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PHILHEALTH

The document discusses PhilHealth, the Philippine government's social health insurance program. It provides information on how uninsured families can enroll, including obtaining certification from DSWD for indigent families or sponsorship through local governments. It also mentions that enrolled families will receive a PhilHealth ID and Medical Data Record as proof of membership. The summary of a patient's clinical information during hospitalization is used by PhilHealth for evaluation.

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Badeth Ablao
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94 views2 pages

PHILHEALTH

The document discusses PhilHealth, the Philippine government's social health insurance program. It provides information on how uninsured families can enroll, including obtaining certification from DSWD for indigent families or sponsorship through local governments. It also mentions that enrolled families will receive a PhilHealth ID and Medical Data Record as proof of membership. The summary of a patient's clinical information during hospitalization is used by PhilHealth for evaluation.

Uploaded by

Badeth Ablao
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Easy round

1. The Philippine Health Insurance Corporation (Philhealth) is a Government owned and Controlled
Corporation (GOCC) created through the National Health Issuance (NHI) Act of 1995 or RA 7875.
2. If the family is listed as NHTS but the PhilHealth enrollment status is not known by the Barangay
Office, the head of the family should secure a certification from the Municipal DSWD office that
they are an NHTS family and then proceed to the nearest PhilHealth Service Office where the
family enrollment status is verified. The head of the family must bring a proof of identification
such as voter’s ID. Once verified as enrolled, the head of the family should request for a
PhilHealth ID and an MDR as proofs of membership.
3. A poor family not listed as NHTS may still be enrolled as a Sponsored Program member through
LGU-sponsorship. The head of the household must be 18 years old at the time of enrollment
with PhilHealth. He/she should approach the Barangay Office and ask about enrolment in
PhilHealth as indigent. The LGU will subject the family to a means test to verify if they qualify. If
yes, the LGU can enroll the family as Sponsored Program member. The head of the family will be
asked to fill up the PhilHealth Member Registration Form (PMRF, see Appendices A and B). The
LGU then pays for the premium. A PhilHealth ID will be provided to the family once enrolled.
4. The family’s proofs of enrolment in PhilHealth – PhilHealth ID and an MDR
5. The summary of pertinent clinical information of a patient/member during their
hospitalization/episode of care that shall be utilized by PhilHealth to conduct evaluation.

Average Round

1. This Act shall be known as the “Universal Health Care Act”.


2. It refers to a group of primary to tertiary care providers whether public or private, offering
people-centered and comprehensive care
3. Refers to any action, scheme or ploy against the NHIP, such as overbilling, upcasing, harboring
ghost patients or recruitment practice.
4. aims to incentivize providers who have afforded access to care to assigned eligible members
through enlistment, profiling, and provision of services.
5. is the electronic record system or the electronic document of a patient’s encounter in one
health facility. In this case, the patient’s medical or health record at a health facility is being
received, recorded, transmitted, stored, processed, retrieved or produced electronically through
computers or other electronic devices.
6. an initial platform for interoperable health information system that streamlines the business
processes and harmonizes the architecture, data structure and technology solutions (i.e.
applications and health information systems) between DOH and PhilHealth to achieve better
efficiency and outcomes in service delivery health data and statistical reporting, and availability,
access, exchange and use of health data/ information.
7.

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