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Daisy

What a PHILHEALTH member or beneficiary should do upon admission

6 posts in this topic

Yesterday, Alan checked out from the hospital after 3 days of confinement. Here are some points I would like to share to avoid some misunderstanding with hospital authorities:

 

1. Upon admission tell them right away that the patient is under PHILHEALTH program. By this you will not be asked for any outright downpayment and medicines will be provided for from the Hospital pharmacy.

 

2. Be aware that if there is an operation, the minimum requirement for the PHILHEALTH membership is 9 months prior to the date of admission. 6 months if just an ordinary admission.

 

3. Be sure also to ask the hospital authorities what are their requirements. Each hospital have their own policies. Here's the example:

 

Two months ago my son was admitted in Polymedic Hospital here in CDO, when I paid his bills, the hospital clerk just asked a photocopy of the official receipt of the last 6 months....and that's it, I only paid the hospital balance after PHILHEALTH deductions.

 

Yesterday, Alan checked out from Ma Reyna Hospital and the hospital required me to have a form signed by PHILHEALTH officer in their office before they will credit the amount due for PHILHEALTH. Since it was Saturday and there is no office, we are obliged to pay the total amount with the assurance that the PHILHEALTH counterpart will be refunded upon submission of the signed form on Monday! This is their own hospital policy and applicable to ALL not only foreigners.

 

It was my fault for assuming that all hospitals have the same policy as regards to PHILHEALTH payment! Although my radical mind told me this is illegal....but POLICY is POLICY!!!! It is always better to know and be aware in anything that we deal with!

 

HAPPY NEW YEAR.........CHEERS 2010!!!

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Yesterday, Alan checked out from the hospital after 3 days of confinement. Here are some points I would like to share to avoid some misunderstanding with hospital authorities:

 

1. Upon admission tell them right away that the patient is under PHILHEALTH program. By this you will not be asked for any outright downpayment and medicines will be provided for from the Hospital pharmacy.

 

2. Be aware that if there is an operation, the minimum requirement for the PHILHEALTH membership is 9 months prior to the date of admission. 6 months if just an ordinary admission.

 

3. Be sure also to ask the hospital authorities what are their requirements. Each hospital have their own policies. Here's the example:

 

Two months ago my son was admitted in Polymedic Hospital here in CDO, when I paid his bills, the hospital clerk just asked a photocopy of the official receipt of the last 6 months....and that's it, I only paid the hospital balance after PHILHEALTH deductions.

 

Yesterday, Alan checked out from Ma Reyna Hospital and the hospital required me to have a form signed by PHILHEALTH officer in their office before they will credit the amount due for PHILHEALTH. Since it was Saturday and there is no office, we are obliged to pay the total amount with the assurance that the PHILHEALTH counterpart will be refunded upon submission of the signed form on Monday! This is their own hospital policy and applicable to ALL not only foreigners.

 

It was my fault for assuming that all hospitals have the same policy as regards to PHILHEALTH payment! Although my radical mind told me this is illegal....but POLICY is POLICY!!!! It is always better to know and be aware in anything that we deal with!

 

HAPPY NEW YEAR.........CHEERS 2010!!!

 

 

Thanks Daisy,that is good useful information.thumbsup.gif

 

Happy New Year to you and your family.

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Ate, I've been confined at three different hospitals before and so far, they all required the same; fill out a Philhealth form, and submit a photocopy of the receipts and of my Philhealth card. They then deducted the Philhealth coverage from the bill upon submission.

 

However, even if you inform them that you are a Philhealth member or the patient is a Philhealth dependent, they will still require you to pay a deposit and the amount differs depending on the nature of the illness. If the patient is going to undergo surgery, the hospital usually requires at least 10,000 deposit.

 

Regarding the medicine, most nurses suggest that you buy from outside pharmacies as hospitals put a mark up of at least 30% on the medicine prices. You just have to keep all the receipts and submit them with the Philhealth form. You will then have to wait for 4 to 6 months for Philhealth to send you the refund. Two weeks ago, I received the refund for my confinement in May.

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Thanks for the excellent info! My experience with Philhealth goes back ten years, so I'm not sure how relevant it is today? My visit to a private hospital in Bacolod was due to me contracting dengue fervour. I'm not sure if my wife told the people at reception that we were covered by Philhealth (a deposit was paid), but when we went to pay at the end of my stay, the Philhealth component was simply deducted from the bill (which reduced the bill by about a third). But like you said, policies vary from hospital to hospital.

 

Regarding the waiting period. I think it can be waived, as long as you prepay about one year's contributions in advance (I tried to check this, but the Philhealth site is down).

 

Andrew

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Regarding the waiting period. I think it can be waived, as long as you prepay about one year's contributions in advance (I tried to check this, but the Philhealth site is down).

 

Andrew

I made a mistake there, Andrew. It was not for my confinement in May, it was in July.

 

It depends on the type of membership you have. In my case, I am now a voluntary paying member and paying 100 pesos per month. I've paid in full for the year 2009.

 

If your wives are working, have them check if their contributions are remitted to Philhealth regularly. Some establishments are collecting from their employees but are not remitting these contributions. The employees will only learn of this and be surprised when they fall sick and could not avail of the Philhealth coverage.

 

You can also do the same with SSS (Off topic now.) If the member falls sick, they can file for Sickness Benefit provided that they're paying regularly.

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Additional inputs:

 

I got our refund today after I went to PHILHEALTH office. From there I knew that as a member, we need to have a copy of a MDR form. (Medical Data Record) Listed in it are also the names of your beneficiary/beneficiaries. Have it photocopied everytime you or your beneficiary is admitted along with the Official Receipts, 6 months prior for normal admission and 9 months if there's an operation!

 

There is no such thing as hospital policy because PHILHEALTH policy will prevail in this case. However keep in mind that there should be an interval of at least 3 months before you could be covered of the same illness. Any re-admission of the same illness in less than 3 months will not be covered!

 

Please don't miss paying every quarter. You can't backtrack payment but you can pay in advance but still have to wait for the 6 or 9 months minimum membership requirement before availment.

 

Hope this will help....lots of Filipinos like me sometimes does not know this until we are there......!

Edited by Daisy

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