The Philippine Health Insurance Corp. (PhilHealth) 11 (Davao Region) paid out PHP8.8 billion in hospital claims last year, officials said Wednesday.
In a press briefing, PhilHealth-11’s public relations officer Kleah Gayle Guevarra said the amount covers 573,299 claims.
“For the past months, we have been addressing the issue (on claims), informing the public that when it comes to claims payment, we are paying with due diligence our hospitals,” she said.
Guevarra said the claims were categorized as good, return to hospitals (RTH), and denied.
“If these claims are completely filed, we will pay such claims. If they are RTH due to insufficiency, we send them back to the hospitals to produce the required documents,” she explained.
Guevarra said denied claims could not be paid if specific provisions or policies of PhilHealth were not followed.
Meanwhile, Dr. Gianelli Kristine Remocaldo, PhilHealth-11 medical specialist, noted that the region’s RTH and denial claims rate are less than 5 percent.
“Our turnaround time for paying off good claims from the time we receive the claim is below the statutory period of 60 days,” she said.
According to the agency’s data, about PHP10.2 million worth of claims were paid for the Konsulta (Konsultasyong Sulit at Tama) package in 2023.
For hemodialysis alone, PHP565.3 million was paid from January to Aug. 5 this year. (PNA)
