The Philippine Health Insurance Corp. (PhilHealth) is set to revolutionize the processing of health insurance benefits through the adoption of artificial intelligence (AI).
PhilHealth has entered into a proof of value agreement with Pulse 63 HV Philippines (SwiftClaims) to implement specialized software aimed at streamlining reimbursement procedures.
The agreement was signed by PhilHealth President and CEO Emmanuel Ledesma Jr., Chief Information Officer Jovita Aragona, SwiftClaims CEO Louis Kweyamba Maguru, and Deputy Managing Director Arvind Appavu.
PhilHealth aims to significantly reduce the time required for claims processing and minimize instances where claims are returned to hospitals due to deficiencies.
The AI-powered system is designed to process claims in real time, applying intricate business rules and validating against PhilHealth policies.
The initiative is expected to eliminate the need for manual intervention, thereby accelerating the approval and payment of claims to partner health facilities.
PhilHealth anticipates that this technological advancement will enhance efficiency and transparency in the reimbursement process, benefiting both healthcare providers and insured individuals alike.
Photo Courtesy: Philippine Information Agency
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