PhilHealth

Circulars

Circulars 2013

(Circular No. 36, s-2013) Clarification to PhilHealth Circular 9, s.2013: Amendments on Indication Professional Fees Reimbursement in Claim Form 2 (applicable for fee-for-service payment mechanism) Philippine Star | Publication Date: 01-27-2014

(Circular No. 35, s-2013) ACR Policy No. 2 ---
Implementing Guidelines on Medical and Procedures Case Rates Philippine Star | Publication Date: 12-17-2013 | Effectivity Date: 01-01-2014
ANNEXES:
• Annex 1: List Of Medical Case Rates - PC 0035 s2013 • Annex 2: List Of Procedure Case Rates • Annex 3: List Of Medical Conditions And Procedures Allowed As Second Case Rate • Annex 4: Examples And Scenarios For The All Case Rates Implementing Guidelines • Annex 5: List Of Medical Case Rates For Primary Care Facilities - Infirmaries/Dispensaries • Annex 6: List Of Procedure Case Rates For Primary Care Facilities - Infirmaries/Dispensaries • Annex 7: List Of Procedures With Laterality • Annex 8: List Of Medical Conditions Allowed For Referral Package • Annex 9: Referral Form • Annex 10: List Of Alternative Documents For Record Of Operative Or Surgical Technique
• Annex 11: Guidelines On The Proper Accomplishment Of Claim Form1 (November 2013) • Annex 11: Guidelines On The Proper Accomplishment Of Claim Form 2 (November 2013) • Annex 11: Important Reminders For The PhilHealth Claim Forms 1, 2 and 3 (November 2013) • Annex 11: PhilHealth Claim Form 1 (revised November 2013) • Annex 11: PhilHealth Claim Form 2 (revised November 2013) • Annex 11: PhilHealth Claim Form 3 Frontpage (revised November 2013) • Annex 11: PhilHealth Claim Form 3 Backpage (revised November 2013)

(Circular No. 34, s-2013) Guidelines on the Provision of Special Privileges to Those Affected By A Fortuitous Event Philippine Daily Inquirer | Publication Date: 11-21-2013

(Circular No. 33, s-2013) Deferment of License to Operate (LTO) Requirement on Renewal of Accreditation of Birthing Homes/Lying-in/Maternity Clinics as Stated in Circular No. 11, s-2013 Manila Bulletin | Publication Date: 11-19-2013

(Circular No. 32, s-2013) Implementation of the Point of Care Enrollment Program Philippine Daily Inquirer | Publication Date: 11-14-2013

(Circular No. 31, s-2013) All Case Rates (ACR) Policy No. 1 --- Governing Policies in the Shift of Provider Payment Mechanism from Fee-For-Service to Case-Based Payment Philippine Star | Publication Date: 10-31-2013

(Circular No. 30, s-2013) Impact of Incentives and Information on Quality and Utilization in Primary Care (I3QUIP) A Performance Evaluation Study for Primary Care Benefit (PCB1) Providers Manila Bulletin | Publication Date: 11-25-2013

(Circular No. 29, s-2013) Implementing Guidelines of "PRevEnTS" (Primary Care Revitalized and Enhanced Through Skills and Services), A Primary Care Booster Package Manila Bulletin | Publication Date: 10-29-2013

(Circular No. 28, s-2013) The New PhilHealth Member Registration Form Philippine Star | Publication Date: 10-05-2013

(Circular No. 27, s-2013) CY 2014 PhilHealth Premium Contribution for the Employed Sector Philippine Daily Inquirer | Publication Date: 10-10-2013

(Circular No. 26, s-2013) Implementing Guidelines on the NHIP Coverage for Victims of the Armed Conflict in Zamboanga City Philippine Star | Publication Date: 10-10-2013

(Circular No. 25, s-2013) Implementation of the OWP Premium and Payment Schemes Effective CY 2014 Manila Bulletin | Publication Date: 10-10-2013

(Circular No. 24, s-2013) Premium Rate for the Individually Paying Program (IPP) effective CY 2014 Philippine Star | Publication Date: 10-05-2013

(Circular No. 23, s-2013) Premium Contributions under the Sponsored Program Effective CY 2014 Philippine Daily Inquirer | Publication Date: 10-10-2013

(Circular No. 22, s-2013) Properly filled-out PhilHealth Member Registration Form (PMRF) as the sole requirement for the Enrollment/Registration of PhilHealth Principal Members Manila Bulletin | Publication Date: 09-27-2013

(Circular No. 21, s-2013) Clarification on the Reimbursement of Radiotherapy and Hemodialysis Philippine Daily Inquirer | Publication Date: 09-27-2013

(Circular No. 20, s-2013) Adoption of the Philippine Package of Essential Non-Communicable Disease (NCD) Interventions (Phil Pen) in the Implementation of PhilHealth's Primary Care Benefit Package Philippine Star | Publication Date: 09-25-2013

(Circular No. 19, s-2013) Z Benefits Rate for the Mobility, Orthosis, Rehabilitation,
Prosthesis Help (ZMORPH) Package for the Fitting of External Lower Limb Prosthesis Below the Knee Philippine Star | Publication Date: 09-15-2013

(Circular No. 18, s-2013) Official Receipt of Bank of Commerce (BOC) and Asia United Bank (AUB) as part of PhilHealth's Acceptable Receipts Manila Bulletin | Publication Date: 09-25-2013

(Circular No. 17, s-2013) Exemption of Cataract Surgery to the Rule on Single Period of Confinement Philippine Star | Publication Date: 08-6-2013 | Effectivity Date: 08-21-2013

(Circular No. 16, s-2013) Revised Bayad Center Payment Transaction Form as proof of PhilHealth premium payment Manila Bulletin | Publication Date: 07-26-2013

(Circular No. 14, s-2013) Revised PhilHealth Category of Institutional Health Care Providers (IHCP)s and Compensable Benefits in Primary Care Facilities Philippine Daily Inquirer | Publication Date: 07-05-2013

(Circular No. 13, s-2013) Amendment to PhilHealth Circular No. 59 s-2012 (Requirement of Cataract Pre-Surgery Authorization) Philippine Star | Publication Date: 06-21-2013

(Circular No. 12, s-2013) Reiteration of Guidelines for Individually Paying Program (IPP) Coverage Relative to PhilHealth Advisory on Deferment of Individual Policy Contract (IPC) Issuance Manila Bulletin | Publication Date: 06-20-2013

(Circular No. 11, s-2013) Clarification/Amendment on Issuances Related to the Engagement of Institutional Health Care Providers (IHCPs) and Other Applicable Issuances Philippine Daily Inquirer | Publication Date: 06-05-2013

(Circular No. 10, s-2013) Expansion of Primary Care Benefit 1 (PCB1) Package to Cover Personnel of the Department of Education (DepEd) Philippine Star | Publication Date: 05-22-2013

(Circular No. 09, s-2013) Amendments on Indicating Professional Fees Reimbursement in Claim Form 2 (applicable for fee-for-service payment mechanism) Philippine Daily Inquirer | Publication Date: 06-04-2013

(Circular No. 08, s-2013) Release of Per Family Payment (PFP) for Primary Care Benefit (PCB1) Services in the Autonomous Region of Muslim Mindanao (ARMM) Philippine Daily Inquirer | Publication Date: 04-19-2013

(Circular No. 07, s-2013) Guidelines for Payment of Primary Care Benefit 1 (PCB1) per Family Payment (PFP) for 4th Quarter of 2012 and CY 2013 Philippine Star | Publication Date: 04-19-2013

(Circular No. 06, s-2013) PNB stamped Allied bank Bills Payment Slip as proof of PhilHealth premium payment Manila Bulletin | Publication Date: 04-19-2013

(Circular No. 05, s-2013) Effectivity of New Classification of Health Care Facilities in PhilHealth Database shall be May 1, 2013 Philippine Daily Inquirer | Publication Date: 04-19-2013

(Circular No. 04, s-2013) Re-imposition of Interest on Employers' Non- and/or Late Remittances of PhilHealth Premium Contributions Philippine Star | Publication Date: 03-28-2013

(Circular No. 02, s-2013) Z Benefit Package Rates for Coronary Artery Bypass Graft Surgery, Surgery for Tetralogy of Fallot, Surgery for Ventricular Septal Defect and Cervical Cancer Manila Bulletin | Publication Date: 02-12-2013
ANNEXES:
Pre-authorization checklist and request • CABG • TOF • VSD • Cervical Cancer • TOF Checklist for Tranche I • VSD Checklist for Tranche I Checklist for mandatory and other services • CABG • TOF • VSD • Surgery for Cervical Cancer Stage IA1 - II A1 • Chemotherapy, High Dose Brachytherapy (Low Dose) with Cobalt Cervical Cancer • Chemotheraphy, Hight Dose Brachytherapy and Linear Accelerator for Cervical Cancer

(Circular No. 01, s-2013) Amendment to PhilHealth Circular No. 50 s.2012 on the Updated Documentary Requirements for Benefit Availment Philippine Daily Inquirer | Publication Date: 02-12-2013

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