TACLOBAN CITY, March 11 (PNA) — The Philippine Health Insurance Corporation (PhilHealth) in Eastern Visayas is eyeing to cut the processing period of claims to only six days this year from nearly two months in 2015.
The regional office of the state-run health insurance firm kicked off piloting last month of the new system where encoding of claims are being
done in hospitals and not in PhilHealth offices. The system is now being implemented in Region 8 and Region 2.
“Usually, the hospitals submit to us hard copies of documents and it takes time for our staff to encode the data. In this new system, they will manually transfer the soft copy to our computer,” said PhilHealth Regional Vice President Walter F. Bacareza.
Currently, 19 public and private hospitals in the region have been piloting the system, designed to reduce claims processing from an average of 54 days in 2015 to less than a week once the system is fully implemented.
The new scheme is part of PhilHealth’s goal to achieve the PHP6 billion claims this year, a big jump from PHP4.39 paid benefits in 2014.
The official admitted that the payment process was delayed after Yolanda due to damaged equipment and majority of PhilHealth staff was relocated to Cebu.
“In September 2013, we were the fastest in the country. When Yolanda struck on November 2013, the payment process was disrupted. In 2014, there was no processing of claims for six months despite rapid increase of claims due to the all-can-avail policy,” he added.
In the past few years, PhilHealth has been addressing delayed claims payment by pushing for case payment, improved operational efficiencies, overtime work by staff, proactive training, and coordination with their respective partner hospitals.
At an average, the region has been processing claims of about 2,500 patients daily, majority of them are poor families whose premium are being sponsored by the central government through funds generated from Sin Tax Law.
All the region’s more than four million population have access to health insurance, according to Bacareza. (PNA)
JBP/SARWELL Q. MENIANO