The Philippine Health Insurance Corporation (PhilHealth) on Thursday reported a significant improvement in its claims processing time, reducing the national average turnaround time (TAT) for good claims to 24 days in 2024 from 34 days in 2023.
“This only shows our continuous commitment to processing and payment of good claims ahead of prescribed 60 days TAT,” PhilHealth Acting President and CEO Dr. Edwin Mercado said through an advisory.
PhilHealth defines “good claims” as those that include all required documents and meet existing guidelines under the National Health Insurance Program and the Universal Health Care (UHC) law.
PhilHealth’s total benefit payouts increased by 22.71 percent in 2024, reaching P165 billion from P119 billion in 2023.
Despite the increase in payouts, around 5.3 percent of total claims, amounting to approximately P10 billion, were either denied or returned to hospitals due to deficiencies or guideline violations.
“Health Facilities (HFs) are hereby encouraged to submit good claims earlier than the prescribed 60-day period to further reduce and ensure early release of PhilHealth payment,” PhilHealth reminded.
“We will continue to work closely with healthcare providers and other partners through continuous reconciliation to maintain the quality of service and improved financial support value that our members can rely on,” the advisory concluded.