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ILOILO CITY – The Philippine Health Insurance Corporation (PhilHealth) has paid over PHP3.995 billion in claims in Western Visayas from January to June 30 this year.
Lifestyle diseases like hypertension ranks second in terms of claims at PHP67.989 million, PhilHealth VI public affairs unit head Janimhe Jalbuna said in an interview on Wednesday.
The highest was moderate-risk pneumonia with PHP314.8 million.
Meanwhile, the hemodialysis procedure, which got the highest claim for medical procedures at PHP593.68 million, has risk factors such as diabetes and hypertension.
‘Some of these conditions can be addressed by our Konsulta benefit package. 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,’ Jalbuna said.
Other top claims for medical cases included hypertensive emergency urgency at PHP67.99 million; acute gastroenteritis, PHP39.86 million; urinary tract infection, PHP40.72 million; peptic ulcer dis
ease without hemorrhage, PHP24.24 million; dengue fever, PHP33.06 million; anemia, PHP34.68 million; chronic kidney disease with PHP47.38 million; fluid and electrolyte disturbances, PHP24.65 million; newborn sepsis, PHP39.48 million; and asthma in acute exacerbation with PHP20.26 million.
For medical procedures, included in the top 10 claims were the expanded newborn package with PHP76.34 million; routine obstetric care including antepartum care, PHP101.6 million; chemotherapy administration, PHP93.28 million; animal bite, PHP34.2 million; intensity modulated treatment delivery, PHP55.94 million; routine obstetric care including prenatal, PHP63.47 million; outpatient with human immunodeficiency virus – acquired immunodeficiency syndrome (HIV-AIDS), PHP61.2 million; caesarean section primary, PHP115.19 million; radiation treatment delivery, PHP10.59 million; and caesarean delivery, with PHP65.22 million.
Jalbuna said through the Konsulta package, they are looking at reducing in-patient care, especially for
common medical conditions.
‘We are campaigning for the Konsulta so that we can keep those who are healthy and at least prevent the worsening of those with medical conditions, and they won’t get admitted in hospitals because we already have early interventions,’ she said.
The Konsulta package offers primary care services, 15 diagnostic services, and 21 drugs and medicines.
This year, from January to June 30, PhilHealth got 407,260 good claims, where 9.77 percent were paid within the applicable time.
PhilHealth said the turn-around time for the payment claims is 19 days, faster by 41 days than the mandated 60 days. (PNA)
Source: Philippines News agency
