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Manila Bulletin devider Philippines devider National devider PhilHealth announces extension of privileges for systems optimization, changes effective on Feb. 1

PhilHealth announces extension of privileges for systems optimization, changes effective on Feb. 1

Published Jan 25, 2024 08:48 am

The Philippine Health Insurance Corporation (PhilHealth) declared on Thursday, Jan. 25, the extension of privileges related to ongoing systems optimization until Jan. 31.

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(PhilHealth)

The announcement through PhilHealth Advisory No. 2023-0039 outlined changes that will come into effect on Feb. 1, impacting the processing of claims and related procedures.

Meanwhile, regarding the extension details, it has been communicated that the privileges due to PhilHealth Systems Optimization will only be applicable until Jan. 31.

It also highlighted that health facilities are urged to take note of this cutoff date, as all privileges outlined in previous advisories will be terminated starting Feb. 1.

Moreover, the health insurer provided detailed clarifications on the filing periods for claims related to PhilHealth Systems Optimization.

It said that claims aging between the 61st and 120th day after the discharge date, submitted from June 1, 2023, to Jan. 31, 2024, will continue to be processed.

However, claims aging more than 120 days after the discharge date, and submitted within the same period, will face denial.

Additionally, claims aging more than 60 days after the discharge date, submitted from Feb. 1, 2024, onwards, will also be denied, as stated by PhilHealth, and the rules on the 60-day filing period will apply to all manually submitted claims.

Meanwhile, despite the changes, PhilHealth highlighted that online registration for Chronic Kidney Disease stage five patients in the PhilHealth Dialysis Database (PDD) and online applications for Cataract Pre-Surgery Authorization (CPSA) will remain "mandatory."

Health facilities and practitioners were advised to stay abreast of these modifications to ensure compliance with the evolving procedures set forth by PhilHealth.

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Philippine Health Insurance Corp.
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