Details about the PhilHealth Benefit for Outpatient Surgeries Coverage & Guidelines
PHILHEALTH BENEFIT FOR OUTPATIENT SURGERIES – Here are the coverage and guidelines for claim of benefit from PhilHealth.
Millions of Filipinos are members of the Philippine Health Insurance Corporation. More commonly called PhilHealth, it is a state-run health insurance agency. Most members submit either a monthly or quarterly contribution to keep their accounts updated.
Updated PhilHealth accounts can qualify members to assistance in times of inpatient and outpatient hospitalizations. It is a turn to in times of medical emergency thus PhilHealth members secure their accounts so they can claim an assistance in times of medical emergencies or even non-emergency ones like the need for surgery, radiotherapy, or hemodialysis.
Among the benefits of the Philippine Health Insurance Corporation for its members are outpatient benefits. One of these is the PhilHealth benefit for outpatient surgeries which include “elective (non emergency) surgical procedures ranging from minor to major operations, where patients are safely sent home within the same day for post-operative care”.
According to PhilHealth, the payments for outpatient surgeries are made to the accredited facility through the All Case Rates which are inclusive of the hospital charges and the professional fees of the attending physician. You must must make sure that the facility is an ambulatory surgical clinic accredited to the state-run health insurance institution. What are needed in claiming PhilHealth Benefit for outpatient surgeries? Prepare the following:
- copy of Member Data Record and duly accomplished PhilHealth Claim Form 1
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You may also read – How To Apply for PhilHealth Membership Online – Here’s A Guide in the Application Process