Timestamp

First Name

3/27/2014 9:40:36 NORTH

3/30/2014 22:30:
27 ERIC

4/2/2014 8:51:18 DEXTER

4/1/2014 18:53:48 CHERRY ANN

4/2/2014 22:04:25 HERCHELE

4/2/2014 22:11:47 JOYCE GRACE

4/3/2014 9:25:13 KRISTINE DIANE

Last Name

ZUBIRI

VITINGCO

OCBIAN

ABIANARES

MANZANERO

LORICHE

ROLDAN

Region

NCR

NCR

NCR

NCR

NCR

NCR

NCR

Email Address

Status

laidocaine@gmail.
com
Permanent

ericvitingco@gmail.com
Permanent

dex_ocbian@yahoo.com
Permanent

Hospital Covered

KDA

MANDALUYONG
CITY MEDICAL
CENTER

VALENZUELA
MEDICAL
CENTER

cherryann1020@gmail.com
Permanent

St. Jude Hospital

tievzs.15@gmail.
com

Permanent

PRES.
DIOSDADO
MACAPAGAL
MEMORIAL
MEDICAL
CENTER

Permanent

MANILAMED
(Medical Center
Manila)

Jloriche@gmail.
com

kristineroldan8@gmail.com
Permanent

SAN LAZARO
HOSPITAL

Hospital Category

Government

Government

Government

Private

Government

Private

Government

PERMANENT
START

Hospital Level

PCF (Primary Care

Facility)

3/4/2014

3/31/2014

3/1/2014

3/1/2014

3/1/2014

3/1/2014

3/1/2014

PERMANENT
END

3/6/2014

3/1/2014

3/31/2014

3/31/2014

3/31/2014

3/31/2014

3/31/2014

ROVING

Formal Economy

19

142

35

108

106

145

Informal Economy Lifetime Members

27

33

76

61

39

58

Indigents (NHTSPR)

20

43

50

134

Sponsored
Member

# of Client's served
No. of
during ward
member/dependent
classes, mother's
No. of Nonwho are able to
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
member/dependent member/dependent
benefits

Non-Member

18

19

10

48

24

Hospital's Best
Practices

GUILLERMO

NCR

mikyllaguillermo@gmail.com
Permanent

JOSE R.REYES
MEMORIAL
MEDICAL
CENTER

104

404

105

261

133

571

55

320

ROVING
AROUND THE
HOSPITAL
PREMISES TO
CHECK THE
INDIGENT OR
4P'S MEMBER TO
INTERVIEW
ABOUT THE
TREATMENT OF
THE HOSPITAL
50 TO THE CLIENTS.

Maximize the use

370 of portal.

3/1/2014

3/31/2014

247

263

54

185

10

12

ACAs

6660

i interview some of
the clients that a
job but the
employers are not
paying their
Philhealth. as i told
to them to set a
no problem as for side all the pay slip
the 3rd month in
as their evidence if
staying in there for the employer didn't
the membership of pay their
the clients
premiums.

N/A

216

Using PBEF for all

patients with
philhealth. If
eligibility is yes, no
more attachment
164 for members....
> Do hospital
rounds to assist
those qualified
member in filing
their requirement
as soon as
possible and
encouraged those
non member to be
a philhealth
member.
> Encouraged
those non member
at out patient
department to
became a
216 member.
N/A

762

Implementing Safe
Keeping when the
member/dependent
can't present the
philhealth
documents upon
742 discharge.
N/A

164

1067

1067

none

As I was stationed
at the admitting
section of the
hospital, I was able
to gather the
admitted clients
and assisting them
in such needed
requirements so
that I can they can
maximized fully the
benefits that they
were entitled to.
Government

Contribution

Healthcare
Provider Relations

Benefits

No Balance Billing

All Case Rates

On site Point of
Care

Internal

As I have
interviewed the
Philhealth section
supervisor as she
verbalized, the
hospital has come
up a so called
PHILHAELTH
TASK FORCE to
enhance the full
implementation of
the Philhealth rules
and regulations so
that they can
assist the client
regarding their
benefits as a result
of this, the hospital
be benefited of
these actions.

MIKYLLA
4/3/2014 19:03:08 MARYBE ANN

Membership

912

912

N/A

N/A

N/A

Please create an
Office Order
regarding
retropayments and
availment of
Philhealth benefit.
Please make an
illustrative
examples so we
can all have the
same
understanding and
to avoid confusion.

One of the
problems that I
have encountered
was about the
4ps/indigents/sponsored
members/dependents
that have
discrepancies and
not consistent on
the data that they
were
using/presenting to
the Philhealth
versus the
hospital. And
because some of
these were not
being able to
produce sufficient
documents, Im
tapping the LHIO
for amendments of
such
inconsistencies.
n/a

a lot of client are

questioning the
reimbursement in
the hospital
because it takes
about 7 months or
batch by batch to
release their
reimbursement.

Some ACA's
accept payment
without observing
the proper
applicable period.
(for informal
economy- self
earning).

N/A

N/A

N/A

N/A
N/A
Metrobank Balut,
Tondo Branch
collects only 300
pesos for premium
payments for year
2013 and 2014.
The member's
name is Feliciano,
Elinor Calderon
with PIN
192012862217:
Payment Details
are as follows:
PAR Number:
306316715
Member Type:
Individually Paying
Member
Applicable Period:
10/01/201310/31/2013
Amount: 300
Validation Date
11/11/2013

n/a

The ACR policy is

well implemented
in this institution.
There are some
policies that are
not that clear, but
they're trying their
best to provide
accurate benefit
for our members.
Concern of the
hospital if upon
admission,
eligibility is yes
then during
discharge, portal is
down so cannot
generate PBEF. Is
it ok if generating
form will be the
following day? Or it
will cause problem
to the claims of
members availing
philhealth benefit?

N/A

as of march 2014,
the medical
director ordered
the cessation of
point of care
enrollment . This is
due to the
confusion of where
to get the funding
for payment for
such enrollees. As
of the moment the
administrative
office of hospital
still on process of
finalizing on where Interpersonal and
to get for such
communication
funds.
training.

N/A
LEGASPI,
ENRICO CORTEZ
(190895843109)
PAID AS DENGUE
1,WORTH
8000Php
THE MEMBER IS
COMPLAINING
BECAUSE AS
PER HIS
KNOWLEDGE HIS
CASE WAS
DENGUE II. WE
CHECKED HIS
CF2 AND THE
HOSPITAL ONLY
CLAIMED FOR
THE DENGUE 1.
AS PER
REQUEST BY
THE MEMBER
WE ASK FOR
THE COPY OF
THE MEDICAL
ABSTRACT AND
WE FOUND OUT
THAT THE
DOCTOR WROTE
DENGUE
SEVERE/DENGUE
II AS THE FINAL
DIAGNOSIS. I
ADVICED THE
HOSPITAL TO
FILE FOR AN
ADJUSTMENT.
N/A

n/a

NBB is strictly
enforced in the
hospital. From the
recent NBB
survey, the
common cause of
out of pocket
expenses is the
patient's choice to
purchase the drug
due to urgency
whenever the
medicine is not
available in the
pharmacy.
After I have
interviewed
selected clients
and the data were
gathered, I also
enlist why such
purchases were
happened.
Primarily reason
was that the
medicines were
not readily
available to the
pharmacy neither
to the welfare nor
to DOH. Secondly,
the requirements
that they needed
to be entitled to
such benefits ;
especially when
some discrepancy
to the data being
presented by them
were not being
processed as soon
as possible that
they were being
admitted so as a
consequence, they
were not being
tagged as a
Philhealth patient
to the institution.
Also, there are
instances that
medicines
purchased of the
client were mostly
when they were at
the Emergency
Room of the
institution.

Email1 Template
sent to
dex_ocbian@yahoo.com
on 04/02/14 at 8:
51:27 AM

> No comment.

Email1 Template
sent to tievzs.
15@gmail.com on
04/02/14 at 10:04:
34 PM

Email1 Template
sent to
Jloriche@gmail.
com on 04/02/14
at 10:11:54 PM

Email1 Template
sent to
kristineroldan8@gmail.com
on 04/03/14 at 9:
25:20 AM

N/A

N/A

GENERAL
ASSEMBLY FOR
ALL NCR CARES
OR MAYBE A
TEAM BUILDING
IN CELEBRATION
OF OUR 2ND
ANNIVERSARY.

PBEF- Mr.
Camacho is the
authorized portal
user but he is no
longer the head of
Philhealth Section.
I advised Miss
Brenda Taguba to
create a letter with
attached POAF
and NDA.

employed
members who are
separated from
work since 2007,
appears to be
"eligible" in IHCP
portal.

If ever there will be

a rotation, please
inform us at least 3
days to properly
create an
endorsement to
the hospital as well
as our Co- CARES
who will take over
our post.

There are
diagnosis that
were not enlisted
at the annexes.

Email1 Template
sent to
ericvitingco@gmail.com
on 04/01/14 at 8:
30:05 AM

Email1 Template
sent to
cherryann1020@gmail.com
on 04/02/14 at 8:
51:31 AM

> Non availability

of some medicine,
supply and
laboratory was
been out of the
pocket by member >Blunt trauma and
but reimbursed
penetrating trauma
accordingly.
not requiring
Nevertheless NBB surgery was not
was implemented. compensable.
N/A

PAR Number:
306316844
Member Type:
Individually Paying
Member
Applicable Period:
01/01/201403/31/2014
Amount: 300
Validation Date:
02/10/2014
none

n/a

burial leave... my
father just died last
march hopefully
they going to have
an exemption
thank you. and am
afraid if ever my
grades will failed in
the month of
march

the hospital didn't

follow the no
balance billing, the
reason of them is
they didn't have
sufficient fund for
all the hospital
needs.

Email1 Template
Status[1]
Email1 Template
sent to
laidocaine@gmail.
com on 03/27/14
at 9:40:44 AM

There are clients

that were enrolled
by the institution
under Point-ofcare program but
there were system
error occurred that
the said clients
were not included
in the Payment
Slip Details. so I
have coordinated it
to our IT dept.
n/a

Email1 Template
sent to
mikyllaguillermo@gmail.com
on 04/03/14 at 7:
03:16 PM

Timestamp

First Name

4/3/2014 15:37:14 Cholo

Last Name

Corona

Region

NCR

Email Address

Status

choloboi57@yahoo.com
Permanent

Hospital Covered

Hospital Category

Dr. Jose N.
Rodriguez
Memorial Hospital Government

PERMANENT
START

Hospital Level

3/1/2014

PERMANENT
END

ROVING

3/31/2014

Formal Economy

54

Informal Economy Lifetime Members

28

Indigents (NHTSPR)

27

Sponsored
Member

# of Client's served
No. of
during ward
member/dependent
classes, mother's
No. of Nonwho are able to
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
member/dependent member/dependent
benefits

Non-Member

15

20

456

222

4/3/2014 19:43:49 RON ALBERT

ELIGADO

NCR

eligado.
ronalbert@gmail.
com

Permanent

MARTINEZ
MEMORIAL
HOSPITAL

Private

3/1/2014

3/31/2014

50

30

12

55

85

4/3/2014 21:00:03 MARICAR

ALLANIGUE

NCR

maricar.
allanigue@gmail.
com

Permanent

MARY
JOHNSTON
HOSPITAL

Private

3/1/2014

3/31/2014

115

85

13

47

192

290

Hospital's Best
Practices

222 n/a

79 N/A

Membership
A senior citizen
client presented
their MDR as
EmployedGovernment, he
become irate when
I explained that
they should
change their
category to
Lifetime Member
to avail philhealth.
They thought it will
be automatically
change as lifetime
member.

N/A

4/3/2014 21:21:55 FLORIANNE

BARBACION

NCR

florianneelf@gmail.com
Permanent

Sta. Ana Hospital

Government

3/1/2014

3/31/2014

83

41

12

12

72

21

4/3/2014 22:43:43 Jessica

Siscar

NCR

jessica.
siscar@gmail.com Permanent

The Family Clinic

Inc

Private

3/1/2014

3/31/2014

22

29

14

20

48

48 n/a

RAMOS

NCR

jrramos5390@gmail.com
Permanent

PHILIPPINE
GENERAL
HOSPITAL

Government

3/1/2014

3/31/2014

105

143

10

43

25

53

1770

1490

JOANNE
4/4/2014 15:04:26 THERESE

BRILLO

NCR

joannetheresebrillo26@gmail.com
Permanent

OSPITAL NG
MAYNILA
MEDICAL
CENTER

Government

3/1/2014

3/31/2014

138

92

35

10

13

189

4/4/2014 15:18:13 Veronica

Bueno

NCR

nica_bueno67@gmail.com
Roving

Martinez Memorial
Hospital
Private

March 1 to 31,
2014

75

77

22

13

54

101

ACAs

Had a problem
with a client who
paid the whole
year of 2014 to
automatically avail
philhealth benefit
but dated march
2014, so I advice
the client that their
contribution is not
qualified.
None.

N/A

N/A

Healthcare
Provider Relations

I had the best

experience with
the hospital
employees.
There was a
member patient
that will be
transferred to a
nearby hospital.
When the relatives
of the member
knew that they
can't avail, they
decided to bring
home the patient
(HAMA). Then the
billing head called
me, she was mad
at me. She
accused me that
I'm the one who
instructed the
relatives of the
member to bring
home the patient
rather transferring
to other hospital.

Benefits

n/a

No Balance Billing

Non-compliant.

1490

189 N/A

97

n/a

none

n/a

none

n/a
MBTC Escolta
Manila payment on
01/27/14 P1,
500.00 reflected as
payment for
10/01/1310/31/2014.
Encountered a
advised to proceed
dependent
LGU sponsored
to lhio for payment
showing renewed members who
verification and
sponsorship for
were not renewed adjustment.
2014,(PIN:
for 2014 were
Member was able
102004793029).
advised to
to process
member died on
continue as
adjustment in
may 13, 2011.
voluntary members LHIO manila and
Advised to
and pay P600.00 was issued
proceed to LHIO to quarter
certification for P2,
process record
contribution for
250.00 10/2013updating.
benefit eligibility
09/2014

N/A
I still have Dual
membership, one
is from the
sponsorship and
from employment.
I advised the
member to arrange
his PIN if he has 2
pins to LHIO
office.

N/A
3/6 rule does not
apply to OWP
member, once
they pay the
Philhealth full
contract year, they
are eligible to use
it at once... no
waiting period.

N/A

All Case Rates

All Case Rate

compliant.

On site Point of
Care

Not yet
implemented.

N/A

N/A
N/A
>Unable to print
Philhealth Benefit
Eligibility Form
(PBEF) due to
down/unavailability
to access HCI
Portal

none

The case rate are

not consumed by
the members. but
a lot of out of
pockets with
regards to the
laboratories, drugs
and medicines and
supplies that are
not available at the
hospital pharmacy
and laboratory. the
hospital doesn't
refund this out of
pockets even if the
case rates were
not exhausted.

no balance billing
are not fully
implemented by
the hospital. a lot
of sponsored
members still incur
out of pocket
expenses. despite
of instruction by
the CARES to
asked the nurses
to do the
emergency
purchase

PBEF, the
philhealth section
tested the portal.
the eligibility of the
member is No but
the member
attached an
updated MDR
none

unstable internet
connection

n/a

n/a

n/a

There was no
electricity/power
supply in PGH
OPD section on
02/26/2014 until
03/22/2014.
electricity was
restored 03/24/14.
OPD operation in Benefit eligibility
those days ware
was updated to
affected and walk- monthly counting
ins were limited.
3/6 months.

N/A
Almost all are
friendly, if there's
anyone with no
work ethics , that
would be only 1,
and she's now end
of employment
because of
retrenchment.

Internal

N/A

n/a

PGH is strictly
NBB COMPLIANT. implementing our
PGH is doing its
ACR policy. Their
best to provide all officers are doing
the necessary
their best to
supplies and
properly apply the
medicines for all
allowed benefits
our eligible
for their conditions
sponsored
and procedures
members and their done to avoid
dependents
errors.
N/A
INDIGENT AND
SPONSORED
MEMBERS ARE
NOT COVERED
BY THE
CORPORATIONS
POLICY
SPECIFICALLY
THE NO
BALANCE
BILLING
BECAUSE THE
HOSPITAL
DOESN'T HAVE
SUFFICIENT
SUPPLY OF
MEDICINES AND
OTHER MEDICAL
SUPPLY
INTENDED FOR
INDIGENT AND
SPONSORED
MEMBERS,
THAT'S WHY
PHIL HEALTH
MEMBER
BOUGHT THE
PRESCRIBED
MEDICINES. THE
HOSPITAL WERE
AWARE OF THE WITH REGARDS
NBB POLICY,
TO
BUT THEY DIDN'T IMPLEMENTATION
GET THE
OF ACR, PBEF IS
RECEIPTS FOR
THE MOST
REIMBURSEMENT COMMON ISSUE,
BECAUSE THEY EVEN THOUGH
ONLY HAVE
THE MEMBER IS
LIMIT ALLOTTED ELIGIBLE THEY
FOR MEDICINES STILL REQUIRE
PER CASE.
CF1 AND MDR.
N/A

Email1 Template
Status[1]

New set of
uniform.

Email1 Template
sent to
choloboi57@yahoo.com
on 04/03/14 at 7:
03:20 PM

N/A

Email1 Template
sent to eligado.
ronalbert@gmail.
com on 04/03/14
at 7:43:57 PM

There was a
philhealth member
who told me about
what the
billing/accounting
head in the
hospital said to
them. The
billing/accounting
head said that if
philhealth
members will avail,
they will not be
given endorsement
letter for PCSO.
The accounting
head will give
endorsement letter
if the patient will
not file for their
philhealth claims.

290

EMERGENCY
PURCHASES
nurses are the
ones who are
supposed to
purchase the
medicines outside
if the medicines
are not available at
the hospital's
21 pharmacy
none

4/4/2014 13:53:31 JAY

Contribution

Email1 Template
sent to maricar.
allanigue@gmail.
com on 04/03/14
at 9:00:24 PM

none
in regards with the
implementation of
the PBEF, kindly
please clarify the
rules especially on
the generation of
the PBEF. Is it
allowed to print or
generate the PBEF
after the date of
discharge of the
patient.

Email1 Template
sent to
florianneelf@gmail.com
on 04/03/14 at 9:
23:45 PM

Email1 Template
sent to jessica.
siscar@gmail.com
on 04/03/14 at 10:
43:51 PM

N/A

Email1 Template
sent to
jrramos5390@gmail.com
on 04/04/14 at 1:
53:38 PM

N/A

Email1 Template
sent to
joannetheresebrillo26@gmail.com
on 04/04/14 at 3:
04:35 PM

Email1 Template
sent to
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on 04/04/14 at 3:
18:24 PM

Timestamp

First Name

4/4/2014 15:39:20 jeffrey

4/4/2014 15:44:58 JESSICA

GETHSEMANE
4/4/2014 17:28:24 SHEABA

Last Name

cruz

NOMIL

ABORDE

Region

NCR

NCR

NCR

Email Address

Status

jeffreycentenocruz@yahoo.com.ph
Permanent

jessicanomil@gmail.com
Permanent

gethsemaneaborde@gmail.com
Permanent

Hospital Covered

Hospital Category

Gat Andres
Bonifacio Memorial
Medical Center
Government

CHINESE
GENERAL
HOSPITAL AND
MEDICAL
CENTER

VICTOR R
POTENCIANO
MEDICAL
CENTER

PERMANENT
START

Hospital Level

3/1/2014

PERMANENT
END

3/31/2014

ROVING

Formal Economy

44

Informal Economy Lifetime Members

21

Indigents (NHTSPR)

56

Sponsored
Member

# of Client's served
No. of
during ward
member/dependent
classes, mother's
No. of Nonwho are able to
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
member/dependent member/dependent
benefits

Non-Member

37

573

Hospital's Best
Practices

none...census
above where for
573 February 2014.

Chinese General
Hospital and
Medical Center is
requesting for a
letter coming from
PhilHealth so as to
get the data of
total number of
monthly hospital
discharges. (No. of
PhilHealth member
covered and not
covered, as well as
No. of members
availed for the
benefits)
Private

Private

3/1/2014

3/1/2014

3/31/2014

3/31/2014

158

141

146

43

14

12

12

33

704

691 N/A

Membership

N/A
1)010504937343
Cabales, Jayson
Dolar declared his
wife as his
dependent while
his wife Cabales,
Sharon Calahi with
PIN
190902635886 is
also an active
member; both
declared their child
as their
dependent.
2)030250442889
Calayag, Joana
Salenga and
Calayag, Reynante
G. with PIN
030250873170
both active
member, declared
each other as their
dependent.
3)050251350415
Chan, John Chua
declared his wife
Chan, Uhua Hao
with PIN
050251797894 an
active member as
his dependent.
4)020002111781
Villanueva, Liza
Seno declared his
husband
Villanueva,
Arlando Valdezco
with PIN
190259959776 an
active member as
her dependent.
5)Bartolata, Tessie
A. has multiple PIN
192006012082
and
230025130311.
6)Miguel, Remigio
Lacambra has
multiple PIN
190521864765
and
192001046663.
7)Ramos,
Rebecca
Rodriguez has
multiple PIN
190251114815
and
052010072654.

none

Contribution

N/A

1)Advised member
020256837812
Singian, Vicenta
Barcelino whose
contribution for first
and third quarter of
2013 paid at CBCI
RESSIBO ATBP
CAMARIN is for
readjustment.
2)090253158742
Sadim, Ivy Kate
Mazon with
contribution from
October 2013 to
March 2014 is not
yet posted.
Payment made at
Pinamalayan,
advised member to
remit her OR to
PhilHealth.
3)070253351576
Santos, Rodolfo
Francisco who
paid P450 for the
4th quarter of 2013
(Dec to Dec as
reflected in his
receipt) paid at
PHIC-SO Sta.
Maria.

none

ACAs

N/A

Healthcare
Provider Relations

N/A

1)Advised member
020256837812
Singian, Vicenta
Barcelino whose
contribution for first
and third quarter of
2013 paid at CBCI
RESSIBO ATBP
CAMARIN is for
readjustment.
2)090253158742
Sadim, Ivy Kate
Mazon with
contribution from
October 2013 to
March 2014 is not
yet posted.
Payment made at
Pinamalayan,
advised member to
remit her OR to
PhilHealth.
3)070253351576
Santos, Rodolfo
Francisco who
paid P450 for the
4th quarter of 2013
(Dec to Dec as
reflected in his
receipt) paid at
PHIC-SO Sta.
Maria.
N/A
CBC SM
MEGAMALL
MANDALUYONG
wrong applicable
period reflected in
the PAR and
icares system. A
member with PIN
of 192009035229
(Ms. Joanna
Molina) paid 1800
Php as IPM last
July 25, 2013. The
reflected
applicable period
on her PAR was
from July 2012 to
July 2013 instead
of July 2013 to
June 2014. The
reflected
applicable period
in iCARES
treasury was from
July 2013 to July
2013. Since it was
Saturday and their
pt was already for
discharge, I told
her to just write a
letter of
authorization,
allowing me to
process the
adjustment of her
contribution
together with her
receipts and valid
id. I went to LHIO
Mandaluyong and
process the
adjustment of the
member
contribution on her
behalf and
attached the copy
to her claims.
none

Benefits

On site Point of
All Case Rates
Care
some mebers are
not asking for the
right amount or the
total amount of
benefit for their
cases when they
already heard that
they has to pay no
single peso for
their
hospitalization; if
they have receipts
bought outside the
hospital, they just
attached it not
knowing how much
are still
reimbursable;some
medical supplies
bought outside
with receipts are
not reimbursable;
with the billing
statement printed if
the case covered
all the hospital
expenses and has
no receipts bought
outside and still
there is excess of
our package they
just match the
amount of total bill
with our philhealth
case rates amount
to show patients
they have zero
not observed to my balance just so
hospital due to:
they avoid refund
late declaration of of members who
members; affiliated has no expenses
laboratory is
at all.
private; no
available
for PBEF: when
prescribed
pbef was
medicine and
generated during
laboratory test to
discharge and just
the hospital;
so happened the
no/some medical patient got felt
supplies are
wrong and extend
scarce/limited;
hospitalization, in
members has
our case we wasn't
lacking
able to correct it
documents/error or because the portal
mistakes with the was not
data used by
regenerating it's
members versus
reference also its
with their
not appearing in
documents.
the history.
N/A
No Balance Billing

Internal

Email1 Template
Status[1]

N/A

Email1 Template
sent to
jeffreycentenocruz@yahoo.com.ph
on 04/04/14 at 3:
39:27 PM

1)Member Ramos,
Miguel Sabanpan
with PIN
190001568756
declared his wife
Shovilla (patient)
with final diagnosis
of
NEUROCYSTICERCOSIS
said that they did
not avail for their
benefit in East
Ave. Medical
Center because
the code (B69.0)
for the said
diagnosis is not in
ANNEX 1 and was
re-admitted in
Chinese General
Hospital and
Medical Center for
the same case.
N/A

Chinese General
Hospital and
Medical Center is
strictly
implementing PC
35 s.2013, with
regards to no
direct filling some
of members are
having difficulty
accomplishing the
said requirements
because they ask
for the required
documents when
they are about to
be discharge
specially during
weekend when
there is no office.
Thus they wait for
Monday so that
they can complete
their requirements
and it will add to
the cost of their
hospitalization.
Moreover, I ask for
the help of their
admitting staff to
instruct clients to
have their
documents ready
prior to discharge
so as to avail their
benefits. (outright
deduction). But
this month of
March there is an
improvement with
regards to
complying of
requirements.
N/A

N/A

Email1 Template
sent to
jessicanomil@gmail.com
on 04/04/14 at 3:
45:07 PM

none

The PBEF cannot

read the reflected
contribution in the
treasury
The PBEF cannot
detect the
declaration of
dependent to other
member. It will just
asked for the
PMRF as
attachment
none

none

Email1 Template
sent to
gethsemaneaborde@gmail.com
on 04/04/14 at 5:
28:32 PM

N/A

none

Timestamp

First Name

GETHSEMANE
4/4/2014 17:30:50 SHEABA

GETHSEMANE
4/4/2014 17:31:40 SHEABA

Last Name

ABORDE

ABORDE

Region

NCR

NCR

Email Address

Status

gethsemaneaborde@gmail.com
Permanent

gethsemaneaborde@gmail.com
Permanent

Hospital Covered

VICTOR R
POTENCIANO
MEDICAL
CENTER

VICTOR R
POTENCIANO
MEDICAL
CENTER

Hospital Category

Private

Private

PERMANENT
START

Hospital Level

3/1/2014

3/1/2014

PERMANENT
END

3/31/2014

3/31/2014

ROVING

Formal Economy

141

141

Informal Economy Lifetime Members

43

43

Indigents (NHTSPR)

12

12

Sponsored
Member

# of Client's served
No. of
during ward
member/dependent
classes, mother's
No. of Nonwho are able to
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
member/dependent member/dependent
benefits

Non-Member

33

33

704

704

GETHSEMANE
4/4/2014 17:31:53 SHEABA

ABORDE

NCR

gethsemaneaborde@gmail.com
Permanent

VICTOR R
POTENCIANO
MEDICAL
CENTER

Private

3/1/2014

3/31/2014

141

43

12

33

704

KRISTINE
4/4/2014 17:45:01 BERNADETTE

RIVERA

NCR

kristinebernadetterivera@gmailcom
Permanent

SEAMENS
HOSPITAL

Private

3/1/2014

3/31/2014

93

78

380

Hospital's Best
Practices

691 N/A

691 N/A

Membership

none

none

691 N/A
none
- no. of
PHILHEALTH
MEMBER/DEPENDENT
is the total number
of discharge for
the month of
February, the
hospital wont
release the exact
number of
discharges with
philhealth. They
said that it will only
be given to the
Cares if letter will
be submitted from
0 the Corporation
n/a

4/4/2014 19:11:45 Donna Rose

Rubio

NCR

donnarubio88@gmail.com
Permanent

Tondo Medical
Center

Government

3/1/2014

3/31/2014

52

25

86

14

30

325

327

4/4/2014 21:38:38 EDWARD

CAMPITA

NCR

edwardqcampita@gmail.com
Permanent

FATIMA
UNIVERSITY
MEDICAL
CENTER

Private

3/1/2014

3/31/2014

26

28

109

343

The hospital
permits "to pay
later" for medicines
and laboratories to
accommodate
possible philhealth
members
especially NBB
patients to avoid
out-of pocket
327 purchases.
Upon admission
they explain to
members about
the new policy of
philhealth, case
rates that can be
covered and giving
a copy of
necessary
requirements for
343 benefits availment.

4/4/2014 19:51:56 JOMAR

DELA TORRE

NCR

BURDENINNOCENCE@GMAIL.COM
Permanent

HOSPITAL OF
THE INFANT
JESUS

Private

3/1/2014

3/31/2014

71

54

21

96

130

159 N/A

Contribution

none

none

none

ACAs
CBC SM
MEGAMALL
MANDALUYONG
wrong applicable
period reflected in
the PAR and
icares system. A
member with PIN
of 192009035229
(Ms. Joanna
Molina) paid 1800
Php as IPM last
July 25, 2013. The
reflected
applicable period
on her PAR was
from July 2012 to
July 2013 instead
of July 2013 to
June 2014. The
reflected
applicable period
in iCARES
treasury was from
July 2013 to July
2013. Since it was
Saturday and their
pt was already for
discharge, I told
her to just write a
letter of
authorization,
allowing me to
process the
adjustment of her
contribution
together with her
receipts and valid
id. I went to LHIO
Mandaluyong and
process the
adjustment of the
member
contribution on her
behalf and
attached the copy
to her claims.
CBC SM
MEGAMALL
MANDALUYONG
wrong applicable
period reflected in
the PAR and
icares system. A
member with PIN
of 192009035229
(Ms. Joanna
Molina) paid 1800
Php as IPM last
July 25, 2013. The
reflected
applicable period
on her PAR was
from July 2012 to
July 2013 instead
of July 2013 to
June 2014. The
reflected
applicable period
in iCARES
treasury was from
July 2013 to July
2013. Since it was
Saturday and their
pt was already for
discharge, I told
her to just write a
letter of
authorization,
allowing me to
process the
adjustment of her
contribution
together with her
receipts and valid
id. I went to LHIO
Mandaluyong and
process the
adjustment of the
member
contribution on her
behalf and
attached the copy
to her claims.
CBC SM
MEGAMALL
MANDALUYONG
wrong applicable
period reflected in
the PAR and
icares system. A
member with PIN
of 192009035229
(Ms. Joanna
Molina) paid 1800
Php as IPM last
July 25, 2013. The
reflected
applicable period
on her PAR was
from July 2012 to
July 2013 instead
of July 2013 to
June 2014. The
reflected
applicable period
in iCARES
treasury was from
July 2013 to July
2013. Since it was
Saturday and their
pt was already for
discharge, I told
her to just write a
letter of
authorization,
allowing me to
process the
adjustment of her
contribution
together with her
receipts and valid
id. I went to LHIO
Mandaluyong and
process the
adjustment of the
member
contribution on her
behalf and
attached the copy
to her claims.

Healthcare
Provider Relations

none

none

Benefits

none

none

No Balance Billing

On site Point of
Care

Internal

Email1 Template
Status[1]

none

The PBEF cannot

read the reflected
contribution in the
treasury
The PBEF cannot
detect the
declaration of
dependent to other
member. It will just
asked for the
PMRF as
attachment
none

none

Email1 Template
sent to
gethsemaneaborde@gmail.com
on 04/04/14 at 5:
31:00 PM

none

The PBEF cannot

read the reflected
contribution in the
treasury
The PBEF cannot
detect the
declaration of
dependent to other
member. It will just
asked for the
PMRF as
attachment
none

none

Email1 Template
sent to
gethsemaneaborde@gmail.com
on 04/04/14 at 5:
31:49 PM

none

The PBEF cannot

read the reflected
contribution in the
treasury
The PBEF cannot
detect the
declaration of
dependent to other
member. It will just
asked for the
PMRF as
attachment
none

none

Email1 Template
sent to
gethsemaneaborde@gmail.com
on 04/04/14 at 5:
32:01 PM

n/a

n/a

n/a

Email1 Template
sent to
kristinebernadetterivera@gmailcom
on 04/04/14 at 5:
45:09 PM

> Members with 3

Philhealth
Identification
Numbers, all are
active and valid
until December
2014.

Late posting of
contributions in
formal and
informal sector
especially when
printing PBEF

none
none
- the user name of
the IHCP portal is
still under the IT
personnel, I
already endorsed
and advised the
Philhealth Head
Ms. Len to fill up a
POAF, NDA and a
letter addressed to
Sir Norman to
change the owner
of the account but
until the rotation
last March 31,
2014 no action
n/a
was done.
n/a
Members were
given clear
Statement of
Account and
Aside from faded
clearly explained
thermal receipts
the amount of
from accredited
philhealth benefits
collecting agents, I
for them and were
do not have any
encouraged to
problems
keep their receipts
regarding this
for possible rematter.
imbursement.

none

none

none

none

none

none

N/A

N/A

N/A

N/A

N/A

N/A

n/a

All Case Rates

Billing staffs were

No Balance Billing able to adjust to
were strictly
the new All Case
monitored.
Rates policy.

n/a

i am very much
happy with whom I
am working with. It
feels great
knowing that I can
Point of Care was help others in
Email1 Template
temporarily freeze achieving and
sent to
due to some issue getting their
donnarubio88@gmail.com
on Commission on benefits entitled to on 04/04/14 at 7:
Audit.
them.
12:36 PM

none
none
The hospital is
asking if it is
allowed to print the
PBEF after the
patient/ member
was discharged? N/A

none

Email1 Template
sent to
edwardqcampita@gmail.com
on 04/04/14 at 9:
39:08 PM

N/A

Email1 Template
sent to
BURDENINNOCENCE@GMAIL.COM
on 04/04/14 at 9:
39:08 PM

Timestamp

First Name

Last Name

Region

Email Address

Status

Hospital Covered

Hospital Category

PERMANENT
START

Hospital Level

PERMANENT
END

ROVING

Formal Economy

Informal Economy Lifetime Members

Indigents (NHTSPR)

Sponsored
Member

# of Client's served
No. of
during ward
member/dependent
classes, mother's
No. of Nonwho are able to
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
member/dependent member/dependent
benefits

Non-Member

Hospital's Best
Practices

Membership

Contribution

ACAs
LBP Taguig City
Hallunderpayment of
premium
contribution

Healthcare
Provider Relations

Benefits

No Balance Billing

All Case Rates

On site Point of
Care

Internal

Email1 Template
Status[1]

LBP CapasIncorrect
applicable period
reflected in the
receipt.
LBC CoronAccepted the
premium payment
of member for last
quarter of 2013
dated December
27, 2013. They
were no longer
accredited
collecting agent
starting December
1,2013.

4/4/2014 21:45:30 JACKIELOU

4/5/2014 7:15:33 ARLYN

YACAP

PAREDES

NCR

NCR

yacapjaja@gmail.
com

Permanent

mypinkpen22@gmail.com
Permanent

UST Hospital

METROPOLITAN
MEDICAL
CENTER

Private

Private

3/1/2013

3/1/2014

3/31/2013

3/31/2014

182

165

191

104

27

18

10

13

none

none

> The new portal

(PBEF) states that
the encoded
dependent(as the
patient) is
undeclared, upon
checking it on
ICARES, the said
patient is declared
and valid as
dependent.

>The employer's
contribution on
ICARES is not still
not updated, he
followed up his
concern to his
employee since
last year but his
contribution on the
system is till the
same.
LHIO Nagtahan
issued a Certificate
of Contribution to a
member with
different PIN. the
member paid her
last quarter of
2014 at LBC and
used the PIN that
was in the COC
issued by LHIO.
upon checking at
the members
profile, the was no
record of the
payment made
since the PIN they
used was not her
PIN. I called sir
roman balgomera
of lhio nagtahan
and explained to
him the scenario.
he told me to just
give the hospital a
go signal to deduct
the patient's
benefit and just
give the COC back
to them. this
should not happen
if the person who
issued the COC
checked the PIN
religiously.

649

267

267 N/A

they tend to give

the member the
best option they
can give for the
member to be able
to avail of
philhealth benefits.
if they can not
solve whatever the
problem is, that's
the only time they
direct the patient to
my service..

4/5/2014 12:05:14 EILHEN

4/5/2014 9:59:27 charlemagne

4/5/2014 12:40:37 MARVIN

4/5/2014 14:29:48 ANGELO

4/5/2014 15:30:52 Sarah Jane

BALLESTEROS

barroga

BARAOIDAN

LIM

Liberato

NCR

jerlhen2904@gmail.com
Permanent

MANILA
DOCTORS
HOSPITAL

ospital ng
sampaloc

NCR

chelleigh16@gmail.com
Permanent

NCR

OUR LADY OF
LOURDES
NIVRAMNADIOARAB12@GMAIL.COM
Permanent
HOSPITAL

NCR

NCR

angeloking.
lim07@gmail.com

Permanent

enyahjsarah17@gmail.com
Permanent

OSPITAL NG
TONDO

Private

Government

Private

Government

National Center for

Mental Health
Government

3/1/2014

3/1/2014

3/1/2014

3/1/2014

3/1/2014

3/31/2014

3/31/2014

3/31/2014

3/31/2014

3/31/2014

215

36

102

78

15

112

42

19

27

32

17

10

12

43

23

13

19

34

140

discharges data to
follow..thanks.

70

238

218

105

147

594

88

65

most of the time,

they dont give
schedule for check
up for OB patients
just because they
dont have updated
premium
contributions or
requirements
(MDR,cf1 and cert
of contribution). I
already talk to the
supervisor of the
OB OPD, but
insisted that it is
their way to help
and encourage
their patient to be
a philhealth
member and its for
their own good
especially now that
the hospital has
started collecting
fees for their
services. I believe
it is not the
appropriate thing
to do just to
encourage nonmembers/inactive
members. check
up is very
important for
patients especially
OB patients to see
the progress of
their pregnancy. I
have one client
9mos pregnant,
and almost
reached her due
date but is not
given schedule for
check up just
because she dont
have philhealth
contribution. she
was teary eyed
when she
prior to admission, approached me
during check up,
because of
patients are
frustration. I tried
already informed
to talk to the staff
about philhealth
on duty, but to no
112 requirements
avail.

594 N/A

N/A

none

>The member paid

her premium
contribution for 2
years (Php 2,400
for the year 2012
and 2013
supposedly) but on
her receipt the
applicable date is
1-2012 to 12-2012
reflecting for 1
year only.
Transaction was
made on 1/4/2012
at Northbay-Virgo
Drive BDO
N/A

none
N/A
>The member did
not avail his
philhealth benefit
because his
diagnosis Herpes
Zoster is not in the
list.
>The member
informed me that
she did not avail
the automatic
deduction because
the doctor did not
put the icd10 code
and the billing staff
said to her that the
diagnosis(allergy
to drug intake) is
not on the list, but
upon checking it in
Annex 1, the
diagnosis is
present on the list. N/A

none

COMPLIANT

N/A

none

Email1 Template
sent to
yacapjaja@gmail.
com on 04/04/14
at 9:45:38 PM

N/A

Most of the time

being asked of the
ICD-10 code/RVS
because the some
doctors just state
the diagnosis and
leave the
responsibility to
their secretary.

Email1 Template
sent to
mypinkpen22@gmail.com
on 04/05/14 at 7:
15:41 AM

new set of
uniforms
vaccines
hazzard pay

Email1 Template
sent to
jerlhen2904@gmail.com
on 04/05/14 at 12:
05:24 PM

no applicable
period. alied bank.

NBB is not
properly
implemented
because of lack of
budget and the
scarcity of
supplies. most of
the time, clients
were forced to buy
all of the
some clients was
medicines and
confused of the 3/6
Newborn
medical supplies
rule, but I always
screening is being needed. the refund
explained to them
for my 3mos in this paid by the client is taking 5-6 mos
that it should be
hospital, there is
and being
because all of the
prior to admission
no untoward
subjected for
fund is being
and the count is on slow remittance of incident that
reimbursement. (5- processed at the
monthly basis.
bayad centers
happened.
6 mos)
city hall of manila.

they were still

adjusting with the
ACR, especially if
they cant find the
diagnosis in the
annexes.

N/A

HERPES ZOSTER
INFECTION, WHY
IS IT NOT
COVERED? AND
OTHER
FRACTURES.
N/A

> Hospital
encourages
members who
have had outside
expenses to file for
refund especially
sponsored and
indigent members
who are covered
79 by the NBB policy

65 Use of portal

PNB Laong LaanIncorrect amount

was collected.

*dual membership * not posted

category
contribution for
*dual pin
employed member

N/A

N/A

N/A

N/A
Just like before,
NBB is not
implemented
because of lack of
supplies and
medication of the
hospital but refund
is encouraged. In
terms of the effect
of the city
ordinance 8331 of
manila being
implemented this
coming april, NBB
policy may also be
affected such that
the hospital is
going to be
partners with a
private company
for their laboratory
services which
may cause
members to pay
for such services.
*no philhealth
charity ward where
in patient with
psychiatric cases
admitted ,thus
* new version of
some nbb patient portal which
have some out of generates pbef is
pocket expenses always down

there is no ORE in
this hospital. but is
accepting ORE
clients as long as
its eligibility was
verified by
PCARES

they were very

thankful for the
deployment of
philhealth CARES
here to assist them
especially in
checking the
eligibility of the
clients.
MY HOSPITAL
ASSIGNMENT IS
ALWAYS FAR
FROM MY
ADDRESS. IT
TAKES ME
ALMOST 2
HOURS JUST
FOR TRAVEL
TIME.

Email1 Template
sent to
chelleigh16@gmail.com
on 04/05/14 at 12:
05:25 PM

Email1 Template
sent to
NIVRAMNADIOARAB12@GMAIL.COM
on 04/05/14 at 12:
40:44 PM

Email1 Template
sent to angeloking.
lim07@gmail.com
on 04/05/14 at 2:
29:55 PM

I hope that cares

management have
fun activities in
stored for the
anniversary of
cares project

Email1 Template
sent to
enyahjsarah17@gmail.com
on 04/05/14 at 3:
31:00 PM

Timestamp

First Name

Last Name

Region

Email Address

Status

Hospital Covered

Hospital Category

PERMANENT
START

Hospital Level

PERMANENT
END

ROVING

Formal Economy

Informal Economy Lifetime Members

Indigents (NHTSPR)

Sponsored
Member

# of Client's served
No. of
during ward
member/dependent
classes, mother's
No. of Nonwho are able to
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
member/dependent member/dependent
benefits

Non-Member

Hospital's Best
Practices

Membership

Contribution

ACAs

Healthcare
Provider Relations

Benefits

No Balance Billing

All Case Rates

On site Point of
Care
Point of Care
during night time
admissions. Since
there are no social
workers to assess
potential POC
enrollee, the latter
will be obliged to
buy medicines and
supplies only to
realize that upon
assessment the
morning or day
after they are
indeed qualified as
critical poor. NBB
was not availed
earlier.

Internal

----We have a LOT

of eligibility
checking on ORE
portal that says
YES for some
listed formal
economy, but upon
checking on
iCARES last
posted contribution
was not active and
indeed not
employed this year
of 2013 as per
interview.
RELIABILITY OF
ORE PORTAL for
these instances is
NOT GOOD and
causes a delay on
the availment side
of members for
2. There is one
possible ORE.
Informal Economy Moreover, for this
member with NO month, members
eligibility but with for Informal
posted qualifying Economy and
contribution on
Indigent category
iCARES. (e.g.
who answered
case of
NO for eligibility
030253992650)
checking on ORE
PORTAL still have
3. Eligibility
to be veified
checking upon
through CARES
admission can be because as per
done through
iCARES there was
PORTAL, however an Informal
prior to discharge Economy with
generation of
valid effectivity as
PBEF is required indigent until
and affix signature December of 2014.
over printed name Also, there were
of
still Indigent
member/patient/representative.
members who
It would be a
were not renewed
problem if the
on ORE PORTAL
internet connection but as per
in the hospital
verification through
even more our
MCIS these were
PORTAL itself was NHTS-PR
down that hinders members and
the generation of could be renewed
PBEF. This
so they were not
eventually delays qualified to be
the signing of
enrolled through
member/patient/representative
ORE.
and worst they
indeed need to go ---Social Workers
with the nearest
of DJFMH
Philhealth Express experiences an
office and get
enrolled member
MDR during after who was DENIED
office hours and
on SAGIP
Sundays where no PORTAL. Upon
CARES is
verification, this
available.
member is an
NHTS-PR
4. As with
member. Patient
attachments, it is were already
common that
discharged so they
misspelled names have to call back
on birth certificates the member to
and the like
comply the
documents. Is it
necessary
really true that
requirements. I
Some still
PMRF only shall
asked the MSW
purchase
suffice? If not,
how long does it
medicines at their affidavit of two
take for them to
expense if
disinterested will
see the STATUS
admitted without
be required if no
of their enrollee if
having an
other documents
FOR PAYMENT or
availment form
are available to
DENIED and the
issued at the
think that mostly
answered was it
hospitals
indigent members depends when the 1. Some
Philhealth Section have this common MEMSEC
guidelines,
once patients were problem.
respond.
memorandums,
admitted.
circulars by the
5. As to
----ORE at DJFMH corporation needs
NBB Beds are not deactivation of
seems to slow
clear interpretation
practiced since
membership to
down because
from the makers
number of patients become a
their Audit findings themselves to us
at DJFMH exceeds dependent of a
questioned where who delivers the
their number of
qualified member it the hospital are
policies especially
beds thus
is not cleared to us getting the
the frontliners to
sometimes bed
with regards in
premiums they
avoid confusions.
ratio is 2 beds
using PBEF.
paid for their
2. Provision of
together and on it
enrollees stating
supplies for
was 3 to 4 mothers 6. Guidelines
that it is not on
members usage e.
side to side plus
concerning the
their mandate to
g. staple wires,
their babies. (on
implementation of pay for such
ballpens and
the other hand,
PBEF as well as
premiums. As far correction tapes.
one doctor said
possible meeting/ as I know letter to 3. Provision of
that that formation training for us
PHIC were already latest flyers and
has a physiologic CARES for more
forwarded and the flipcharts for
side they called
clarificatory
hospital are now
information
"TANDEM"
concerns
seeking
dessimenation on
towards
concerning IT,
coordination of this our updates for
encouragement for MEMSEC and
thing with our
members and
breastfeeding.)
BAS.
Corporation.
partners (e.g. HCI)

Email1 Template
Status[1]

1. Eligibility
checking through
PBEF still have
loop holes.
-For instance, an
illegitimate child
(case of newborn
for NCP) who has
no middle name to
be encoded will
have a chances of
ELIGIBILITY
checking with
BLANK RESULT,
where as per for
the mothers claim
eligibility was
YES already.

1. Employers
certification on
CF1-Part 2 is not
sufficient proof of
PHIC contribution.
Hospital prefers to
obtain certificate of
PHIC remittances
from respective
employers
especially if on
iCARES
contribution is also
not posted.

4/5/2014 16:57:33 ERECA ANGELA

CEPILLO

NCR

ereca.
cepillo@gmail.com Permanent

DR. JOSE
FABELLA
MEMORIAL
HOSPITAL

Government

3/1/2014

3/31/2014

128

53

160

28

1974

1974

1. Delayed posting
of contribution of
some employed
members
With regards to
especially on
iCARES, wishing government.
that we could also 2. With regards to
see and verify who iCARES, wishing
sponsored our
also that validity
indigent and
period for migrant
sponsored
workers (land
1. Reimburses
members like what based) reflects the
official receipts of was seen on MCIS start and end
members once
because it could
validity format like
HCP was paid by help us lessen our what was seen on
PHIC and upon
TAT instead of
MDR and MCIS,
presentation of
calling our TL (who because if we click
BPN. (late filing)
sometimes is on PREMIUM
2. MSWO are
roving/meeting/busy CONTRIBUTIONS
helpful to enroll
attending
on iCARES we
emancipated
immediate
dont know if
minors on ORE.
concerns) and
posted contribution
3. Appreciates the Command Center is really as migrant
presence of
(who sometimes
worker or already
CARES in the
have no access to shifted as informal
809 hospital.
MCIS).
sector.
-The Hospital Is
still reimbursing
the out of the
pocket of our
Philhealth
Members whether
they are Indigent
or not. The
reimbursement
process will take 4
months upon
discharge of the
patient or more
than 4 months
depending on the
status of Claim.

1. Poor internet
connection.
2. Lack of
manpower and
computers with
good
specifications.

PIN
030255278025
account created
2/3/2014 as
Informal Economy
made payment
was February to
April 2014
amounting to
600php paid at the
Philippine
Business Bank. As
you can see, it
should be January
to March 2014.

4/5/2014 19:33:33 ERICKA ELAINE

LOPEZ

NCR

erickaelainelopez2gmail.com
Permanent

Justice Jose Abad

Santos General
Hospital
Government

3/1/2014

3/31/2014

65

54

92

15

432

246

3. None issuance
of MDR on our
offices and
encouragement of
the use of hospital
portal might cause
a delay on the
availment of
benefit of our
members since
DJFMH has an
intermittent
internet
connection. A bit
risky for CARES to
facilitate issuance
of PCF1 using only
phonecall
verification to cocares.

-Very
Accommodating
and also the
Medical Director is
very nice.
NONE

NONE

Email1 Template
sent to ereca.
cepillo@gmail.com
on 04/05/14 at 4:
57:41 PM

-Upper GI
Bleeding is not
Listed at ANNEX A
-Bronchiolitis is not
also compensable.
(I already relayed it
to Doc Pe upon
the ACR Seminar
held on the
Hospital last March
31,2014)

-I don't have
problem in the
hospital because
they know what to
do. If there are
problems they are
consulting it to the
Philhealth CARES.
They are very
open on what i
say/ comments
that I give.

-The Hospital is
using PBEF
-The Philhealth
Members are free
from hospital bills if
they have
complete
Philhealth
requirements
whether the bill
exceeds from the
Philhealth
80 package.

*DJFMH is now
open to change
their flow of
availment inside
the hospital from
ER/Admitting area
until the discharge
of patient to avoid
the cause of their
NBB violations
with regards to
official receipts of
members.
Establishment of
internet connection
and provision of
computers were
already I think is a
priority.

2. Ideally, upon
presentation of
PHIC ID and/or
MDR on hospital
shall make the
patient eligible for
PHIC availment.
However, in
DJFMH complete
requirements must
be submitted first
to their Philhealth
Section for
Philhealth
availment
issuance. Thus, if
patients were
admitted with
incomplete
requirements
he/she should pay
first, for whatever
drugs, supplies or
laboratory she
needs.

NONE

-No Balance Billing

is still not
accomplished b
the hospital
because of the
lack of supplies to
accommodate
several of patients
per day.

IHCP PORTAL:
-When a member
do not have middle
name registered at
our system there
are no results
appearing if the
patient is eligible
or not.
NOT APPLICABLE

-Team Building
-More set of
uniform
-more supplies
-Hazard pa
-8hours per day
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