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Philippine Health Insurance Corporation

This document is PhilHealth Circular No. 031-s-2013 from the Philippine Health Insurance Corporation. It clarifies PhilHealth Circular No. 9 from 2013 regarding indicating professional fees on Claim Form 2. Specifically, it states that professional fees will still be reimbursed if a healthcare provider indicates "zero," "complimentary," or "PhilHealth benefit" on the form. Likewise, fees will be reimbursed if those terms are written in the box for PhilHealth coverage. This circular has the same effectivity and coverage dates as the one from 2013 that it is clarifying.

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Patrick Mitchell Villaruz
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35 views

Philippine Health Insurance Corporation

This document is PhilHealth Circular No. 031-s-2013 from the Philippine Health Insurance Corporation. It clarifies PhilHealth Circular No. 9 from 2013 regarding indicating professional fees on Claim Form 2. Specifically, it states that professional fees will still be reimbursed if a healthcare provider indicates "zero," "complimentary," or "PhilHealth benefit" on the form. Likewise, fees will be reimbursed if those terms are written in the box for PhilHealth coverage. This circular has the same effectivity and coverage dates as the one from 2013 that it is clarifying.

Uploaded by

Patrick Mitchell Villaruz
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Republic of the Philippines

i
.·'.i
PHILIPPINE HEALTH INSURANCE CORPORATION

PHILHEAL TH CIRCULAR
Citystate Centre Building, 709 Shaw Boulevard, Pasig City
Healthline 441-7444 www.philhealth.gov.ph

No. b031e .s.2013


~
FOR : ALL ACCREDITED HEALTH CARE PROVIDERS , PHILHEAL TH
MEMBERS, PHILHEALTH OFFICES AND ALL OTHERS CONCERNED

SUBJECT :-Clarification to PhiiHealth Circular 9, s.2013: Amendments on Indicating


Professional Fees Reimbursement in Claim Form 2 (applicable for fee-for-
service payment mechanism).

Phi!Health 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. I company" either in words or amount in the boxes for
total actual PF or amount paid by members in Phi!Health 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 Phi!Health
benefit.

The effectivity and coverage of this Circular shall follow that of Phi !Health Circular 9, s.20 13.
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.

teamphilhealth IJ www.facebook.com/Phi!Health Iii info@philhealth .gov.ph

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