PhilHealth to hospitals: Start filing claims as submission period is now 60 days
MANILA, Philippines — The Philippine Health Insurance Corporation (PhilHealth) on Wednesday reminded partner hospitals to start filing reimbursement claims after the submission period reverted to 60 calendar days from a patient’s discharge.
With the end of the COVID-19 emergency, Philhealth said that the submission deadline has returned to its regular 60 days.
It can be recalled that the COVID-19 state of calamity provided special privileges, including extending the submission period from 60 to 120.
“We urge all our partner hospitals to start submitting their claims within the usual 60 calendar days as provided for in Section 46, Rule II of Republic Act 7875, as amended by RA 9241 and RA 10606 as amended for their admitted patients starting January 1 of this year,” PhilHealth Chief Emmanuel Ledesma Jr. said.
“Para maiwasan naman ang mga claims na denied o bumabalik sa ospital, patataasin natin ang kaalaman ng mga providers at billing personnel patungkol sa ating mga polisiya para maiwasan ang mga depektibong claims at ang pabalik-balik na proseso,” he added.
(To avoid claims that are denied or returned to the hospital, we will increase the knowledge of providers and billing personnel regarding our policies to prevent defective claims and the back-and-forth process.)
Ledesma then emphasized the importance of settling the claims to allow Philhealth to pay per the country’s rules and regulations.
He then urged the hospitals to coordinate with their respective PhilHealth Regional Offices to continue reconciling claims data, and for other assistance they may need to serve PhilHealth members and their families best.
In 2022, PhilHealth recorded an average turn-around time of 29 days in paying claims.
It also reported benefit payouts amounting to P129.6 billion as of December 31, 2022.
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