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PhilHealth pays P461M for health claims of OFWs - March 03, 2006

THE Philippine Health Insurance Corporation (PhilHealth) recently announced that it has paid P461 million for the health insurance benefit claims of Overseas Filipino Workers (OFWs) and their families as of December-end 2005.

Lorna O. Fajardo, Officer-in-charge of the Office of the PhilHealth President and CEO said that P258 million or 56 percent of this amount represents PhilHealth’s payments for 35,158 claims for in-patient and out-patient benefits that it inherited from the Overseas Workers Welfare Administration (OWWA) in March last year.

She added that P203 million or 44 percent of total benefit payments were for about 29,363 claims for in-patient and out-patient benefits it received directly from OFWs from March to December last year. Total current claims received reached 40,215, for which 73 percent had already been paid for.

"When we started handling the Medicare program for OFWs and their families, we did not exactly begin with zero number of claims. In fact, we inherited 48,964 claims from the OWWA, 72 percent of which have already been paid for before 2005 ended," Fajardo emphasized. She added that some 9,826 or 20 percent of these were returned to hospitals for various reasons while 2,038 or four percent were denied. "We had to introduce measures to ensure that we would be able to immediately settle these claims for the benefit of our OFW-members," Fajardo said. These measures included hiring additional personnel to beef up its current workforce, specially where claims processing is concerned.

About 1,942 more of the OWWA-inherited claims are being processed as of press time. "We would like to assure our OFW-members and their kins that we are doing our best torespond to their needs," she said. "After all, it is our mandate to see to it that social health insurance is working to their advantage," Fajardo stressed.

With the turnover of the Medicare program for OFWs and their kins, PhilHealth ensured that no diminution nor discontinuity of existing benefit packages will ensue.

Land-based OFWs are covered by PhilHealth through the OWP. Sea-based OFWs, meanwhile, are covered under the Employed Sector Program. Both types of OFWs may file for reimbursement of their hospitalization expenses with PhilHealth even if they are confined overseas. At the same time, their legal dependents in the country may avail themselves of PhilHealth benefits through any of the 1,564 accredited hospitals in the country.

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