The Philippine Health Insurance Corporation or PhilHealth paid for pneumonia, stroke and infarction, pneumonia (high-risk), dengue fever, hypertension/hypertensive emergency urgency, stroke (hemorrhagic), newborn sepsis, chronic kidney disease, acute gastroenteritis, and urinary tract infection as among the top cases in the region.
PhilHealth 6 Acting Regional Vice President Lazaro T. Tabsing, during the Kapihan sa Bagong Pilipinas (KBP) episode, clarified that the office hasn’t received any directive from the Central Office to halt or cut the claims processes.
From December 27, 2024 to January 31, 2025, PhilHealth has paid P20.13 billion, which is 38 percent higher compared to the same period from the previous year.
PhilHealth 6 further reported that it has disbursed P927,449,839.99 for timely payments for valid claims.
“PhilHealth is committed to partner with healthcare providers, health centers, rural health units, freestanding clinics (stand alone facilities) and hospitals in addressing payment delays and streamline payment processes. We have actually lessened our average processing time to 19 days,” said Tabsing.
Janimhe Jalbuna, head of the Public Affairs Unit of PhilHealth 6, said these top cases were paid for by PhilHealth to assure the public that it has sufficient funds to cover its enhanced benefit packages, citing its P281-billion fund in reserves and P150-billion surplus funds as of October 2024, and an investment portfolio of P489 billion as of November 2024.
In terms of procedural case rates, hemodialysis is on top, followed by the claims for cesarean sections.
“PhilHealth is financially robust and we are much capable of continuing paying to fulfill our mandate. Given the figures, wala sang dapat ikakulba as we continue to give benefits,” Jalbuna assured.
(Given the figures, there is nothing to worry about, as we continue to give benefits.)
To note, the latest set of its newly-introduced and enhanced benefit packages include ischemic heart disease–acute myocardial infarction, Z package for peritoneal dialysis, Z package for kidney transplantation covering living organ donor transplantation, preventive oral health services as part of primary care services under its Konsultasyong Sulit at Tama (KonSulTa) package, and Outpatient Emergency Care Benefit providing comprehensive coverage for emergency services, among others. (PIA 6)
