Higher than last year’s payment
TACLOBAN CITY – The Philippine Health Insurance Corp. (PhilHealth) in Eastern Visayas has disbursed a record P5.6 billion in claims in 2024, reflecting a 51% increase from P3.7 billion in the previous year.
According to Asisclo Militante Jr., head of PhilHealth’s field operations division, the rise in claims is attributed to the agency’s expanded coverage, particularly benefiting low-income families, and improved awareness of healthcare benefits among members.
“We had more claims last year as we expanded our coverage, especially for poor families. We are focused on maintaining critical services to ensure that those who need them most continue to receive proper medical care despite funding challenges,” Militante said during the ‘Kapihan sa Bagong Pilipinas’ of the Philippine Information Agency(PIA) Tuesday, February 11.
PhilHealth also accelerated its claims processing, reducing the turnaround time from 26 days to just 19 days, significantly faster than the 60-day legal limit and the 30-day ideal processing period.
Militante emphasized that there have been no cases of delayed payments to hospitals and healthcare providers in the region.
Currently, there are over 200 accredited PhilHealth healthcare facilities in Eastern Visayas, including hospitals, rural health centers, and birthing clinics.
Meantime, Rosario Suyom, the agency’s health care delivery management chief, reported that moderate-risk pneumonia ranked first in total benefits paid, amounting to P741 million, while hemodialysis remained the most frequently claimed procedure, with payments reaching P710 million.
In 2023, PhilHealth processed 162,733 hemodialysis claims, compared to 19,678 pneumonia-related claims. However, the higher payout for pneumonia in 2024 is due to a 50% increase in benefits, from P15,000 to P29,250 per case.
At present, 4.9 million individuals—including PhilHealth members and their dependents—are covered under the agency in Eastern Visayas.
(JOEY A. GABIETA)
