The Philippine Health Insurance Corp. (PhilHealth) announced a total disbursement of P137.6 billion in benefit claims to over 12,000 accredited health care facilities nationwide from January 1 to October 31, marking a 37.7% increase compared to the P99.9 billion paid during the same period last year.
PhilHealth also significantly improved its claims processing efficiency, reducing the average turnaround time to 25 days, well below the 60-day benchmark set by the National Health Insurance Act of 2013. The faster processing has been applauded by partner hospitals, aiding them in maintaining liquidity, purchasing medicines, paying health workers, and upgrading facilities, according to PhilHealth president and CEO Emmanuel Ledesma.
Ledesma urged health care providers to prioritize the timely submission of accurate claims to avoid issues like incomplete documents or errors that could lead to denied payments. He emphasized that PhilHealth’s stringent review process ensures the proper use of public funds.
Looking ahead, PhilHealth is exploring the adoption of artificial intelligence (AI) to further enhance claims processing. “We recently completed a study on how AI can revolutionize our operations, and with the support of our partners, we hope to implement it soon,” Ledesma added.
