Manila: The Philippine Health Insurance Corporation (PhilHealth) announced on Tuesday that it will commence the reprocessing of previously denied hospital claims from November 15 until March 31, 2026. This initiative encompasses claims that were neither protested nor appealed and were submitted late between January 1, 2018, and December 31, 2024.

According to Philippines News Agency, PhilHealth President and Chief Executive Officer Edwin Mercado highlighted that the decision reflects an understanding of the difficulties hospitals encounter during claim processing. “We understand that hospitals have long raised concerns about denied claims,” Mercado stated, pointing out that many claims were not processed due to late submissions or other administrative issues.

Mercado emphasized that these claims were not fraudulent and are eligible for reprocessing. “These are not fraudulent claims and will be reprocessed,” he noted. He further stressed the importance of timely claim submissions, which enable the state insurer to efficiently deliver quality healthcare by ensuring prompt payment processing for services rendered by healthcare providers.

PhilHealth has urged affected hospitals to engage with their respective PhilHealth Regional Offices to obtain comprehensive guidelines on the reprocessing procedure for denied claims.