracy and collectability of its claims totaling P1,085,422,417.35 from PhilHealth.
Denied claims amounted to about P786.66 million while return-to-hospital (RTH) claims totaled P298.77 million, according to the state auditor.
The COA report attributed the challenges to “persistent non-compliance with PhilHealth claims processing guidelines” and “internal systemic weaknesses” within the hospitals that “compromise the timely recovery of public funds,” which may “adversely affect the delivery of vital health care services.”
Asked to react to the COA findings, Presidential Communications Undersecretary Claire Castro said Marcos has ordered the DOH to fix their records, adding that the agency is now working to ensure the completeness of its documents.
With regards to the outstanding claims, Castro noted that most of the hospitals were unable to provide documents for their claims within the 60-day period.
The COA has recommended that the health secretary form a committee to review all denied and RTH claims against PhilHealth.
It also suggested an assessment of staffing requirements on the billing and other departments, formal engagements with PhilHealth to ascertain the status of a hospital’s outstanding receivables and explore actionable measures that can expedite the processing and collection of these claims.
