(from left to right) PhilHealth Chief Information Officer Jovita Aragona, President and CEO Emmanuel R. Ledesma, Jr. and Pulse 63 HV Philippines (SwiftClaims) Chief Executive Officer Louis Kweyamba Maguru and Deputy Managing Director Arvind Appavu signed a Proof of Value Agreement for the integration of AI in the insurance claims processing system of PhilHealth. (Photo Courtesy: PhilHealth Media Relations)
QUEZON CITY (PIA) – The Philippine Health Insurance Corp. (PhilHealth) will soon implement an AI-powered health insurance claim processing system to enable more streamlined access to healthcare services.
PhilHealth President and Chief Executive Officer (PCEO) Emmanuel R. Ledesma Jr., recently signed a Proof of Value Agreement with software designer Pulse 63 HV Philippines (SwiftClaims) CEO Louis Kweyamba Maguru to launch the use of the system.
According to the project’s Proof of Concept, the use of artificial intelligence will allow PhilHealth to improve its operational efficiency, especially in terms of eliminating the need for manual intervention in the processing of insurance claims.
Through this innovation, insurance claims will undergo real-time processing, reducing the delay in the approval and payment of clean claims to partner health facilities.
It will also lessen the instances of claims being returned to health facilities due to deficiencies or non-compliance with the applicable policies and standard requirements.
“Our application is designed to revolutionize the PhilHealth claim approval process in the Philippines,” SwiftClaims underscored.
The AI-driven technology designed by SwiftClaims guarantees to reduce the filing time of claims by 80 percent and the return-to-sender rate by 99 percent.
PhilHealth PCEO Ledesma, for his part, expressed the state health insurer’s continuous initiative to improve the quality of health insurance services for the benefit of Filipinos.
“Your PhilHealth continues to bring positive changes in how the government cares for the people through various social services. We are committed to further unburdening our Kababayans by providing responsive financial coverage under our thrust, “Pinalawak at mga Bagong Benepisyo para sa Mamamayang Pilipino,” said Ledesma during the recent PhilHealth Kapihan.
It can be recalled that PhilHealth initially implemented the Electronic Claims Submission System, which also provides for the digital submission of insurance claim requirements via the PhilHealth Web Service.
With this technological advancement, PhilHealth can further bring affordable and accessible healthcare services to Filipinos, consistent with the aim of the Universal Health Care (UHC) vision. (JMP/PIA-NCR)
