The state health insurance has already reimbursed 83.48 percent or P9.367 billion of the 1,434,130 claims filed by accredited health care institutions (HCIs) in Western Visayas for the 2020-2021 period.
In a statement released on Monday, June 28, the Philippine Health Insurance Corporation (PhilHealth-6) said since January 2020 until June 25 this year, it has paid 1,197,148 claims while 20,594 are already approved for payment and 83,140 are being processed.
“PRO VI recognizes its duty to process and reimburse claim benefits that were afforded to PhilHealth members in Western Visayas, and has paid 83.48 percent of good and complete claims in the average of 27 days in 2020 to 2021,” the statement said.
Those that were paid included 87,273 claims from Aklan; 68,818 from Antique; Capiz has 87,613; Guimaras, 10,799; Iloilo province, 127,077; Iloilo City, 349,969; Negros Occidental, 171,809; and Bacolod City with 293,790 claims.
Claims that were approved for payment amounted to P109.55 million while those that are being processed totaled P447.2 million.
However, 109,068 were returned to HCIs for requirements compliance while 24,180 claims were denied.
Those returned to HCIs amounted to P689.98 million while denied claims were valued at P181.6 million.
“Returned and denied claims that will be re-filed or appealed will undergo validation and re-processing before payment. These are not considered arrears of the corporation while not yet approved for payment,” the statement added.
The healthcare insurance said the average turnaround time for accredited HCIs to submit their claims is at 79 days upon discharge of patient while PhilHealth processes good and complete claims in just 27 days.
It also urged HCIs to submit their claims for the soonest validation and payment.PNA
