BY: VALERIE ANN DISMAYA
Despite challenges in the healthcare sector during the previous administration, the provincial government of Pangasinan views the reforms in hospitals as a significant success.
From 73.95 million pesos in denied claims and 109 million pesos in return-to-hospital (RTH) claims in 2021, these figures dropped when Governor Ramon V. Guico III assumed office in 2022.
According to the governor, collaborating with PhilHealth and focusing on systematic solutions were key to this achievement.
Governor Ramon V. Guico III mentioned, “In the past administration, in 2021, the hospitals had 73,952,094 pesos in denied claims. In 2022, we reduced it to 59,409,670 pesos. In 2023, it was 36,292,974 pesos. By 2024, it dropped to 14,928,409 pesos. This shows we’ve been addressing the issues by working with PhilHealth and identifying solutions through communication.”
He identified manpower shortages, inefficient utilization, and policy issues as some of the primary causes of denied claims.
However, Dr. Raquel Ogoy, OIC of the Provincial Hospital Management Services Office, clarified that denied claims do not necessarily translate to a loss for the province.
“This administration ensures that RTH and denied claims won’t be a total loss. We can still file and collect these claims through MAIPP. So, the province won’t incur losses,” she stated.
Aside from addressing collection issues, Governor Guico also responded to allegations of medicine shortages in hospitals.
Governor Ramon V. Guico III emphasis, “Let me clarify the claims about medicine shortages. We are working within the national formulary, which limits what medicines the government can procure. Sometimes, doctors prescribe drugs outside this list, and patients have to buy them elsewhere. This issue needs to be addressed by Congress and the Senate.”
The governor assured that reforms would continue to further reduce denied and return-to-hospital claims across the province’s 14 hospitals.
