The Philippine Health Insurance Corporation (PhilHealth) said it paid 78% of hospital claims amid reports of unpaid claims.
In the House of Representatives hearing on Friday (Sep. 3), PhilHealth claimed that they have paid ₱132 billion from the estimated 15 million claims they received from January 2020 to Aug. 24, 2021.
The agency is currently processing the ₱21 billion for more than 3.5 million claims, ₱10.4 billion is allotted for return to hospital claims, while over 700,000 claims worth ₱6.2 billion were denied.
PhilHealth explained that some claims were denied because they were filed after the 120 days statutory period, the covered case is not compensable, or they were non-compliant with the requirements.
However, the agency assured that it is coordinating with the hospitals to organize their documents and pay the requested claims.
Meanwhile, the lawmakers also questioned the duration of the hospital claims in PhilHealth that take more than two months, in which the agency answered that it is part of its process to ensure that the funds will be used properly.
Report from Kenneth Paciente/NGS-rir
