PhilHealth signs pact to use AI for faster claims reimbursement

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The Philippine Health Insurance Corporation (PhilHealth) recently signed a Proof of Value Agreement with Pulse 63 HV Philippines (SwiftClaims) for the use of a special software designed by the former to enhance processing of health insurance claims using artificial intelligence.

The Proof-of-Concept which is the subject of the proof of value agreement aims to reduce claims processing time and minimize claims being returned to health facilities due to deficiencies.

The AI-powered system is expected to process claims in real-time, applying complex business rules and validating against PhilHealth policies and guidelines. Expected results include the elimination of manual intervention and acceleration of approval and payment of clean claims to partner health facilities.



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