PhilHealth-Davao ensures timely claims payments

A PHILHEALTH Regional Office Davao (PhilHealth-Davao) representative reported that they are on track with paying claims to hospitals, having disbursed around P8 billion in claims within the region.

Kleah Gayle D. Guevera, PR Officer of PhilHealth-Davao, shared during Wednesday's Habi at Kape on August 7, 2024, at Ayala Malls Abreeza that they handle hospital claims with diligence, provided they are valid. For 2023, PhilHealth-Davao has paid out P8.8 billion for 573,299 claims.

“For the past year or months we have been actively addressing the issue informing the public that when it comes to claims payment we are very right on track dito po sa [here in] Davao Region and we are paying with due diligence the claims of our hospitals,” she said. 

She explained the types of claims: good claims, which are fully completed with all required documentation and comply with PhilHealth’s policies; Return to Hospital (RTH) claims, where incomplete claims are returned to the hospital for additional information; and denied claims, which do not meet PhilHealth’s policies and provisions.

“What we can assure that when it comes to good claims PhilHealth pays for it within our prescribed turnaround time,” she said. 

Dr. Gianelli Kristine Remocaldo, a medical specialist at PhilHealth-Davao, noted that RTH and denied claims in the Davao Region account for less than five percent. The turnaround time for good claims is well below the statutory period of 60 days.

“The paying of good claims meaning from the time that we receive the claims in the regional office until the hospital or the HCIS [Health Care Information System] is way below the statutory period of 60 days,” she said.  

Guevera also highlighted that, under the Universal Health Care Law, PhilHealth-Davao is working towards universal coverage for all Filipinos. 

As of 2023, the registration rate is 98 percent, covering 5 million individuals in the projected population for the region.

The office encourages non-members and those aged 21 and above to register, aiming for a 100 percent registration rate. RGP