A personal experience with PhilHealth fraud

/ 05:02 AM June 14, 2019

The recent controversial news, “PhilHealth pays for ghost kidney treatments” (6/6/19), is nothing new. The government must dig deeper to uncover other bogus claims, not just on kidney treatments, that could deplete the resources of the Philippine Health Insurance Corp. (PhilHealth).

Years back, my daughter had an eye procedure in one tertiary private hospital in Metro Manila. As we availed of the outpatient service of the institution, and the procedure had to be done in the private/pay facility of the hospital, I was informed that I would be charged more than P2,000 if not a PhilHealth member/dependent, or pay none at all. With the latter, I had to secure a paper from PhilHealth that my daughter is my dependent, and such had to be presented to the hospital on the scheduled appointment.


To enjoy the free service, I complied with the paper from PhilHealth, and true enough, I was not charged a single centavo, but I was made to sign a paper without the benefit of reading it first. I hastily put my signature; anyway, I got my daughter’s treatment for free. It was like, I owed something to the hospital, and in good faith I signed, without question, the paper handed to me by the secretary of the eye clinic.

Months after, I received a notice regarding the amount billed by the hospital to PhilHealth. Lo and behold, there were multiple charges for this and that item, much greater than the amount I was supposed to pay had my daughter been not a dependent of a PhilHealth member.


During the next checkup, I asked the doctor about the discrepancy. Sadly, my discovery was not given that much attention, which to me was a form of fraud. I was even told nonchalantly that maybe my suspicions were wrong.

Any act that defrauds PhilHealth’s funds must be stopped. My experience may just be one of countless personal accounts of fraud out there. I hope other PhilHealth members with similar experiences would come out, too.

BELEN DOCENA-ASUELO, [email protected]

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TAGS: medical fraud, Philhealth
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