THE amounts being cited by Philippine Health Insurance Corp. (PhilHealth) officials regarding the claims of some eye clinics, including the Quezon City Eye Center (QCEC), for cataract surgery procedures are bloated and are meant to mislead the public, the owner of QCEC told Senate reporters.
Speaking to the media Raymond Evangelista, QCEC owner, said he has documents to prove that PhilHealth’s figures are “grossly inaccurate.”
“I am willing to submit all our financial documents, including our records of payments to the Bureau of Internal Revenue [BIR], showing the actual amount of our claims and what we have actually received from PhilHealth,” Evangelista said.
“There is a discrepancy of almost P46 million between what PhilHealth says we have received and what our records show,” he said. “There is definitely something wrong with their figures, and we don’t know if the padding of the amounts is deliberate on part of some PhilHealth insiders.”
“PhilHealth submitted bloated figures to the Senate; we can easily prove this based on what we paid to the BIR,” he said.
“As far as I know, the figure presented by PhilHealth to the Senate hearings for another eye clinic, Pacific Eye Center, is also bloated by P62 million,” Evangelista said during a chance interview.
He said that at present, “what we are concerned about is the plight of thousands of cataract patients, many of them senior citizens who are automatically covered by PhilHealth, who will now have to find other eye clinics and capable facilities to avail themselves of the free cataract surgeries, which are their benefits as PhilHealth members.”
This is because eye clinics, like QCEC, have no choice but to stop catering to PhilHealth members because of PhilHealth’s decision to withhold payments to them without any due process, Evangelista added.
He said he does not understand why PhilHealth is singling out eye clinics, which charge the minimum P16,000 per cataract procedure as mandated by PhilHealth, when there are bigger hospitals that are performing similar surgeries, but are charging so much more.
He also said the plan of PhilHealth and the Department of Health to limit the number of patients that eye doctors can operate on will result in opthalmologists being selective, leaving the poorer cataract sufferers in the dark. “We feel that this is anti-poor; if you put a cap on the number of cataract surgeries, then doctors will choose the ones that can pay the most,” Evangelista said. “That will result to discrimination.”