The Philippine Health Insurance Corporation (PhilHealth) on Monday signed an agreement aimed to reduce claims processing time using Artificial Intelligence (AI) technology.
According to PhilHealth, the Proof of Value Agreement signed with Pulse 63 HV Philippines (SwiftClaims) is for the use of a specialized software designed to cut claims filing time by up to 80%, allowing healthcare providers to focus on patient care instead of paperwork.
Philhealth also said that the AI-powered system is expected to process claims in real-time, applying complex business rules and validating against PhilHealth policies and guidelines.
Beyond optimized claims reviewing, SwiftClaims technology allows insurers like PhilHealth to access analytics rich with real time data necessary to creating actionable insights, and prevent fraud by verifying trust and revealing suspicious and flagged claims in an automated manner.
“Expected results include the elimination of manual intervention and acceleration of approval and payment of clean claims to partner health facilities.”
Philhealth President and CEO Emmanuel Ledesma Junior and Chief Information Officer Jovita Aragona led the signing of agreement with Pulse 63 HV Philippines (SwiftClaims) Chief Executive Officer Louis Kweyamba Maguru and Deputy Managing Director Arvind Appavu.
