Implementation of Adjusted Rates for Severe Dengue and for the Rates Adjustment of the Inpatient Benefits Package Coronavirus Disease (COVID-19)

PhilHealth has released Circulars No. 2024-0025 and No. 2024-0026, which introduce revised rates for Severe Dengue and the Inpatient Benefits Package for COVID-19, effective November 1, 2024. 

To ensure smooth implementation of these updates and full system compliance, we advise hospitals to follow the workaround outlined below for managing the new Case Rate Amounts until system updates are fully deployed:

We recommend prioritizing the submission of claims for patients who were confined before November 1, 2024. This will ensure that all claims made under the previous rates are processed before the rate change takes effect.

After submitting claims for confinements that occurred before November 1, 2024, please proceed to update your facility’s eClaims Case Rate with the new amounts effective starting November 1, 2024. For instructions on how to update the rates, please refer to the link below.

Guidelines in editing case rate amount build

Process New Claims Under Updated Rates

Once your eClaims Case Rate is updated, you may begin processing new claims that qualify for the revised rates starting November 1, 2024.

For Beacon user
Tag Case Rate and Update Custom Amount

The Beacon has already updated the case rate amount. For claims dated before November 1, 2024, the process after tagging the case rate is to proceed to the "ALL CASE RATES" section and input the old case rate amount. For detailed guidance on how to customize the case rate amount, please refer to the link below.

Guidelines in editing case rate amount build

We appreciate your cooperation as we work to ensure full system compliance with these updated guidelines.

Best regards,
BizBox Team