Over P4-B claims paid in Q1 2024 in W. Visayas, PhilHealth reports

By Rjay Zuriaga Castor

The Philippine Health Insurance Corporation (PhilHealth) said it has paid out a total of P3.995 billion in claims in Western Visayas from January 1 to June 30 this year.

Of the total amount, P310.8 million was paid for claims in Aklan, P216.1 million in Antique, P347.6 million in Capiz, P54.8 million in Guimaras, P1.5 billion in Iloilo, and another P1.5 billion in Negros Occidental.
The paid claims have benefitted a total of 453,016 PhilHealth members benefited from these claims during the six-month period.

The largest number of beneficiaries is from Negros Occidental with 184,680 counts, followed by Iloilo with 168,177 counts, Capiz with 34,388; Aklan with 31,546; Antique with 28,710, and Guimaras with 4,515.

Meanwhile, Bien Paul Obordo, Officer-in-Charge of PhilHealth-6 Field Operations Division, said 6.2 million individuals in the region are PhilHealth members as of August. PhilHealth is projecting a population of 8.1 million for the region.

“Our target usually is 95 percent of the population and last year we were almost there. But we don’t want to settle for our target. We want no one to be left behind,” he said.

Despite recording a high number of membership count, Obordo said only around 180,000 have registered in the Konsultasyong Sulit Tama, or Konsulta package.

“Our struggle really is with the employed because there is no opportunity to apply for a Konsulta accreditation, otherwise they will be absent. In our accredited facilities, only few are open 24/7,” he added.

The Konsulta is a primary care benefit package that provides capitation payments for free annual check-ups, selected diagnostics and medicines as mandated by the Universal Health Care Law.

The PhilHealth-6 reported that the region has at least 172 Konsulta Package Providers (KPPs, with 126 of these providers in various local government units (LGUs).

There are 22 KPPs in Aklan, 27 in Antique, 21 in Capiz, 41 in Negros Occidental, 41 in Iloilo province, 11 in Iloilo City, and eight in Guimaras.

Obordo said 11 LGUs have yet to be accredited for the program, including 6 in Iloilo, 4 in Negros Occidental, and 1 in Capiz.