ILOILO CITY—The Philippine Health Insurance Corporation (PhilHealth) has paid out over PHP3.995 billion in medical claims across Western Visayas in the first half of this year, highlighting a broad spectrum of medical conditions and procedures financed by the insurer.
According to the Philippines News Agency, Janimhe Jalbuna, head of the public affairs unit at PhilHealth VI, reported in an interview on Wednesday that lifestyle diseases such as hypertension were significant contributors to the claims, totaling PHP67.989 million. The highest individual claim was for moderate-risk pneumonia, amounting to PHP314.8 million. Hemodialysis procedures, heavily influenced by diabetes and hypertension, topped the list for medical procedures with claims reaching PHP593.68 million.
Jalbuna emphasized the potential of PhilHealth’s Konsulta benefit package to address some of these conditions preemptively. “Hopefully, they will be able to maximize the Konsulta benefits to at least prevent the medical condition, if they have, from worsening and getting confined,” she stated. This initiative is part of a broader effort to reduce in-patient care by enhancing early interventions through primary care services.
Other notable claims for medical conditions included hypertensive emergency urgency (PHP67.99 million), acute gastroenteritis (PHP39.86 million), urinary tract infections (PHP40.72 million), and chronic kidney disease (PHP47.38 million), among others. The claims for medical procedures also featured significant payouts for routine obstetric care, chemotherapy, and caesarean sections, with the latter receiving claims upwards of PHP115.19 million.
The Konsulta package, aimed at reducing hospital admissions, offers comprehensive primary care services, including 15 diagnostic services and 21 drugs and medicines. Between January and June, PhilHealth processed 407,260 claims, with 9.77 percent paid within the applicable timeframe. The organization noted an improvement in the turnaround time for payment claims, now averaging 19 days—significantly faster than the mandated 60 days.
This substantial disbursement reflects PhilHealth’s ongoing commitment to providing timely and effective healthcare financing across the region, amid efforts to streamline operations and enhance patient care through preventive health measures.