PhilHealth disburses P137-B in claims within 10 months

State health insurer PhilHealth has paid P137.6 billion in benefit claims to more than 12,000 accredited health care facilities nationwide from January 1 to October 31 this year, with a national average turnaround time (TAT) of 25 days.

The payment is P37.6 billion, or 37.7 percent, higher compared to P99.9 billion during the same period last year. The national average TAT for claims processing also significantly improved to 25 days, which is 35 days faster than the 60-day standard prescribed under Republic Act No. 10606.

According to PhilHealth President and CEO Emmanuel R. Ledesma Jr., the steady flow of payments and accelerated processing times are part of their commitment "for a timely and efficient support to our health care partners."

"The reduced turnaround times have been commended by partner hospitals around the country. It is helping them maintain liquidity, ensuring a steady supply of medicines and supplies, salaries for health workers, and continuous improvement of facilities, all of which translate to better services for members,” he explained.

Ledesma also expressed hope that, in due time, they will be able to address the remaining bottlenecks in claims processing through the use of artificial intelligence (AI).

“We have just completed a study conducted by experts on how AI can aid us in receiving and processing claims at breakneck speeds never before seen,” Ledesma announced. “We are confident that, with the support of our healthcare partners, this will happen in the very near future,” he added.

He also issued an appeal to healthcare facilities to invest in adequate and properly trained human resources to ensure the submission of “good” claims within the prescribed filing period.