Merry Christmas and a Happy New Year to you and your staff!
May tanong lang po ako tungkol sa PhilHealth.
Na-confine ang anak ng kaibigan ko sa isang private hospital dahil sa sakit na dengue.
Covered naman ng PhilHealth ang anak niya.
My concern is this, some of the medicines ay wala sa pharmacy ng hospital kaya napilitan silang bumili sa labas.
Can my friend reimburse the expenses she made for the medicines?
Magkano ba ang allotted na budget for a dengue case?
Salamat po sa inyong gagawing tugon.
Thanks and regards.
Marianita C. de Vera
REPLY: Dear Ms. De Vera:
Greetings from Team PhilHealth!
Regarding your inquiry on PhilHealth Case Rates, these are the guidelines, for your information and reference:
Since September 1, 2011, the following medical case are being paid through case rate or packaged rate:
Dengue I (Dengue fever, DHF grades I&II) – P 10,000
Dengue II (Severe Dengue, DHF grades III & IV)-P 16,000
These rates shall be the amount to be paid to the facilities, and shall include the Professional Fees (PF).
The PF for the medical case shall be 30 percent of the reflected amount. For instance, breakdown of the rate for Dengue I (P10,000) shall be:
Hospital charges (70%): P7,000
Professional Fee (30%): P3,000
Total: P10,000
For Dengue II (P16, 000):
hospital charges (70%) : P11,200
Professional Fee (30%) : P4,800
Total: 16,000
In case you have not maximized the amount for hospital charges (P7,000 or P11,200), you may coordinate with the billing section of the hospital with regard to the reimbursement of medicines bought outside the hospital during the confinement.
If warranted, you must present the Official Receipts of the medicines. You may photocopy the ORs for your personal copy.
For more concerns and other queries you may e-mail us again or call our action center hotline at 441-7442.
You may also visit our website at www.philhealth.gov.ph
Thank you.
Warm regards,
CORPORATE ACTION CENTER
Website: www.philhealth.gov.ph
Twitter: @teamphilhealth
Facebook: www.facebook.com/PhilHealth
Call Center: 441-7442
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