IMPLEMENTATION AND BENEFITS OF PHILHEALTH E-CLAIMS IN GOVERNMENT HOSPITALS
Authors:ETHELMAY R. ROMERO, MBA
Open Access
Journal Type:Research Article
Subject:Business Studies
Subject Field:Business and Management
Volume:70, Issue: 1, February, 2021
Publish Date:25 February 2021 7:00 pm
Pages:216-230
Download:3196
Views:1434
Abstract
The study entitled, Implementation and Benefits of PhilHealth E-Claims of Government Hospitals
is a descriptive research design with the use of purposive non-probability sampling technique as basis for the
distribution of questionnaire in type of Likert Scale and close-ended interview guide sheet to twenty seven
(27) authorized personnel of Government Hospitals to determine the 1) demographic profile of the
respondents; 2) level of eClaims quality service in terms of Claim Eligibility Web Service (CEWS),
Electronic Claims Submission (ECS) and Claim Status Verification (CSV); 3) the implementation and
benefits of E-Claims of Government Hospital in Laguna; 4) level of perception of authorized personnel in the
eClaims system, and 5) the significant effect of PhilHealth Circular No. 30, s-2017 to the level of
implementation and benefits of Government Hospitals in Laguna.
Based on the overall analysis on the level of eClaims quality service in terms of CEWS, it is ?Moderately
Implemented?; ECS is ?Moderately Implemented?; and CSV is ?Fully Implemented?. Therefore, the
researcher inferred that the PhilHealth Circular No. 30, s-2017 has significant effect on the level of
implementation of Government Hospitals in Laguna.
For all the given result of the data, the researcher highly recommends to update and to enhance the two phases
of eClaims system which are the CEWS and the ECS which could complete the essential features and the
implementation of the said system. The PhilHealth must actively monitor the compliance of all of their
Accredited Health Care Institution (HCI) which could reduce the length of their compliance. And they must
also continue to develop and sustain a program for the improvement of the employee?s performance in order
to enhance clients? satisfaction