• 07/21/2019
  • 12:07 AM
League Online News
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PHILHEALTH PAYS P2.5-B IN CLAIMS IN NEGOCC



BACOLOD CITY -- The Philippine Health Insurance Corporation (PhilHealth) released more than PHP2.508 billion in benefit payments to its members in Negros Occidental from January to November this year.

A report of PhilHealth-6 as of Monday showed the amount which was released for a total of 270,708 claims was part of the almost PHP7.193 billion paid by the agency in Region 6 (Western Visayas) during the period.

Janimhe Jalbuna, head of PhilHealth-6 Public Affairs Unit, said in Western Visayas, the average turn-around time for payments is 32 days, which is faster than the 60-day allowable period.

In November, it was only 19 days while in October and September it was 22 days, records also showed.

“There is no reason for providers not to provide benefits to our members,” Jalbuna said in an earlier statement.

As of Nov. 30, 2018, the bulk of benefit payments in Negros Occidental, which is 26 percent or PHP660 million, was for indigent members. Others included PHP521 million (21 percent), for senior citizens; PHP505 million (20 percent), informal economy; PHP453 million (18 percent), formal economy; PHP216 million (9 percent), lifetime members; and PHP151 million (6 percent), sponsored members.

The top paid medical conditions in Negros Occidental were the following: pneumonia moderate risk (17,588 benefit cases/payments), PHP254.967 million; dengue fever (5,282cases), PHP51,338 million; hypertensive emergency-urgency (5,556 cases), PHP48.412 million; urinary tract infection-admissible (6,175 cases), PHP42.756 million; and acute gastro enteritis (7,124 cases), PHP39.994 million.

For procedural, the highest paid conditions included hemodialysis procedure, (68,911 cases) PHP379.448 million; normal spontaneous delivery package for hospitals (17,648 cases), PHP92.314 million; maternity care package-first claim(8,236 cases), PHP65.965 million; normal newborn care package (29,910 cases), PHP49.311 million; and chemotherapy administration (4,889 cases), PHP35.675 million.

Meanwhile, five of the top 10 paid medical facilities in Western Visayas are in Negros Occidental. These are the Corazon Locsin Montelibano Memorial Regional Hospital (CLMMRH) in Bacolod City with the highest benefit payment of PHP601.030 million; Dr. Pablo O. Torre Sr. Memorial Hospital in Bacolod City, third, PHP290.121 million; Adventist Medical Center-Bacolod Inc., sixth, PHP179.706 million; Teresita L. Jalandoni Provincial Hospital in Silay City, seventh, PHP166.174 million; and San Carlos City Hospital, ninth, PHP186.224 million. (PNA)

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