PhilHealth


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Membership

  • PMRF: PhilHealth Member Registration Form

  • PMRF-FN: PhilHealth Member Registration Form for Foreign Nationals

  • Claims

  • Claim Signature Form

  • Claim Form 1: Member and Patient Information
  • Claim Form 2: Provider Information
  • Claim Form 3: Patient's Clinical Record

  • PhilHealth Claim Form 1 Guidelines »»
  • PhilHealth Claim Form 2 Guidelines »»
  • PhilHealth Claim Form Reminders »»

  • Dialysis Database

  • Registration Form
  • Certification on Diagnosis and Management of CKD Stage 5

  • Payment

  • PPPS: PhilHealth Premium Payment Slip

  • Employers

  • ER1: Employer Data Record
  • ER2: Report of Employee-Members
  • ER3: Employer Data Amendment Form
  • RF1: Employer's Remittance Report

  • Kasambahay

  • PPS-HEUR1: Household Employer Unified Registration Form
  • PPS-HEUR2: Household Employment Unified Report Form
  • PPS-KUR FORM: Kasambahay Unified Registration Form
  • PPS: Household PhilHealth Payment Slip
  • Collecting Agents

  • CAAF: Collecting Agents Accreditation Form

  • Health IT Partners

  • e-Claims Implementation Guide »

  • Health Care Professionals

  • Requirements for Health Care Professional Accreditation
  • Performance Commitment For Health Care Professionals per PhilHealth Circular 013-2015
  • Health Care Professional Provider Data Record

  • Health Care Facilities

  • PDR: Provider Data Record
  • MMHR: Monthly Mandatory Hospital Report
  • SOI: Statement of Intent (Initial/Re-accreditation)

  • MOP: Manual of Procedures of the New Accreditation Process (PEACHeS)

  • Performance Commitment:
  • Performance Commitment for Health Care Institutions (Revision 2)
  • Performance Commitment with Additional Provision for PCB1 Providers


  • Survey Tools
    Self-Assessment Tools

    Pre-Authorization and Claims Reimbursement

    Coronary Artery Bypass Graft Surgery
    Tetralogy of Fallot
    Ventricular Septal Defect Surgery
    Mobility, Orthosis, Rehabilitation, Prosthesis Help (Z MORPH)

  • I. Requirements for Pre-authorization
  • A. Pre-authorization Checklist and Request
  • B. Member Empowerment Form (Annex B)

  • II. Requirement for submission of claims for reimbursement
  • When claiming for reimbursement: Single Tranche

  • Transmittal Form (Annex H)
  • Tranche Requirements Checklist (Annex E)
  • Discharge Checklist for Z MORPH (Annex C)
  • Z Satisfaction Questionnaire (Annex D)
  • Cervical Cancer
    Selected Orthopedic Implants
    Colon Cancer
    Rectal Cancer

  • I. Requirements for Pre-authorization
  • A. Pre-authorization Checklist and Request (Annex A)
  • B. Member Empowerment Form (Annex B)

  • II. Requirement for submission of claims for reimbursement
  • A. Rectum Cancer Stage I (clinical and pathologic stage):
  • When claiming for reimbursement: Rectum Cancer Stage I (clinical and pathologic stage) - (Single tranche)

  • Transmittal Form (Annex H)
  • Tranche Requirements Checklist (Annex E1.1)
  • Checklist of Mandatory Services and other services (Annex C1.1)
  • Z Satisfaction Questionnaire (Annex D)

  • B. Rectum cancer pre-operative clinical stage I with post-operative pathologic stage II - III
  • 1. When claiming for Tranche 1, Rectum cancer pre-operative clinical stage I with post-operative pathologic stage II - III

  • Transmittal Form (Annex H)
  • Tranche Requirements Checklist (Annex E1.2)
  • Checklist of Mandatory Services and other services (Annex C1.2)
  • Satisfaction Questionnaire (Annex D)
  • 2. When claiming for Tranche 2, Rectum cancer pre-operative clinical stage I with post-operative pathologic stage II - III

  • Transmittal Form (Annex H)
  • Tranche Requirements Checklist (Annex E2.2)
  • Checklist of Mandatory Services and other services (Annex C2.2)
  • Satisfaction Questionnaire (Annex D)
  • 3. When claiming for Tranche 3, Rectum cancer pre-operative clinical stage I with post-operative pathologic stage II - III

  • Transmittal Form (Annex H)
  • Tranche Requirements Checklist (Annex E3.2)
  • Checklist of Mandatory Services and other services (Annex C3.2)
  • Satisfaction Questionnaire (Annex D)

  • C. Rectum cancer pre-treatment clinical stage II - III
  • 1. When claiming for Tranche 1, Rectum cancer pre-treatment clinical stage II - III

  • Transmittal Form (Annex H)
  • Tranche Requirements Checklist (Annex E1.3)
  • Checklist of Mandatory Services and other services (Annex C1.3)
  • Z Satisfaction Questionnaire (Annex D)
  • 2. When claiming for Tranche 2, Rectum cancer pre-treatment clinical stage II - III

  • Transmittal Form (Annex H)
  • Tranche Requirements Checklist (Annex E2.3)
  • Checklist of Mandatory Services and other services (Annex C2.3)
  • Z Satisfaction Questionnaire (Annex D)
  • 3. When claiming for Tranche 3, Rectum cancer pre-treatment clinical stage II - III

  • Transmittal Form (Annex H)
  • Tranche Requirements Checklist (Annex E3.3)
  • Checklist of Mandatory Services and other services (Annex C3.3)
  • Z Satisfaction Questionnaire (Annex D)
  • Acute Lymphocytic Leukemia
    Breast Cancer

  • I. Requirements for Pre-authorization
  • A. Pre-authorization Checklist and Request (Annex A)
  • B. Member Empowerment Form (Annex B)

  • II. Requirement for submission of claims for reimbursement
  • A. When claiming for reimbursement: Tranche 1

  • Transmittal Form (Annex H)
  • Tranche Requirements Checklist (Annex E1)
  • Checklist of Mandatory Services and other services (Annex C1)
  • Z Satisfaction Questionnaire (Annex D)
  • B. When claiming for reimbursement: Tranche 2

  • Transmittal Form (Annex H)
  • Tranche Requirements Checklist (Annex E2)
  • Checklist of Mandatory Services and other services (Annex C2)
  • Z Satisfaction Questionnaire (Annex D)
  • C. For mortalities and "lost to follow up" patients (to be submitted as attachment to the claims for tranche 2 if services were provided)

  • Breast Cancer Medical Records Summary Form (Annex O)
  • Prostate Cancer
    Kidney Transplantation

    Member Empowerment Form (ME Form)


    1. e-Flip Chart

  • Mga Dapat Malaman Tungkol sa PhilHealth

  • 2. TV Commercials

  • Sangla
  • Alagang PhilHealth

  • 3. Infomercials

  • The PhilHealth Story
  • PhilHealth Cares, Nagmamalasakit
  • Corporate Action Center, Nagmamalasakit
  • PhilHealth LHIOs and Express Offices
  • No Balance Billing - Short Story
  • No Balance Billing
  • TSeKap
  • ALAGA KA Briefer
  • All Case Rates and Z-Morph Benefit Briefer
  • PhilHealth Medical Detoxification Drug Rehabilitation Package
  • Benepisyong PhilHealth para sa mga OFWs
  • Magparehistro
  • Magbayad ng Kontribusyon
  • Alamin ang inyong Benepisyo

  • 4. Jingle

  • Basta't Ika'y Pinoy