1. Inpatient Benefits
• These benefits are paid to the accredited Health Care Institution (HCI) through All Case Rates
• The case rate amount shall be deducted by the HCI from the member’s total bill, which shall include professional fees of attending physicians, prior to discharge
• The case rate amount is inclusive of hospital charges and professional fees of attending physician
• Availment condition: Member must have six (6) months contributions preceding the three months qualifying contributions within the 12-month period prior to the first day of confinement
• Documents needed: copy of Member Data Record or PhilHealth Benefit Eligibility Form (PBEF) and duly accomplished PhilHealth Claim Form 1
• Where available: all accredited HCIs*
*Different case rate amounts for selected medical conditions are being implemented when done in Primary Care facilities (PhilHealth Circular 14, s-2013)
• Only admissible cases shall be reimbursed
2. Outpatient Benefits [...full article]
3. Z Benefits [...full article]
4. SDG Related [...full article]
List of Accredited Health Facilities [Click Here]
• Level 3 Hospitals »
• Level 2 Hospitals »
• Level 1 Hospitals »
• Ambulatory Surgical Clinics »
• Freestanding Dialysis Clinics »
• Primary Care Benefit Providers »
• Maternity Care Package Providers »
• Animal Bite Package Providers »
• Outpatient Malaria Package Providers »
• Expanded Primary Care Benefit Providers »
• Accredited Primary Care Facilities (Infirmary/ Dispensary) »
• Family Planning Providers »
• TB-DOTS Centers »
• Drug Abuse Treatment and Rehab Centers »
• Z Benefits Contracted Hospitals »
• DOH-Designated HIV Treatment Hubs »
• Health Facilities with My PhilHealth Portal »
• HCIs with Letter of Intent under GIDA and HHSRA
No comments:
Post a Comment