THE Philippine Health Insurance Corporation (PhilHealth) is set to tap artificial intelligence (AI) technology to further improve its processing of health insurance claims.
In a statement after signing an agreement with Pulse 63 HV Philippines (SwiftClaims), PhilHealth said it is set to start using AI in processing health insurance claims.
“We will use a special software designed by the former to enhance processing of health insurance claims using artificial intelligence,” said PhilHealth.
The state-run health insurer said the AI-powered system is expected to process claims in real-time by applying complex business rules and validating against PhilHealth policies and guidelines.
Its expected results include eliminating manual intervention and accelerating approval and payment of clean claims to accredited hospitals and health facilities.
“We aim to reduce claims processing time and minimize claims being returned to health facilities due to deficiencies,” said PhilHealth.
PhilHealth has faced criticisms over delays in its reimbursement of hospital claims in private and public health facilities.
