1,000 ‘ghost’ patients in CAR probed

BAGUIO CITY — The Philippine Health Insurance Corp. (PhilHealth) is investigating roughly 1,000 “ghost” patient claims, involving benefits already paid to healthcare providers for treatments never received in the Cordillera Administrative Region (CAR), the agency said on Monday.

The cases, spanning 2022 to 2024, include patients who died before the claimed services, and instances of double billing, such as one person undergoing dialysis at two facilities on the same day. Similar irregularities were detected under the Yaman ng Kalusugan Program.

PhilHealth-Cordillera lawyer Eric Mandiit said about P680,000 in benefits were disbursed for questionable claims, some uncovered when members received text alerts for services they did not use.

PhilHealth has ramped up monitoring, including surprise facility inspections, claim validation via home visits, and real-time text notifications. Facilities found guilty after due process face fines or suspension of accreditation, officials said. — Artemio A. Dumlao