Aboitiz Group submits P 1-B offer to digitize PhilHealth claims process

Singapore—A consortium led by the Aboitiz Group has submitted a P1-billion unsolicited proposal to digitize the claims process of the state-controlled Philippine Health Insurance Corp. (PhilHealth), which has grappled with fraudulent claims for years.

Aboitiz InfraCapital president Cosette Canilao said the group had teamed up with UBX, the group’s fintech arm, and technology solutions provider Unisys in submitting the proposal to PhilHealth.

“It’s not a big project [in terms of amount] but it’s one that can render significant service,” Canilao said on the sidelines of the launch of Aboitiz Data Innovation (ADI) here.

Canilao said the consortium would also tap the services of ADI, which uses data science and artificial intelligence to solve everyday problems of institutions, for this crucial project.

In a press briefing ahead of ADI’s launch last Thursday, Aboitiz Group president Sabin Aboitiz told journalists from Manila and Singapore that ADI would like to help President Marcos with his administration’s digitalization and innovation initiatives.

There are so many ways by which ADI could help the government, beginning with PhilHealth, Aboitiz said.

For years, PhilHealth has battled fraudulent practices of institutional and professional health-care providers and even employers. In 2019, for instance, a dialysis center in Quezon City was found to have defrauded PhilHealth by filing claims on behalf of dead patients as far back as 2016. Administrative cases were filed against this entity.

Timely process

Canilao said the proposal to digitize the claims process of PhilHeath was timely because e-government or state digitalization initiatives had started. The consortium, she said, hopes to make PhilHealth’s claim process more efficient and eliminate questionable claims. However, she said the consortium may have to wait until the appointment of a permanent Health Secretary for PhilHealth to act on the proposal.

As an unsolicited proposal, if and when PhilHealth gives the original proponent status to the Aboitiz-led consortium, negotiations on the terms can begin. Once finalized, the package will be subjected to a Swiss challenge, to give others an opportunity to offer better terms. However, the original proponent has the right to match the best terms offered by competitors.

In its 2020 report, the Commission on Audit said PhilHealth had settled P14.97 billion worth of claims under its interim reimbursement mechanism without legal basis, releasing money to 711 health-care institutions that have yet to complete the services they were supposed to render. INQ