MY experience at being hospitalized for the coronavirus disease (Covid-19) included having to complete document requirements that would allow the hospital to get paid by PhilHealth.
I was hospitalized for 10 days in late July, not at the Perpetual Succour Hospital (PSH) in Cebu City whose officials are among those charged with filing false claims with the Philippine Health Insurance Corp. (PhilHealth). The charges stemmed from the hospital and PhilHealth 7 officials allegedly conspiring to make fraudulent claims to get bigger amounts from the government health insurer.
The PSH denied the allegation of fraud and said the treatment of the patient cited in the complaint was “based on the medical diagnosis of competent and respected medical professionals.”
This case raises the importance of completing the documents required in the treatment of Covid-19 patients. This includes the document that states the patient was found positive of the Sars-CoV-2 that causes Covid-19 after a swab test.
In my case, from the time I was at the emergency room of the hospital I went to (not PSH), the doctors asked if I had a copy of the swab test result that showed I was infected. I said I did not and that I was only told of the result of my swab test taken at my cluster clinic at the Cebu Medical Society in Banilad. The team of barangay officials, health workers and police members who came to my house informed me of my positive test result but did not give a document. I was told I was positive and it seemed their concern was on who I got in contact with within the 14 days before the start of symptoms.
The investigation done at the emergency room showed I had Covid pneumonia, so I thought there was no need for the document. While at the hospital, many tests were done but not a second swab test. I had an antibody test before being discharged and it showed I have developed antibodies after infection.
I was asked a second time before being discharged about the document on my swab test positive result and, again, I replied I do not have it and it must still be with the barangay. It ended there. I thought my antibody test result was enough to prove I had Covid-19 and I recovered. Until, two months after being released, the hospital called to again ask for the document. The person explained that the hospital needed it to get paid for the P143,267 it had deducted from my bill as the amount was compensation due me from PhilHealth for my moderate pneumonia.
It was after the importance of that document was explained to me that I reached out to my barangay to get the official result of my swab test. It took a day to get my copy of the document which I immediately sent to the hospital. The hospital can now seek payment from PhilHealth.
It’s up to the Ombudsman to determine any culpability of the PSH or PhilHealth local officials cited in the complaint because the corruption that was alleged may be more than about getting documents in order.