PhilHealth 10 settles P17.3m Covid claims

By : Uriel Quilinguing Mindanao Today/12:59:33pm 07/29/2021


The Philippine Health Insurance Corporation (PhilHealth) has settled P17,280,720 hospitals claims in Northern Mindanao on the admissions of coronavirus disease (Covid-19) patients.

Acting vice president Delio A. Aseron II, who assumed his post in the region two weeks ago, disclosed the payments of Covid-19-related claims to various hospitals in a virtual news conference on Wednesday, July 21, 2021.

“Our turn-around time, for good claims, is 25 to 30 days,” said Aseron, though PhilHealth, by law, is given 60 days for the processing and payment of claims.

He said PhilHealth, which has fiduciary duties to safeguard members’ insurance premiums, usually pays 60% of the amount of claims, the remaining 40% upon reconciliation and review of documents.

“Ang mga kaso natin sa Covid ay naka-ankla sa pneumonia (Our Covid cases are anchored on pneumonia),” said the PhilHealth 10 chief, hence the benefit packages are based on the health status of the pneumonia patient.

As provided for under PhilHealth Circular No. 2020-0009, range of benefit packages range from P43,997 to P786,384, depending on the symptoms whether mild, moderate, severe or critical. These patients must have yielded positive results from reverse transcriptase-polymerase chain reaction (RT-PCR) tests.

Also, PhilHealth Circular No. 2021-0008 issued on Feb. 10, this year, provides for “intermediate package” of benefits, ranging from P18,000 to P38,000 for patients tagged as probable Covid-19 case and whose RT-PCR test result was negative for Covid-19-causing severe acute respiratory syndrome-coronavirus 2 (Sars-CoV-2).

Aseron said all claims are being subjected to medical pre-payment review, hence there are those that are denied, others only need to comply with documentary requirements.

Meanwhile, the new PhilHealth 10 head advised all employers in the region to report the status of their businesses; those who had shut down, downsized, or temporary closed due to pandemic.

He said that as of June, this year, 47 “large” firms and 253 “retail” businesses have informed PhilHealth 10 they have either temporarily or totally stopped operations. These employers used to remit about P8 million premiums to PhilHealth annually.

PhilHealth Regional Office 10 (PRO 10) has enrolled 4,126,442 members, as of the end of May this year, roughly 81% of the 2021 projected 5,074,563 regional population.

PRO 10’s membership management group has listed 4,126,442 registered members: 2,288,195 regular and 1,838,247 dependents. (30)

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