PhilHealth urges hospitals to be updated in health claims policies, requirements

SunStar Publishing Inc.

IN A bid to further improve the processing of medical claims, the Philippine Health Insurance Corporation is calling on all accredited hospitals and health facilities to stay updated with the latest policies and requirements. In a statement, PhilHealth president and chief executive officer Emmanuel Ledesma said they are urging hospitals and health facilities to have their personnel in charge of submitting medical claims get adequate information and training on the claims processing.

Ledesma noted how claims are normally returned to the hospitals due to discrepancies in entries, incomplete, inconsistent, or unreadable documents, and improperly completed claim forms. On the other hand, he said claims are normally denied payment due to late filing/re-filing, non-compensable cases, and confinement during which the hospital has accreditation issues.

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