Private hospitals laud PhilHealth Region 6 for speedy claims processing


The Philippine Health Insurance Corporation (PhilHealth) Region VI Office has recently been recognized by the Private Hospital Association in Western Visayas headed by its President Elmer Q. Pedregosa, MD, MPH, MHA, and concurrent President of the Philippine College of Hospital Administrators, said that PhilHealth's efforts "resulted in faster processing of benefit claims and also reduced the number of Return-To-Hospital claims thereby contributing to a successful relationship among private hospitals in Western Visayas as partners in the healthcare industry."

Despite the marked increase in claims received from an average of 1,200 in 2011 to 1,700 in 2012, claims were processed at an average of five to seven days compared to 130 average processing days in 2011.
Turn-around-time of some 15 thousand case rate and nine thousand Fee-for-service claims in October 2012 dramatically shortened from receipt of claims up until check preparation without additional manpower and even without overtime.
The said office also successfully reduced its denied claims by more than half from 3,000 in January 2012 to only 1,400 in December of same year.
According to Dennis S. Mas, PhilHealth Vice President for Region 6, these achievements are attributed to a series of ICD 10 trainings and regular dialogues with hospitals in the Western Visayas Region.
He also said that because of proper coordination with and retooling of some 200 hospital billing clerks, return-to-hospital claims were significantly reduced from 9,000 in January 2012 down to 2,600 in December 2012.
In another development, PhilHealth Region VI’s local health insurance office in the cities of Bacolod , Kabankalan and Passi also received the Citizen’s Satisfaction Center Seal of Excellence Award by the Civil Service Commission.
Last year in celebration of 2012 National Statistics Month, said PhilHealth regional office also bagged the first prize in the Search for Best Statistical Bulletin Board by the National Statistical Coordination Board and the Regional Development Council. (END)

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