P10-B hospital claims denied in 2024, says Philhealth

A TOTAL of P10 billion in benefit claims by its accredited hospitals have been denied by the Philippine Health Insurance Corporation (PhilHealth) last year.

In a statement, PhilHealth president and chief executive officer Edwin Mercado said that it has denied hospital claims amounting to P10 billion in 2024 alone.

"About 5.3 percent of the total claims received, estimated to cost around P10 billion, were either denied payment or returned to hospitals (RTH) due to deficiencies and/or violations of existing policies and guidelines," said Mercado.

He said the PhilHealth has also made a P165 billion benefit payout for 2024.

"PhilHealth remains steadfast and committed to paying claims that are without deficiencies and compliant to all pertinent policies and requirements," said Mercado.

He urged all hospitals and health facilities to submit good claims or those with complete documentary requirements and compliant to existing policies and guidelines.

The PhilHealth chief also urged the filing of claims earlier than the prescribed 60-day period.

Mercado said those in need of assistance may contact the PhilHealth Corporate Action Center Hotline at (02) 866-8580 or email actioncenter@philhealth.gov.ph. (Anton Banal/SunStar Philippines)