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IMPLEMENTATION AND BENEFITS OF PHILHEALTH E-CLAIMS IN GOVERNMENT HOSPITALS

Volume: 70  ,  Issue: 1 , February    Published Date: 26 February 2021
Publisher Name: IJRP
Views: 839  ,  Download: 1143 , Pages: 216 - 230    
DOI: 10.47119/IJRP100701220211742

Authors

# Author Name
1 ETHELMAY R. ROMERO, MBA

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