benefit availment procedures

Outright/automatic deduction of benefits:

1. Present your valid Lifetime ID Card to the admitting/billing section.

2. Submit the following to the billing section prior to discharge:

• Duly accomplished PhilHealth Claim Form 1
• Copy of valid Lifetime Card
• Clear copy of Member Data Record (MDR)
  
  If qualified dependent is not listed in MDR, submit applicable proof of dependency.

3. Agree with attending physicians on how much is left to be paid for their services over the professional fee benefit.

4. Upon submission of all applicable documents, the billing section will compute and deduct your benefits from the total hospital bill.

Direct Filing/reimbursement

Submit the following to PhilHealth or through the hospital in addition to the documents mentioned earlier within 60 calendar days from the date of discharge:

• Health Claim Form 2 (CF-2) filled up by the hospital and attending physicians
• Official receipts or hospital and doctor's waiver
• Operative record for surgical procedures performed

Confinements abroad:

Submit the following within 180 days from the date of discharge. Overseas confinements shall be paid based on Level 3 hospital benefit rates.

• PhilHealth Claim Form 1
• Member Data Record (MDR) or supporting documents
• Original official receipt or detailed statement of account (written in English)
• Medical certificate (written in English) indicating the final diagnosis, confinement period, and services rendered