Philhealth reimbursement how long

All processing of payment for unclaimed refunds will be done at PhilHealth regional offices. Hence, if you file at a distant service office, processing time may be longer than if you filed at the regional office.

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Unclaimed Refunds? Check the List Now. What is an unclaimed refund? What to do if your name is on the list 1. Who are entitled to the refund?

How much is the refund? How will I know if I have an unclaimed refund? How do I collect my refund? If member is not available, who may claim the refund? The claimant must bring the following documents: a. If a member is deceased, who may claim the refund? The following documents may be relevant to prove relationship: a. Absence of conditions that will compromise safety and functionality with the use of prosthesis, orthosis, iii.

On physical examination: no fresh or non-healing wound on body part of interest iv. At least three months-post-surgery, if acquired amputation b. With mobility impairment, presenting with any of the following: i. Disorders resulting to mobility impairment: a. Talipes equinovarus clubfoot b. Neuromuscular conditions characterized with any of the following: weakness or paralysis, imbalance, incoordination, sensory deficits classified into: i.

GMFCS-3, 4, and 5 for seating device, wheelchair and orthosis ii. Description for yearly diagnostics, after the first year of enrolment Yearly Diagnostics for Categories 1, 2, 3 and 4 - 3, General Criteria 1. Chronological age must be equal to 0 to 17 years and days old; 2. AND any of the following: i. The child must have undergone a visual disabilities assessment from an ophthalmologist where the child was categorized into Category 1, 2, 3, 4, or 5 visual disability and determined to need assistive devices with prescribed appropriate rehabilitation plan ii.

Children needing an ocular prosthesis should fulfill the following criteria: a. The child has enucleated eye b. Other clinical indications determined by ophthalmologists 3. Must be eligible at the time of pre-authorization Children With Hearing Impairment Description for assessment and hearing aid provision of children 0 to less than 3 years old at the time of approval of pre-authorization Assessment and hearing aid provision, with moderate hearing loss Assessment: Otoacoustic Emission Screening and Auditory Brainstem Response ABR Habilitation: Hearing Aid fitting, hearing aid device, batteries good for 5 years, ear mold, hearing aid verification Ear mold refitting every six months for five years 53, This require a new application for pre-authorization.

Includes hearing aid fitting, hearing aid batteries good for five years, ear mold and hearing aid fitting verification 48, Age must be equal to 0 to 17 years and days old 2.

A child must have undergone professional assessment and is deemed to have ALL of the following: i. Sensorineural hearing loss presenting with either moderate or severe to profound hearing loss described as: a. Severe to profound hearing loss —three frequency Hz, Hz, Hz average threshold greater than or equal to 61 dBHL iii. Absence of signs and symptoms of an active ear infection e.

Initial providers are the accredited facilities for the Outpatient benefit for the indigent members, i. Microscopy-detection of malaria parasites in Giemsa- stained blood smear; or b.

Local wound care iv. Tetanus toxoid and anti-tetanus serum ATS v. Antibiotics vi. Supplies such as, but not limited to, syringes, cotton, alcohol and other antiseptics PhilHealth accredited Animal Bite Treatment Centers This package shall cover the following: a. The following are identified as reimbursable PEP service items: i.

Supplies such as, but not limited to, syringes, cotton, alcohol and other antiseptics b. Dog bites primarily. However, persons bitten by other domestic animals cats and livestock cows, pigs, horses, goats as well as wild animals bats, monkeys may be covered. Category III Rabies exposure i. Handling of infected carcass or ingestion of raw infected meat iv. Category II Rabies exposure involving the head and neck c.

Disclaimer The PhilHealth Logo, Photographs and information on this Web Site may not be reproduced, copied, or downloaded in any form or by any means -- graphic, electronic, or mechanical, including recording, taping, photocopying, or information storage and retrieval systems -- for use in illegal, damaging or pornographic material. Prostate Cancer low to intermediate risk P, No uncontrolled co-morbid conditions. End-stage renal disease eligible for requiring kidney transplantation low risk P, Other congenital anomalies.

No chromosomal abnormalities and other associated congenital defects. Treatment plan from gynecologic oncologist. Selected Orthopedic Implants 1. Clinical Features. Any hip fracture not covered under the total hip package for femoral neck fracture. Femoral shaft fracture. The new policy shall cover claims using case rates with the exception of directly filed claims those for confinements abroad and claims for Z Benefits, among others.

This also translates to faster turnaround time for claims processing, and good health outcomes for our patients. Roy B. Ferrer explained.