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(NAR) VOL. 25 NO. 1 / JANUARY - MARCH 2014
[ PHILHEALTH CIRCULAR NO. 0036, S. 2013, November 19, 2013 ]
CLARIFICATION TO PHILHEALTH CIRCULAR 9, S.2013: AMENDMENTS ON INDICATING PROFESSIONAL FEES REIMBURSEMENT IN CLAIM FORM 2 (APPLICABLE FOR FEE-FOR-SERVICE PAYMENT MECHANISM)
Date Filed: 17 February 2014
PhilHealth has long been in partnership with health care professionals in pursuit of Universal Health Care (UHC) and provision of quality health service for PhilHealth members. The National Health Insurance Program’s success depends on the full cooperation and participation of accredited health care professionals. As such, PhilHealth endeavors to reimburse the professional fees for their services rendered.
This Circular clarifies Item No. 2 of PhilHealth Circular No. 9, s. 2013, that for as long as the health care professional indicated any of the following “zero or (0)”, “complimentary” or “PhilHealth benefit”, “No PF”, “co/ co. / company” either in words or amount in the boxes for total actual PF or amount paid by members in PhilHealth Claim Form 2, the PhilHealth benefit for professional fee shall be reimbursed to the concerned health care professional. Likewise, professional fee shall be reimbursed to the health care professional if he/she indicated “complimentary” or “PhilHealth benefit” either in words or amount in the box for PhilHealth benefit.
The effectivity and coverage of this Circular shall follow that of PhilHealth Circular 9, s.2013. Furthermore, this Circular shall be published in a newspaper of general circulation and shall be deposited thereafter with the National Administrative Register at the University of the Philippines Law Centre.
(SGD) ALEXANDER A. PADILLA
President & CEO