PhilHealth implements use of new claim forms

CEBU, Philippines - Effective September 1, admissions, members and health care providers must use the enhanced claim forms when filing for reimbursement with PhilHealth.

Members shall use the Claim Form 1 when filing for a benefit claim for both local and overseas confinement. The form contains the member and patient information, and the member and employer’s certification (when applicable).

Members or representatives of members must certify that the information provided in the form are true and correct and may be used by PhilHealth for any legal purpose. The employer must also certify that the information supplied by the employed member or the member’s representative are consistent with its available records.

It should be noted that in the Form 1, the employer certifies that the applicable three monthly contributions within the immediate six months prior to the first day of confinement have been deducted or collected by it and remitted to PhilHealth.

With the enhancement of Form 1, employers must now certify that all monthly premium contributions for and on behalf of the member-employee while employed with the said company have also been deducted or collected and remitted to PhilHealth.

PhilHealth reminds accredited health care providers that Claim Forms 4 and 5 (for the maternity care/normal spontaneous delivery package and tuberculosis treatment package respectively) shall no longer be in use.

The Claim Form 2 has been enhanced for use by accredited facilities in all types of claims for PhilHealth-covered local admissions or confinements. As such, beginning September 1 admission dates, claim applications using the old forms shall be returned to the facility.

The Form 2 contains a certification by the health care provider that the services rendered by it are recorded in the patient’s chart and hospital records, and that the information provided in the form are true and correct.   — /LPM (THE FREEMAN)