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State health insurer PhilHealth said Friday it paid P137.6 billion in benefit claims to more than 12,000 accredited health care facilities nationwide in
State health insurer PhilHealth said Friday it paid P137.6 billion in benefit claims to more than 12,000 accredited health care facilities nationwide in the first 10 months of 2024, with a national average turnaround time of 25 days.
The payment was P37.6 billion, or 37.7 percent, higher than P99.9 billion over the same period last year. The national average TAT for claims processing also improved to 25 days, or 35 days faster than the 60 days prescribed under Republic Act No. 10606.“The steady flow of payments and accelerated processing time are part of our commitment to provide timely and efficient support to our health care partners. The reduced turnaround time have been commended by partner hospitals around the country. It is helping them maintain liquidity, ensuring steady supply of medicines and supplies, salaries for health workers, and continuous improvement of facilities which all translate to better services to members,” said PhilHealth president and chief executive Emmanuel Ledesma Jr. The significant improvement in claims payments and faster turnaround time was recognized by the agency’s partners and stakeholders. Dr. Jose P. Santiago Jr., president of Philippine Hospital Association, noted the improvement in payment to hospitals by PhilHealth. Sharing the same observation, Private Hospitals Association of the Philippines Inc. president Dr. Jose Rene De Grano thanked PhilHealth for “their initiative to improve claims processing and payment to hospitals better.” De Grano said that “for the past several months, we’ve seen significant improvements in claims processing, which hospitals can attest to, as they’ve acknowledged this positive change.” Ledesma expressed hope that in due time, they would be able to address the remaining bottlenecks in claims processing through the use of artificial intelligence . “We have just completed a study conducted by experts on how AI can aid us in receiving and processing claims at break-neck speeds never before seen,” said Ledesma. He also asked healthcare facilities to invest in adequate and properly-trained human resource to ensure the submission of “good” claims within the prescribed filing period. “This will help ensure claims are complete and in order, free from deficiencies, incomplete documents or signatures, and unreadable attachments, among other reasons,” he said.
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