However, the Philippine Heart Center noted a reduction in the number of rejected claims from 4,214 in 2021 to 949 in 2022.
MANILA, Philippines – A total of 949 reimbursement claims worth P110 million filed with the Philippine Health Insurance Corporation were either denied or returned for amending to the Philippine Heart Center .
Out of the total claims, about P27.6 million were completely denied, while P82.5 million were returned to the hospital for refiling. According to the COA report, the management of the Philippine Heart Center’s billing and claims division is actively monitoring the denied and returned claims. They are also making efforts to collect payments from PhilHealth by filing motions for reconsideration, conducting outreach activities, and holding meetings with PhilHealth to stay updated and address gaps in implementing PhilHealth guidelines.
Although the total amount of returned and denied claims remained significant, it was lower compared to the previous year. In 2021, the Philippine Heart Center reported 4,214 denied and returned claims.
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