PhilHealth urged to expedite reforms

SEN. Bong Go has renewed his call to the Philippine Health Insurance Corp. (PhilHealth) to hasten reforms that would ensure Filipinos would pay less for medical expenses.

"PhilHealth funds should not be dormant or going anywhere. They should be used to benefit each member — lower hospital bills, more free medicines, and fast and hassle-free services," said Go in Filipino.

"Faster payment of hospital claims so that the cost would not be passed on to the patient should be addressed. This is especially important in public hospitals where medicines are often in short supply," Go added.

PhilHealth president Edwin Mercado said the agency is working on benefits system adjustments, including expanded free medicines program and additional coverage for assistive devices such as eyeglasses and wheelchairs.

Mercado added one key program is the Emergency Care Package, which will reimburse members for essential diagnostic tests such as X-ray, ultrasound, MRI, and CT scan when seeking emergency treatment.

Mercado said coverage for maternal care and open-heart surgeries has also been expanded.

Go urged PhilHealth to resolve the denied claims backlog.

The state-run health insurer replied that it would allow hospitals to resubmit P 8.8 billion of previously rejected claims.

It added that, upon board approval, hospitals would be given six months to resubmit claims originally denied due to the 60-day filing rule. This applies to cases from Jan. 1, 2018, to Dec. 31, 2024.