4b (Responses)

Timestamp
First Name
Last Name
Region
Email Address
Status
Hospital Covered
Hospital Category
Hospital Level
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
>Some of our
clients who wanted
to be members of
PhilHealth were
asked to provide
supporting
documents and
ID's in the
officeeven if there
were no
discrepancies
obseved.
11/29/2013 14:46:
58 ARIESPOL
ZABALA
4b
zabalaariespol@yahoo.com
Permanent
BATANGAS
MEDICAL
CENTER
Government
11/1/2013
11/30/2013
41
67
91
146
10
32
1172
849
Insisted to attach
official receipt of
purchased
medicines and
849 medical supplies.
11/29/2013 19:46:
15 Jasmin Dane
11/29/2013 20:00:
10 Jasmin Dane
11/29/2013 20:16:
29 DONN RENE
11/30/2013 9:17:
01 CHRISTIAN
11/30/2013 9:36:
04 CHRISTIAN
11/30/2013 9:56:
02 CHRISTIAN
CUETO
Alisna
Alisna
PEREZ
TEMPLE
TEMPLE
TEMPLE
4b
PEEJAY.
CUETO@GMAIL.
COM
4b
jdalisna@gmail.
com
4b
jdalisna@gmail.
com
4b
4b
4b
4b
Permanent
BATANGAS
MEDICAL
CENTER
Government
Roving
Medical Mission
Group of Hospital
Roving
Oriental Mindoro
Provincial Hospital Government
donnrenetperez0728@gmail.com
Permanent
christianotemple@yahoo.ca
Roving
Roving
Roving
DON JUAN
MAYUGA
MEMORIAL
HOSPITAL
METRO SAN
JOSE MEDICAL
CENTER
MADONA
GENERAL
HOSPITAL
METRO LIPA
MEDICAL
CENTER
Private
Government
Private
Private
Private
11/1/2013
11/30/2013
11/11 to 16/2013
41
11/18 to 23/2013
11/1/2013
11/30/2013
268
11/04 to
11/09/2013
11/11 to 15/2013
11/16 to 29/2013
23
14
116
69
313
21
11
39
94
13
222
146
297
14
37
35
1172
849
849
585
543
543
Misspelled names
in the MDR of
Sponsored/Indigent
members in their
MDR.
Some of the nonmembers are still
hesitant to enroll
until they validated
the information
through us CARES
and with the LHIO
offices.
-The hospital is not

strict on our
Philhealth
member's
requirements when
it comes to
membership, they
accept supporting
documents and
are compliant to
our policy. (circular
50)
-PCF1 from
CARES are being
accepted as proof
of membership
-The hospital is not
strict on our
Philhealth
member's
requirements when
it comes to
membership, they
accept supporting
documents.
- When it comes to
employed
membership, the
MDR should be
updated with the
current employer
being printed in the
hospital - As
CARES I suggest
them to still accept
the requirement
granted that the
member has the
CF1 properly
signed by both
member and
employer and
when the member
has other proof of
employment.
11
Many of our clients

are non-members
and members but
do not have
qualifying
contributions.
> We encouraged
our clients to pay
the premium
contribution for the
unpaid portion of
the year 2013, or
for the nonmembers, pay the
whole year.
A Formal sector
member
(Employed
member) who has
been employed for
a year is still under
informal sector in
our data base.
571
Encountered
numerous
mistakes and
discrepancies in
Member Data
Record (MDR),
especially in
sponsored
members.
11
338
ACAs
Healthcare
Provider Relations
Many of our clients

are non members
and members but
don't have
qualifying
contributions.
>We encouraged
them to pay the
premium
>Encountered a lot unpaid months for
of
the whole year of
mistakes/discrepancies
2013 to
in their MDR. Most immediately avail
in sponsored
of PhilHealth
members.
benfits.
Some of our
clients who wanted
to be members of
PhilHealth were
asked to provide
supporting
documents and
IDs in the office
even if there were
no discrepancies
observed.
11/29/2013 15:05: PAMFILO

31 RODOLFO III
Contribution
Some
discrepancies with
the names in the
receipt of
PhilHealth
premium payment
from some
collecting agents
none
There were some

discrepancieswith
the names of the
member in the
receipt of
PhilHealth
premium payment
from some
collecting agents. None
Accredited
Philhealth
contributing agents
( e.g. Western
Union) should be
oriented regarding
the new policy of
the implementation
of the new IRR
regarding
retroactive
/nonmember can
still pay the whole
premium
contribution for
2013 even it is the
last quarter of the
month.
-Late posting of
contribuon of OFW
members who paid
the premium
contribution before
leaving the
country.
-Hospital follows
Philhealth's policy
on 3/6 months
premium
contribution to all
cases and are
aware of the policy
that helps nonmembers to avail
benefits upon
successfully
applying for a
Philhealth
membership and
having paid the
amount of the
whole current year
within the
confinement
period.
-Hospital follows
Philhealth's policy
on 3/6 months
premium
contribution to all
cases and are
aware of the policy
that helps nonmembers to avail
benefits upon
successfully
applying for a
Philhealth
membership and
having paid the
amount of the
whole current year
within the
confinement
period.
-Hospital follows
Philhealth's policy
on 3/6 months
premium
-The hospital is not contribution to all
strict on our
cases and are
Philhealth
aware of the policy
member's
that helps nonrequirements when members to avail
it comes to
benefits upon
membership, they successfully
accept supporting applying for a
- Personnel with
documents and
Philhealth
good customer
are compliant to
membership and
service makes a
our policy. (circular having paid the
difference
50)
amount of the
(Philhealth clerk in -PCF1 from
whole current year
the hospital)
CARES are being within the
- Updated on
accepted as proof confinement
324 Philhealth's policy of membership
period.
Benefits
Sponsored
members are
restricted from
getting medicines
from the hospital
pharmacy despite
of having a
PhilHealth ID with
validation period.
The PhilHeath
clerk refers the
client to PhilHealth
CARES to provide
PCF1 even if the
member hasd
his/her PhilHealth
ID. In otherwords
the PCF! serves as
a permit to get
medicines from the
hospital pharmacy
Sponsored
members are
restricted from
getting medicines
from the hospital
pharmacy despite
of having a valid
PhilHealth ID with
validation period.
The PhilHealth
clerk refers the
client to PhilHealth
Cares nurses to to
provide PCF1
even if the
member has
his/her PhilHealth
ID. In other words,
the PCF1 serves
as a permit to get
medicines from the
hospital pharmacy.
Philhealth clerk
assigning
members/patients'
attending
physician to sign
the back of their
CF2. They are not
accepting the
claim forms not
unless its sign by
the attending
physician.
-Take home oral
medication are not
covered by
PhilHealth
pharmacy.
-Supplies in the
CSR are
purchased through
cash.
-Philhealth clerk
still requiring forma
economy sector (
private employed)
to provide proof of
contribution from
the employer to
fully avail benefits.
No Balance Billing
All Case Rates
On site Point of
Care
Internal
PLEASE SELECT
ONE
NBB is still not fully

implemented in
this hospital.
Patient tends to
buy medicines and
other medical
supplies due to
luck of supplies
and unavailability
of medicines.
none
none
none
New Entry
NBB is not
observed.
N/A
None
New Entry
N/A
Cares Post is not

visible to clients.
No computer
provided for Cares. New Entry
No billing
statement provided
for discharged
PhilHealth
member.
New Entry
Unavailability of
medications that
are bought outside
the hospital are the
primary concerns
of the members.
New Entry
-No issues
- CARES are very
much welcome in
the hospital
-Hospital having
problems with
clients who do not
declare their
Philhealth benefits
being exhausted.
(some hospital
claims got denied
due to benefits
exhaustion benefits being
used less than 90
days)
- Private hospital
-no issues
-CARES are
welcome
-Members are
being informed of
their benefits
especially when
their case is
assumed to fall on
case rates
category.
- Private hospital
- No PF on ward
type and
sponsored
category
membership
New Entry
- no issues
- CARES are very
much welcome in
the hospital
- CARES are
provided with
computer and
internet
connection.
- Hospital follows
our benefits
amount and are
being utilized.
- Cases when
hospital are being
underpaid
(Pneumonia 2 is
being paid with
amount of
Pneumonia 2)
- Private Hospital
New Entry
- Portal system in
the hospital is not
updated.
(according to the
hospital's
personnel)
New Entry
Timestamp
First Name
11/30/2013 10:05:
44 JEEMA
11/30/2013 11:19:
54 Jasmin Dane
Last Name
BRINAS
Alisna
Region
4b
4b
Email Address
dhanjem@yahoo.
com
jdalisna@gmail.
com
Status
Roving
Roving
Hospital Covered
Hospital Category
UNITED
DOCTORS OF ST.
CAMILLUS DE
LELLIS HOSPITAL Private
Ma. estrella
General Hospital
Private
Hospital Level
Formal Economy
11/25 to 30/2013
11/25 to 30/2013
13
Indigents (NHTSPR)
Sponsored
Member
No. of
during ward
member/dependent
classes, mother's
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
benefits
Non-Member
NOTE : I HAVE
NO AVAILMENT
DATA FOR THE
MONTH OF
OCTOBER
BECAUSE THE
UNITED
DOCTORS OF ST.
CAMILLUS DE
LELLIS OPEN
LAST NOVEMBER
4, 2013.
19
Hospital's Best
Practices
81
773
Membership
1.Registration
Procedure Under
OM 0257 s 2013.
2.Correction in
dependents Data
3.Renewal of
Membership
4.Qualified
dependent not
declared in
Member Data
Record.
Contribution
1.Members lost
their premium
contribution
receipt.
2. Contribution
Payment for year
2014.
ACAs
No issues and
concerns were
encountered.
Sponsored/Indigents
birthplace not
indicated in the
mdr
-multiple
declaration of
dependents
-dependents full
midle name is not
indicated in the
mdr
773
Healthcare
Provider Relations
Benefits
1.Hospitals have
difficulty
determining
benefits for
multiple
medical/surgical
case rates.
2.They also have
difficulty in
determining RVU
and ICD 10 codes.
3.Members did not
avail the benefits
due to incomplete
diagnostic
procedure needed
for the case rate.
Like, Patient was
diagnose with
CVA 1, but she did
not undergone
neurologic exam
because
according to the
clerk the
Neurologist was
not available.
Hospital staff is
4.In cases of
very
death, Philhealth
accommodating to clerk has difficulty
CARES nurses
in deducting
and no issues and benefits.They did
concerns were
not deduct benefits
encountered.
under case type D.
-Member availed
the wrong benefit.
Patient was
admitted last July
2013 and claim a
benefit of P8000
for DHF1. whe
member received
the BPN this Oct
the BPN stated
that PhilHealth
paid the hospital
the amount of
P16000 for DHF 3;
4. the hospital
reimbursed the
member right
away.
-Patients are
staying in the
hallway.
-RTH claims
requiring patients
signature are
being forged by
the philhelath
clerk.
No Balance Billing
All Case Rates
11/30/2013 12:19:
28 Datinguinoo
11/30/2013 12:03:
10 JANICE
11/30/2013 12:25:
31 Datinguinoo
11/30/2013 13:24:
03 JOANNE
Inah
4b
SANDAHAN
4b
Inah
4b
JAVIER
4b
mia8jian16@gmail.
com
Roving
janzsandahan@gmail.com
Permanent
mia8jian16@gmail.
com
Roving
joanne_dust@yahoo.com
Roving
OMPH
Government
ROXAS
MEDICARE
HOSPITAL
Government
OMPH
Government
MARTIN
MARASIGAN
MEMORIAL
HOSPITAL
Government
11-4-9,2013
11/1/2013
11/30/2013
11-4-9,2013
11/1 to 15/2013
11
11
41
41
31
11
21
89
58
54
11
11
41
41
41
29
12
13
69
PLEASE SELECT
ONE
New Entry
New Entry
Assisting the client
on fillinh their CF1
and PMRF
Instructing them
how to correct the
wrong data on
their MDR
told them to
always go first on
hospital pharmacy
Informing the non

philhealth clients
that to be able the
benefits
immediately they
have to be a
Individually paying
member and pay
the whole year
premium.
Some sponsored
members didn't
know that their
philhealth
membership was
already renewed. If
I didn't verify it
through ICARES
they wont be able
to avail their
claims. Also, some
sponsored
members didnt
know that they are
in the list of
sponsored
members because
their philhealth IDs
were given only to
them 1 month
before the
expiration date of
the validity period.
- Hospital clerk's
were
accommodating.
- They were
updated in new
policies and also
informed in-patient
and outpatient
members about it.
- We do morning
rounds to check
requirements and
encourage Nonphilhealth
members to enroll
to avail benefits.
- They allow
members to follow
up requirements
after discharge to
complete the
needed documents
but before they
leave the hospital,
they do deposits.
Then once the
needed documents
were submitted,
they can refund
the deposit.
- Hospitals
Administrative
Officer also help
charity patients
once the
PHilhealth Benefits
were maximized.
Internal
1.Board and
lodging for CARES
nurses assign far
from their
residence.
2.Hazard Pay
allowance for
CARES since we
are doing rounds
and were
very exposed to
different diseases.
3.CARES should
have an ICD
training to
maximize their
functionality in the
hospitals.
4.Claim status and
OFW validity
period should be
included on
ICARES.
5. Payslip in every
salary.
Hospital did not

implement NBB
because it is
Private.
Mother in-law
declared as
dependent,but i
told himn that is
not valid.
Having a separate
Pharmacy for
They are very
PhilHealth and
thankful for our
non-PhilHealth
new circular which
member.
is only the
documents of the
give a free
beneficiaries are
hospitalization to
needed.
indigenous group
(mangyan)
Almost every
clients that i have
give a discount to encounterd on the
non-philhealth
hospital had
member who
applied to be
cannot afford to
member of
pay the full bill.
PhilHealth to avail
41
the benefits.
On site Point of
Care
On my morning
rounds, I always
make sure that I
talked to phic and
non-phic
members. I
advised non-phic
to enroll as new
member to avail
hospital benefits
and explained the
requirements
needed for
enrollment and
updating according
to the new Circular
22 s. 2013 and
Circular 0028 s.
2013. I also
instructed
members on
shifting their
membership
I discussed and
category to have a instructed
continuous/updated members in
contribution that is continuing
needed during
payments by
confinement. I also following the
encountered some guidelines
government
according to office
employees
orders 0112 s.
wherein theirs no 2013 and office
contribution posted memo 257 s.
into their PIN but
2013. Some
with deductions on patients and
there payslip and members agreed
even their category but some also
were not shifted to were hesitant to
employed. I
pay because its
advised them to
expensive. I
submit PMRF, CF1 explained to them
and ER2 from
clearly the benefits
employer to
they can avail and
update his
the possible refund
membership and
for the out of
for him to avail
pocket expenses
benefits.
for medicines and
laboratory exams. none
Dr. Cruz told me

that we should
have computer to
supply the needed
documents of the
clients especially
MDR
A doctor told me
that as a CARES I
should check the
written final
diagnosis of the
patient to know
whether it is
compensable or
not. So that if it is
not compensable
they can change it
to the nearest
diagnosis that
would fit the case
of the patient and it
would be already
compensable. I
said to that doctor
that it is not a part
of the job of
CARES to do that
and it is not
prohibited to do
that. Some staff
didn't give the
patient a lab
request
immediately upon
admission thats
why although the
case of the patient
is compensable
they cant avail it
because they dont
have laboratory
result that will
support their
cases.
The hospitals
administrative
officer, doctors,
clerks and other
hospital staff were
accommodating.
We helped each
other in providing
quality health care
for each and every
members and
patients in the
hospital. Hospital
staffs were
approachable
leading to a
smooth transaction
and explanation of
new policies and
updates were also
adapted.
clients can avail

the benefits but did
not maximize it
because of
insufficient supply
of medicines.
they practice the

No Balance Billing
but the clients still
have a out-pocket
expenses on
medicines bought
outside.
Difficulty
understanding
BPNs, especially
for those illiterate
members.
Members
complained that it
took them months
before they
received their
reimbursement
since the hospital
still waits from the
trust fund release
by provincial office.
Some members
didnt know that
their dependents
have 45 days
benefit allowance.
They thought that
if one dependent
already use their
philhealth
availment the other
dependents can no
longer use it.
The Sponsored
members are not
oriented about
Case Rates and
NBB Policy upon
admission. The
NBB Primer is not
visible in any area
of the hospital.
There is no free
potable drinking
water instead; they
have to buy at the
Nurses station or
stores outside the
hospital.
PhilHealth
members are
forced to buy their
medicine and other
medical supplies in
the cooperative
store since the
hospital lacks
medical supplies.
Members also
need to pay first
for the laboratory
fees.
Benefits of patients
were maximized
and out of pocket
receipts on
expenses for
medicines and
labs were collected
by the hospital for
future refund. I
explained to them
to always write
their present
address on the
claim form for
them to receive the
benefit payment
notice or follow up
after 2 to 4 months
at the hospital or
nearest PHIC
office. I also
distributed flyers
and pamphlets
about case rates
and benefits for
them to be
empowered and
knowledgeable
about their rights
for complete
benefit.
This hospital is
non compliant with
the no balance
billing because of
out of pocket
expenses on most
of the drugs and
medicines,
laboratories and
diagnostic exams
from other hospital
and also for private
doctors excess
fee. Statement of
account is not
automatically given
on each patients
discharged and the
actual total doctors
fee were not
reflected on the
SOA. I advised
them that the soa
must be given and
the fees should be
reflected but they
only answered that
if the member only
requested for it,
they can
photocopy the
SOA. and
regarding the PF,
they just log it on
their PF received not yet
log book.
implemented
having a specific
teaching about the
benefits of being a
member especially
to those who are
non-PhilHealth
individual and in
doing so,
Helping them in
encouraging them getting and update
to be a member . their MDR
New Entry
New Entry
not yet
implemented
Please increase
our transportation
allowance because
most of the
hospitals where I
was assigned were
so far and the
transportation fee
is expensive. PRO
lines were difficult
to contact. 2
CARES should be
assigned in private
hospitals with high
bed
capacity/census.
New Entry
Timestamp
First Name
11/30/2013 14:38:
23 JOANNE
11/30/2013 19:42:
58 DAVY
11/30/2013 20:08:
56 DAVY
11/30/2013 21:34:
06 JHELYN
Last Name
JAVIER
LIZARDO
LIZARDO
GARBIN
Region
4b
4b
4b
4b
Email Address
Status
joanne_dust@yahoo.com
Roving
davy.
lizardo@yahoo.
com
davy.
lizardo@yahoo.
com
Roving
Roving
jhelyngabin@yahoo.com
Permanent
Hospital Covered
GOLDEN GATE
GENERAL
HOSPITAL
CALATAGAN
MEDICARE
HOSPITAL
MARY
MEDIATRIX
MEDICAL
CENTER
SAN JOSE
DISTRICT
HOSPITAL
Hospital Category
Private
Government
Private
Government
Hospital Level
Formal Economy
11/16 TO 30/2013
PCF (Primary Care

Facility)
11/04 to 16/ 2013
11/18 TO 30/ 2013
11/1/2013
11/30/2013
89
16
24
75
107
18
53
14
Indigents (NHTSPR)
35
Sponsored
Member
No. of
during ward
member/dependent
classes, mother's
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
benefits
Non-Member
11
46
15
11
28
65
244
50
35
80
96
11
119
292
606
53
1105
247
Hospital's Best
Practices
Hospital clerks
were
accommodating
and approachable.
They provided
needed
information about
patient/ members
like daily census
and diagnosis
needed for
morning rounds.
They also provided
laptops for easy
access on i-cares
and for releasing
PCF1. They gave
statement of
account for all
discharged
patients reflecting
the total actual PF
of doctors and the
total PHIC
601 deductions.
Membership
I do morning
rounds to make
sure all patient and
members will be
able to use and/or
update their
membership. Most
non-phic were
encouraged to
enroll and they
were able to avail
the benefit
according to their
final diagnosis. I
also helped
members to
update their
category by
distributing the
new PMRF and
explaining the new
policy regarding
updating and
adding
dependents. Also
those retired
Government
employees who
didn't know that
they were already
a lifetime members
were informed
according to the icares and also
availed.
1.Erroneous
member data
record specially
4ps member and
LGU Sponsored.
2.MDR showing
varying degrees of
ward rounds
discrepancies.
together with the
3.Shifting of
social worker
membership from
identified patient
one category to
who have no
another. Usually
philhealth and
employed
encouraging them members dont
to enroll to
know how to shift.
philhealth,
4.Member is out of
explaining the
town/country and
benefits and
who will be the
procedure for
authorized person
30 enrollment.
to signed the CF1.
Retired members
assumed that their
membership
category will be
updated form
Assists members IPP/Employed to
especially
lifetime member.
indigent/sponsored Erroneous
with their
member data
documentary
record specially
requirements.
4ps member and
Monitored and
LGU Sponsored.
gathered
Informing member
prospective
to get mdr or pcf1
members and
on CARES even if
validated if they
the member had
are already
presented their
1105 members.
philhealth ID's.
Patients are not
aware of Cir no. 22
series of 2013
which states that
"PMRF as the sole
requirement for
registration. Most
of them says they
did not enroll
because of the
requirement they
needed to submit.
Contribution
I discussed and
instructed
members in
continuing
payments by
following the
guidelines
according to office
orders 0112 s.
2013 and office
memo 257 s.
2013. Also
informed members
where they could
pay premium
contributions.
none
1.Members under
the employed
sector,
government and
private alike, with
remittances that
are not updated.
not remitted on
time and have
missed quarters of
remittance.
2.Members have
to travel a long
distance just to
pay their premium
contributions.
Sometimes the
cost of travel for
transportation is
more than their
premium
contribution that is
why members
(IPP) do not pay
their contributions
due to distance in
which will they pay
their premium,
requesting and
hoping that
philhealth should
have remittance
center in that area.
Payment made at
Accredited
Collecting Agents
cannot be verified
through iCARES or
delayed posting of
contributions.
Proof of payment
from ACAs easily
fades off.
Members under
the employed
sector,
government and
private alike, with
remittances that
are not updated.
not remitted on
time and have
missed quarters of
remittance.
One client did not

avail the benefits
because when
they go to LHIO to
register, one of the
staff says that they
need to pay 450
pesos first then the
1800 for the whole
year. So the client
got confused and
did not register at
all.
Failure of the
members to pay
They also
Most of the formal their contributions
encourage patients economy members but because of the
to register to
did not update
new IRR, they
Philhealth and they their membership were able to pay
monitor their
to informal sector their missed
patients through
and did not
contributions and
the Bantay
continue to pay
availed the
247 Pasyente program. their contributions. benefits.
> There are still
considered
indigents people
who do not have
their own
philhealth.
ACAs
Healthcare
Provider Relations
The hospitals
administrative
officers, doctors,
clerks and other
hospital staff were
accommodating.
We helped each
other in providing
quality health care
for each and every
members and
patients in the
hospital. They
were open on
adapting new
policies and
updates on phic.
Some of the
concerns that
needed immediate
actions were
relayed to me and
I then reported it to
the PRO or to any
concerned offices
for immediate
action.
Benefits
No Balance Billing
Benefits of patients
were maximized
according to their
diagnosis. I
distributed flyers
and pamphlets to
help members and
patients to be
aware of their
benefits. Ct scans
were paid in cash
even if patients
were admitted in
the hospital. Newly
enrolled members
also enjoyed the
benefits and I also
advised them to
always continue
the membership to NBB not
prevent gap.
implemented.
All Case Rates
On site Point of
Care
Internal
Please increase
our transportation
allowance. PRO
lines were difficult
to contact.
not yet
implemented.
informed the
hospital especially
the social worker
who will assess
the patient
economic
background, that
once the patient is
not member of
philhealth, member
but lack of
qualifying
contribution, they
can still avail
philhealth benefits
if they pay the
whole year
(current year) for
non members and
missed
months/quarters
for the members.
Sponsored
members/4Ps are
unable to avail
NBB due to the
following reasons:
(1) 4Ps
beneficiaries are
not aware that they
are entitled to
PhilHealth benefits
(2) Out of pocket
expenses for
medicines are
being incurred
when admitting
diagnosis differs
from the case rate
final diagnosis.
>Non PhiHealth
members who are
capable and willing
to enroll as IPM
but do not have
the knowledge on
the process and
requirements for
enrollment.
>GSIS and SSS
retirees are
misinformed about
lifetime
membership, they
thought that upon
their retirement
they are
automatically
lifetime members
in PhilHealth.
12/1/2013 2:21:27 MILAFLOR
ALCURAN
4b
flong_30@yahoo.
com
Roving
ROMBLON
DISTRICT
HOSPITAL
Government
11/4 to 9/2013
13
15
15
>Indigents and
sponsored
members who
have multiple
PhilHealth
Identification
Number.
>
Members/dependents
with lapsed in their
contribution
thought they could
no longer use their
Philhealth.
>Members do not
know where to pay
their contributions
aside from
Philhealth offices.
> Members who
lost their official
receipt on
Philhealth
contribution.
New Entry
New Entry
New Entry
Private doctors
charged patients
with high
professional fees.
Mostly OB gyne
doctors because
the hospital don't
have resident OB
doctor.
Most of the
medicines are
bought outside the
Most of the
hospital.
patients availed of
the benefits
Some laboratory
because of the
examinations are
new IRR.
done outside of the
hospital.
Some of the clients
got confused
Some of he
because their
Sponsored
benefits are not
members with
fully explained to
pregnant patients
them. They expect have no choice but
that Philhealth will to have private OB
cover all their
doctors and they
hospital bills
needed to pay in
including the
excess for the
professional fees. professional fees.
All case Rates is

not yet
implemented but
the hospital's
Medical director is
asking when it will
be implemented so
that they can have
a meeting with all
their consultant
doctors.
> Members under

formal sector are
not informed
regarding change
in membership
category upon
separation from
their respective
agencies/companies.
.
>Sponsored and
indigents members
and their
dependents with
discrepancy in
their name in
MDR.
>Several
PhilHealth
members
especially under
formal economy
particularly the
private sectors do
not know their
Philhealth number.
PLEASE SELECT
ONE
Not yet
implemented but if
ever this will be
implemented very
soon, the hospital
> Some of the
will be more
Philhealth
benefited because
members/dependents
Philhealth
are not aware on
members/dependents
their benefits
have to buy
including free of
medicines and
> Since the
charge in
other medical
hospital in under
medicines and
supplies in the
the provincial
other hospital
hospital due to
government, all the
charges. They
shortage of these decisions/approval
usually bought
in the hospital.
lies in the
their medicines
Other concern is
provincial
outside the
NBB is not
that unavailability government. They
hospital.
implemented in the of revolving fund of still have to wait for
hospital. Philhealth the hospital for the the memorandum
> Indigents and
members/dependents
medicines
from their heads of
sponsored
still purchased
purchased outside offices in the
members/dependents
medicines out from the hospital since provincial
are not well
their own pocket
the concerned
government about
compensated in
particularly the
hospital is under
enrolling of
their benefits claim indigents and
the provincial
identified indigents
in government
sponsored ones
government, all the persons who do
hospital due to
because of lack of financial aspects
not have their own
lack of medicines medicines and
should be
Philhealth in the
and other medical other medical
consulted first in
implementation of
supplies.
supplies from the the provincial
"point of care".
hospital pharmacy. governement.
> Hazard pay

since we are at
risk in acquiring
communicable
diseases and other
diseases related to
our work.
> Change in
schedule from our
planned schedule
is very feasible for
sudden changes
because of some
reasons:
geographical
location, change in
weather condition
which is very
unpredictable,
unavailability of
transportation from
one islet
municipality to
another islet
municipality which
it takes 4-6 hours
of travel via sea
from our place of
residence.
Timestamp
First Name
Last Name
Region
Email Address
12/1/2013 10:38:
59 DANICCA
VINO
4b
4b
Sponsored
Member
No. of
during ward
member/dependent
classes, mother's
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
benefits
Non-Member
28
20
49
laurena_marygrace@yahoo.com
Roving
BULALACAO
COMMUNITY
HOSPITAL
Government
11/4 to9 2013;

11/18 to 23 2013
20
10
29
Roving
BULALACAO
COMMUNITY
HOSPITAL
Government
evaRN.
CARES@gmail.
com
BAUAN GENERAL
HOSPITAL
Government
4b
RONDAEL
Indigents (NHTSPR)
RONDAEL
12/1/2013 9:29:46 MARY GRACE
16
12/1/2013 7:28:51 MARY GRACE
MADLANGBAYAN 4b
Formal Economy
11/1 to 2/2013 &

11/11 to 30/13
flong_30@yahoo.
com
12/1/2013 8:43:18 EVA
Hospital Level
4b
4b
Hospital Category
Government
ALCURAN
RONDAEL
Hospital Covered
SIBUYAN
DISTRICT
HOSPITAL
12/1/2013 2:41:43 MILAFLOR
12/1/2013 8:37:48 MARY GRACE
Status
Roving
Permanent
Roving
danicxz_13@yahoo.com
Permanent
Oriental Mindoro
LIPA CITY
DISTRICT
HOSPITAL
Government
11/4 to9 2013;

11/18 to 23 2013
11/1/2013
11/30/2013
11/11 to 16 2013;
11/25 to 30 2013
11/4/2013
11/29/2013
20
10
29
12
12
30
18
37
48
21
29
12
69
30
66
342
678
389
61
Hospital's Best
Practices
42
170
172
970
The hospital
pharmacy head
get to know the
concerns of our
member in terms
of purchasing
medicines and well
informed their staff
in the situation of
our member as
898 their client.
587
There are some

instances that the
members or
dependents cannot
submit the
requirements
needed by the
hospital philhealth
clerk give a one
week period to be
able to accomplish
it. It is more often
happen for those
employed
members wherein
their employer
cannot sign the
587 Cf1.
Membership
>Sponsored and
indigents members
and their
dependents with
discrepancy in
their name in
MDR.
Contribution
ACAs
Healthcare
Provider Relations
Benefits
No Balance Billing
All Case Rates
On site Point of
Care
Not yet
implemented but if
ever this will be
implemented very
soon, the hospital
will be more
>Several
> Some of the
benefited because
PhilHealth
Philhealth
Philhealth
members
members/dependents
members/dependents
especially under
are not aware on
have to buy
formal economy
their benefits
medicines and
particularly the
including free of
other medical
Since the hospital
private sectors do
charge in
supplies in the
in under the
not know their
medicines and
hospital due to
provincial
Philhealth number. > Philhealth
other hospital
shortage of these government, all the
members/dependents
charges. They
Is not well
in the hospital.
decisions/approval
There are still
do not know where
usually bought
implemented in the Other concern is
lies in the
considered
to pay PhilHealth
their medicines
hospital because that unavailability provincial
indigents people
contributions aside
outside the
of lack of
of revolving fund of government. They
who do not have
from Philhealth
hospital.
medicines and
the hospital for the still have to wait for
their own
office
other medical
medicines
the memorandum
philhealth.
> Indigents and
supplies in the
purchased outside from their heads of
> Philhealth
sponsored
hospital.
the hospital since offices in the
> Members under members with
members/dependents
Therefore,
the concerned
provincial
formal sector are lapsed/gap in their
are not well
indigents/sponsored hospital is under
government about
not informed
contributions
compensated in
members/dependents
the provincial
enrolling of
regarding change
> Lack of
their benefits claim still bought and
government, all the identified indigents
in membership
> Lost/missed
medicines and
in government
purchased
financial aspects
persons who do
category upon
official receipt of
other medical
hospital due to
medicines and
should be
not have their own
separation from
Philhealth
No available ACAs supplies from the lack of medicines others medical
consulted first in
Philhealth in the
their respective
contribution.
in the island of
hospital pharmacy and other medical supplies outside
the provincial
implementation of
agencies/companies.
Sibuyan, Romblon
supplies.
the hospital.
governement.
"point of care"
Some of
Bulalacaonon
availed the
membership in Phil
Health by paying a Some of our
Requesting to the
1,800 as annual
employed Phil
higher authority to Some of our Phil
The said hospital
contribution. They Health member
please allowed
Health member
and the
much felt thank
have a difficulty in Palawan Pera
complaint that
bulalacanon felt
you to the Health getting of their
Padala as
some of staff
much importance
Insurance by
signed CF1 to their collecting agent for nurses in that said in the newest
getting to this
employment for
Phil Health
hospital make
policy by allowing
Much aware to the
newest policy,
the reason of: the contribution for the some undesired
them to be a Phil Actively involved to cases of our Phi
must of them says employer in based reason of
sounds that makes Health member
provide the no
Health members /
that the Phil Health on our town,
unavailability of
interferes the
and availed the
balance billing to
dependents to
Insurance give
delayed issuance LBC and Bayad
resting time of our benefits by paying our Phil Health
provide their needs Not yet
them more
of signed CF1 from Center on the said confined Phil
1,800 as annual
member /
to gain the highest implemented in the
importance.
the employer.
area
Health members. contribution.
dependents.
care.
said hospital.
Some
Requesting to the
Bulalacaonon felt
higher authority to
more importance
allowed the
to our newest
Palawan Pera
policy by paying
Padala to be as
Some of our Phil
1800 for annual
one of collecting
health member
contribution. They
agaent of premium complaint that
The hospital staff
must felt thank you
contribution for the some of nurses of and bulalacaonon The said hospital The said hospital
to the health
Delayed issuance reason of
the said hospital
are felt much
make their actively make their best to
insurance by
by the employer of unavailability of
make a unwanted importance in the involving in
give the highest
allowing them to
CF1 to our
LBC o Bayad
sounds that
newest policy
providing our Phil care for all the
Not yet
be a member of
privately employed Center on the said interferes their
governing by the
Health member a patients in all case implemented in the
Phil health.
member.
area.
sleeping time.
Health Insurance. No balance billing. rate.
said hospital.
1. Clerk file their
hospital claims
1.Member who
beyond 60 days.
wants to
deactivate her
2. Clerk doesn't
account and wants
aware on 3 months
to become a
within 6 months
dependent of her
(3/6) requirement
husband come to
in order to avail
PhilHealth CARES
benefits for those
post to asked the
member whose
requirements in
dependent or
doing so.
member itself was
admitted whether
2. A previously
medical or surgical 1. The hospital are
employed member
cases. Clerk are
still not compliant
wants to shift to
not updated/aware with the No
individually paying 1. Non- Member
on the new IRR.
Balance Billing
member but
asked if he will be
Policy. The
doesn't know how enrolled as
3. The previously medicines (i mean
to do so and the
member, how
member whose
ALL the
requirements
much he will pay if
missed to paid the medicines) are
needed.
he's going to pay
April-September
sold by the patient
for one whole year.
2013 asked me if outside the
3. An individually
she can still pay
hospital premises.
paying member
2. An ofw member
the missed quarter Even IV Fluids are
asked the CARES asked if the
and she can still
not available the
on duty if she can benefits the
able to avail the
pharmacy.. The
declare her mother member can avail
PHIC benefits
Sponsored/4P's
who is currently
is depend on the
because her
are always
admitted at the
amount of
daughter was
complaining 'coz
said hospital. her contribution the
admitted due to
they have a lot of
mother will turn 60 member pay.
Pneumonia.
out of the pocket
next year.
for that admission.
The IPM under
new category
Informal as much
well appreciated
and enjoying the
new governing
policies of the
Health Insurance.
They give gratitude
to the Higher
The hospital of
authority by saying
Oriental Mindoro
" mas maganda
give their best to
ngayon ang policy
On the part of
provide the NO
ng Phil Health mas
hospital: failure of Balance Billing to
matutulongan ang
submission of the our member by
mga member,
claims to the Phil coordination to
salamat at
Health Regional
other pharmacy
mamagamit kami
Knowing the
Office before on
with in vicinity to
ng Phil Health,
concerns of our
the end of the
provide the
Malaking tulong sa
member by getting given time on the prescribe
Some of our
amin. Thank you
To LBC please
in touch to our
other hand our
medicines in case
Not yet
member still holder po." as verbalized provide readable
members and
member badder
the said medicines
implemented in the
of a double Phil
by one of my client print out of as
significant others when they
is unavailable
Well implemented hospital of
health cards with significant others proof of payment and take the
received a letter
inside the hospital in the said
Province of
the same validity. during ward visit. for our members. appropriate action. from our PRO.
pharmacy.
hospital.
Oriental Miondoro.
There are many
philhealth
members do not
know the
breakdown of the
benefits of
philhealth. there
are always
pointing out that
they cannot feel
the benefits
provided by the
corporation when it
comes to the
professional fees
of the doctorsband
For almost one
There are many
as we observed
month of duty,
philhealth
patients are right
there are minimal members still do
because
issues regarding
not know the new
professional fees
membership like
policy of philhealth
of doctors are like
for the sponsored regarding the
they are admitted
program some
contributions and
in a private
members do not
as a responsible
hospital.
Still the hospital do
know how long
CARES nurses we
there are no
Some members
not implemented
their validity
explained to them
resident doctors
says'' sa halip na the Nbb the
period. There are that even if they
like OB, surgeon
mapamura kme at members still
some non
missed quater
thats why patients pag aari ito ng
payed for the
philhealth
contribution they
During our duty
do not have any
gobyerno lalo
medications and
during our duty
members do not
can still pay the
there are no issues choice but to call a nman kme na
other laboratory
All case rate still
there are no issues
know how to apply. previous quarter. reported to us
private doctors.
papamahal"
exam.
not implemented
about it.
Internal
PLEASE SELECT
ONE
> Hazard pay

since we are at
risk in acquiring
communicable
diseases and other
diseases related to
our work.
> Change in
schedule from our
planned schedule
is very feasible for
sudden changes
because of some
reasons:
geographical
location, change in
weather condition
which is very
unpredictable,
unavailability of
transportation from
one islet
municipality to
another islet
municipality which
it takes 4-6 hours
of travel via sea
from our place of
residence
New Entry
Requesting to the
higher authority to
please provides us
the a list or copy of
load allowance as
reference.
New Entry
We are requesting
to the higher
authority to please
provide us a copy
of list of load
allowance that
they given to us.
Corrected Entry
New Entry
Please provide us
a copy of
computation of our
taxes.
New Entry
There are no
computer provided
by the CARES
nurses. As far as
CARES where
concerned doing of
rounds is still a
health threat for us
because we don't
know all the
conditions of
patients.
New Entry
Timestamp
First Name
Last Name
Region
Email Address
Status
Hospital Covered
Hospital Category
Hospital Level
Formal Economy
Indigents (NHTSPR)
Sponsored
Member
No. of
during ward
member/dependent
classes, mother's
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
benefits
Non-Member
Hospital's Best
Practices
Membership
Dependent
declared in MDR
are not LEGAL
dependent (Not
Legally Married,
Grandchildren
Declared)
Contribution
ACAs
Healthcare
Provider Relations
Benefits
No Balance Billing
All Case Rates
On site Point of
Care
Internal
PLEASE SELECT
ONE
Sponsored
members who
showed many
discrepancies in
their MDR.
Sponsored
beneficiaries who
were not legal
bearer of their
surname who were
listed in philhealth
found hard time to
use their benefits,
or they cannot use
their philhealth
without any legal
document
presented esp. 4p
s spouse
beneficiaries.
12/1/2013 11:49:
22 PRINCESS JOY
12/1/2013 12:27:
16 BERNADETTE
12/1/2013 12:53: ISAGANI

48 LEONCIO
12/1/2013 13:09: ISAGANI

53 LEONCIO
MACMAC
BACOSA
TAN
TAN
12/1/2013 13:44:
48 MARTA RAFAELA DEMETRIO
12/1/2013 13:59:
42 MARTA RAFAELA DEMETRIO
12/1/2013 14:35:
54 NERISA
PANGANIBAN
4b
4b
4b
4b
4b
4b
4b
princessmacmac029@gmail.com
Permanent
bernadette.
bacosa1111@gmail.com
Permanent
isagani_puyo@yahoo.com
Roving
isagani_puyo@yahoo.com
Roving
Culion Sanitarium
& General Hospital Government
SOUTHERN
PALAWAN
PROVINCIAL
HOSPITAL
Saint Patrick
Hospital
Medical Center
Western Balayan
martarafaelademetrio@gmail.com
Roving
MALIPAYON
DISTRICT
HOSPITAL
martarafaelademetrio@gmail.com
Roving
ROMBLON
PROVINCIAL
HOSPITAL
fairy_asiren@yahoo.com/
fairymushrum@gmail.com
Roving
SAN JUAN
DISTRICT
HOSPITAL
Government
Private
Private
Government
Government
Government
PCF (Primary Care

Facility)
11/1/2013
11/1/2013
11/29/2013
11/30/2013
14
11/1 to 11/15
11/16 to 11/30
NOVEMBER 4-9
11/10 to 30/2013
11/3-16/2013
29
66
26
10
17
40
30
27
11
54
64
34
28
32
17
10
10
14
18
30
14
139
-1
56
110
215
67
227
227
127
127
281
125 *none
Members have
more than 2 pins,
especially those
who are under
NHTS and LGU
sponsored.
127
-Inaccessibility on
payment method
within locality
given that LBC,
LBP and Postal
Office are not yet
allowed to accept
payment in
instances wherein
member lack at
least three (3)
months within the
six (6) months
contribution prior
-Errors in
to the first day of
member/dependent availment requiring
data record
them to pay in full
-Unavailability of
the whole calendar
documents
year or remaining
required for data
unpaid months for
amendment.
the year.
The hospital were

able to adapt the
circulars issued by Informed the
the Institution as
admitting
per PCARES
department about
assistance
the IRR 10606
0
The hospital
admitting section
were able to
informed clients
that they have
Pcares to assist
Philhealth
members if their
philhealth
requirements are
288 not completed.
Informed the
clients the new
IRR 10606 if their
patients are not yet
member.
89
Automatic
availment of
newborn screening
prior to discharge
89 of patient.
Still erroneous
MDR's specially
with our indigent
and sponspored
members.
89
Almost full
implementation of
NBB and
automatic
Erroneous MDR's
availment of New most specially with
born screening
our sponsored and
89 prior to discharge. indigent members.
Informed the 3/6

policy of Philhealth
and the 1 year
contribution if they
are not yet
enrolled in the
PHIC.
Members that had
missed
contributions were
not aware that by
next year
contribution will
increase to two
hundred per month
and complains that
this is somehow
not affordable
especially with
some of the
informal sector
members and
sponsored
members whose
validity had
already expired
> Positive
feedbacks on the
new IRR policy
about the
amendment of the
9/12 contribution
and the
implementation of
the 3/6 policy or
the full payment of
contribution for
nonmembers/inactive
members.
12/1/2013 14:48:
59 NERISA
12/1/2013 16:44:
55 SHAWLYN
PANGANIBAN
LAYA
4b
4b
fairy_asiren@yahoo.com/
fairymushrum@gmail.com
Roving
shawjhun@gmail.
com
Roving
LOBO MUNICIPAL
HOSPITAL
Government
BAUAN
DOCTORS
GENERAL
HOSPITAL
Private
11/18-29/2013
11/01 TO 15 /2013
17
61
15
72
13
13
11
17
22
73
34
41
111
Since the location

of the hospital is
geographically not
accessible to and
from our LHIO and
also no available
ACA in said
municipality,
collections are
somehow
impossible.
Common inquiries
regards to the
amount of
contribution and
mode of payment. None.
> Positive
feedbacks on the
new IRR policy
about the
amendment of the
9/12 contribution
and the
implementation of
the 3/6 policy or
the full payment of
contribution for
non>Erroneous profile members/inactive
or MDR.
members.
> Sponsored
members have
>Hospital Clerks
difficulty in
are still confused
providing proof of about the new IRR
identity for
policy in paying
erroneous profile. contributions.
129
>Members have to
travel a long
distance just to
pay their premium
contributions.
> Members and

Non-phic members
are requesting for
the allocation of
nearest bayad
centers or an
Accredited
Collecting Agents
near the
> Sponsored
Municpality. One
members have
of the cause of
difficulty in
unavailment of the
providing proof of >Hospital Clerks
benefits is the
identity for
are still confused location and
erroneous profile. about the new IRR additional
>Erroneous profile policy in paying
expenses for the
or MDR.
contributions.
transportation.
90
UPON
ADMITTING
PATIENTS,
HOSPITAL
EXPLAINED THE
NEEDED
REQUIREMENTS
TO AVAIL
PHILHEALTH
BENNEFITS AND
FOR PATIENTS
WITH NO
PHILHEALTH
THEY REFER
THEM TO
PHILHEALTH
CARES.
MOST OF
INDIGENT
MEMBERS WERE
ABLE TO
CONTINUE
AVAILING
BENEFITS FROM
PHILHEALTH BY
SHIFTING TO
INFORMAL
CATEGORY AND
PAY THE WHOLE
YEAR OF 2013.
Members are not

aware where to get
their
reimbursements.
Members under
the employed
sector,
government and
private alike, with
remittances that
are not updated.
not remitted on
time and have
The receipt that
missed quarters of has been released
remittance.
by the accredited
collecting agent
IPP lost their
particularly LBCreceipt of premium coron easily fades
contributions.
off.
MEMBERS FROM
INFORMAL
SECTOR WAS
INFORMED
ABOUT THE NEW
POLICY OF
PHILHEALTH
REGARDING
THEIR PREMIUM
CONTRIBUTION.
Difficulty
understanding
BPNs, especially
for those illiterate
members.
Clarification
regarding SPC 90day ruling if it is
renewed every
calendar year.
The hospital is
strictly
implementing the
NBB policy for all
the indigent
members.
-In order to comply
with the provisions
of No Balance
Billing Policy, the
Southern Palawan
Provincial Hospital,
made an
agreement with a
certain private
pharmacy in the
area to ensure the
availability of drugs
and medicines
needed by the
PhilHealth
sponsored
member admitted
for the conditions
covered under
case rates. There
are instances
however that the
drugs and
medicines
obtained by
sponsored
members in that
pharmacy exceed
on the total
amount of package
covered by
PhilHealth, thus
requiring them to
pay the excess.
The hospital is
strictly
implementing ACR
policy for all the
entitled members
of philhealth
The CARES
project is very
welcome in this
institution. They
have great
expectations for
the cares assigned
here. And all the
employees are
very kind and
accommodating
and also the chief
of hospital.
New Entry
New Entry
Good
Philhealth
members were
able to availed
their benefits as
soon as their
Philhealth
requirements are
submitted.
New Entry
Good
Informed the Case

rate to the
members
New Entry
NBB not fully

implemented due
to lack of
Not all benefits are medicines and
availed since this drugs( no hospital
is only a primary
pharmacy ),and
care facilty.
other supplies.
N/ A
Not implemented.
Almost fully
implemented but
out of pocket
expenses were still
unavoidable due to
unavailablity of
PCB not yet
some medicines
Good work
implemented and and supplies and Not yet
Not yet
relationship with
package for animal laboratory
implemented as of implemented as of
the hcp.
bite as well.
examinations.
now.
now.
Sponsored
members/4ps are
unable to avail true
NBB due to the
following reasons:
(1)Out of the
pocket expenses
for medicines that
are not available
inside the hospital.
(2)Out of the
pocket payment for
diagnostic test that
are not available
>delayed issuance (3)
of BPN.
Insufficient/Unavailability
of medicines inside
>delayed issuance the hospital.
of
(4) Professional
refund/reimbursement.
fees for Private
Doctors who are
>Professional fees >Professional fees Residence on duty
charges increased charges increased from the time of
when the patient
when the patient
admission of the
has Philhealth.
has Philhealth
clients.
>member who is
out of the country
have difficulty in
providing the
necessary
requirement for
benefit availment Sponsored
of her dependents. members/4ps are
unable to avail true
>Members are not NBB due to the
aware where to get following reasons:
their
(1)Out of the
reimbursements.
pocket expenses
for medicines that
are not available
>delayed issuance inside the hospital.
of BPN.
(2)Out of the
pocket payment for
>delayed issuance diagnostic test that
of
are not available
> "Professional fee refund/reimbursement.
+ Philhealth"
(3)
confused the
>PF charges
members upon
increased when
of medicines inside
paying their
the patient has
the hospital.
Hospital bill.
Philhealth
Hospita clerk
seldomly attend
updates and
unaware of new
circulars.
No access to
icares,no
computer,no
internet connection
and power supply
is only scheduled. New Entry
Still no computer
and internet
connection
provided.no
iCares,no IHCP
portal access.
New Entry
Logistics
>Hospital must
provide computer
for CAREs used
only.
New Entry
Logistics
>Hospital must
provide computer
for CAREs used
only.
New Entry
New Entry
Timestamp
First Name
12/1/2013 17:12:
19 JAN BERRAY
12/1/2013 17:17:
52 SHAWLYN
Last Name
ALDABA
LAYA
12/1/2013 17:50:
47 JONAH ROSARIO AUSTRIA
12/1/2013 17:51:
31 RELAN
12/1/2013 18:04:
57 JAN BERRAY
12/1/2013 18:47: RACHELLE

13 MOREEN
MAPA
ALDABA
BATHAN
Region
4b
4b
4b
4b
4b
4b
Email Address
Status
janberray30aldaba@yahoo.com
Roving
shawjhun@gmail.
com
Roving
jrcaustria@yahoo.
com
Permanent
mapa_relan@yahoo.com
Permanent
Roving
atribirn08@gmail.
com
Roving
Hospital Covered
PINAMALAYAN
COMMUNITY
HOSPITAL
LIPA MEDIX
MEDICAL
CENTER
CORON
DISTRICT
HOSPITAL
NORTHERN
PALAWAN
PROVINCIAL
HOSPITAL
Hospital Category
Government
Private
Government
Government
ROXAS DISTRICT
HOSPITAL
Government
LEMERY
DOCTORS
MEDICAL
CENTER
Private
Hospital Level
Formal Economy
11/04-07/2013
11/16 TO 30 /2013
11/1/2013
11/1/2013
11/30/2013
10
72
11/30/2013
14
11/18 to 23/2013
11/4 TO 11/9/2013
17
16
63
11
21
Indigents (NHTSPR)
22
11
28
65
28
Sponsored
Member
No. of
during ward
member/dependent
classes, mother's
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
benefits
Non-Member
20
10
13
23
16
43
30
17
Hospital's Best
Practices
56
56
68
37
71
71
129
137
961
90
127
THEY
IMMEDIATELY
PROVIDE PMRF
FOR PATIENTS
WITH NO
PHILHEALTH TO
BE USED AND
REFER TO
PHILHEALTH
CARES FOR
QUERIES
REGARDING
961 NEW POLICIES.
58
120
Membership
Contribution
Erroneous
member data
record specially
4ps member and
LGU Sponsored.
MDR showing
IPP lost their
varying degrees of receipt of premium
discrepancies.
contributions.
Shifting of
Members have to
membership from travel a long
one category to
distance just to
another. Usually
pay their premium
employed
contributions.
members dont
Sometimes the
know how to shift. cost of travel for
4P's member
transportation is
without ID to
more than their
provide, they only premium
have the
contribution.
agreement/certification
Most of my
that they are part clients was still not
of the program.
aware of the
Unfortunately,
increase of
what we honor is premium
just the idetification contribution by
card.
next year.
ACAs
Healthcare
Provider Relations
No Balance Billing
All Case Rates
Out of pocket
expenses for
medicines/supplies
of philhealth clients
due to
unavailability in the
hospital.
Laboratory was
not available
during my stay in
the hospital due to
unavailability of
Members are not electric power in
aware where to get some parts of the
their
hospital buildings
reimbursements.
including the
The benefits of
laboratory section.
the member are
Water to drink
not maximized on was not provided
case rates.
for the patients. No
Most of my
curtains to
clients were not
separate patients The benefits of
aware of the new in the ward and
the member are
3/6 policy for all
poor ventilation
not maximized on
cases.
was observed.
case rates.
SOME
EMPLOYERS
FROM FORMALPRIVATE
SECTOR
PROVIDE CF1
REVISION OF
2009 WHICH
CAUSES RTH OF
THE HOSPITAL.
DEPENDENTMEMBERS
DAUGHTER WHO FROMBINFORMAL
GAVE BIRTH
SECTOR WERE
WERE
ABLE TO AVAIL
ENCOURAGE
PHILHEALTH
ENROLL IN
BENEFITS BY
ORDER TO AVAIL PAYING THEIR
PHILHEALTH
MISSED
BENEFITS.
QUARTER/S.
Some
members/dependents
were unable to
comply their
requirements
needed as
supporting
documents to avail
philhealth benefits
The legal
documents of
some members
need to have an
affidavit from a
lawyer because of
discrepancies from
the data given,
such as incorrect
name spelling,
different middle
names and etc.
Erroneous record
commonly
encountered to
those under the
NHTS and
sponsored
program.
A sponsored
member who
needs the
certification issued
by the Office due
to unavailability of
the validity in the
system. According
to the Philhealth
Staff, maybe the
member is subject
for termination and
needs that
certification once The Philhealth
the
Staff assigned in
member/dependentstheir municipality
confined in the
were just present
hospital.
every other Friday.
Erroneous
Too seldom,
member data
according to my
record specially
clients that I
4ps member and interviewed.
LGU Sponsored.
IPP lost their

MDR showing
receipt of premium
varying degrees of contributions.
discrepancies.
Members have to
Shifting of
travel a long
membership from distance just to
one category to
pay their premium
another. Usually
contributions.
employed
Sometimes the
members dont
cost of travel for
know how to shift. transportation is
4P's member
more than their
without ID to
premium
provide, they only contribution.
have the
Most of my
clients was still not
that they are part aware of the
of the program.
increase of
Unfortunately,
premium
what we honor is contribution by
just the idetification next year.
card.
The philhealth
clerk of the
hospital were
confused
regarding the
Circular 20 s.
2008. What they
knew was the 5th
pregnancy with
abortion was not
covered by
philhealth benefits.
Members are
not aware where to
get their
reimbursements.
The benefits of
the member are
not maximized on
case rates.
Most of my
clients were not
aware of the new
3/6 policy for all
cases.
-THE HOSPITAL
ADMINISTRATOR
,CLERKS AND
STAFF ARE
GOOD TO US.
On site Point of
Care
Internal
PLEASE SELECT
ONE
The hospital just

provide a small
table and a chair
beside the
information desk.
We don't even
have the fan for
ventilation and
another chair for
our
clients/customer.
Our client is just
standing in front of
our desk while we
are explaining for
their inqueries.
New Entry
New Entry
Sponsored
members were
made to buy
prescribed
medicines outside
the hospital
of some prescribes pharmacy as well
medicines and
some medical
medical supplies. supplies needed
for laboratory.
1. Under utilization
of NHIP benefits.
Case rate cannot
maximize due to
limited hospital
supplies, drugs
and medicines as
well as reagent
being used in
laboratory.
2.
Misrepresentation Non - compliance
by Furnishing
to NBB policy. ALL
False or Incorrect qualified
Information.
member/dependent
Changing of final spent out of pocket
diagnosis from not for drugs and
compensable
medicines.
disease into
Laboratory also
compensable one being charged to
for claiming
qualified NHIP
purposes.
patient.
Referring to our
members under
the formal
economy, posting
of contribution on
data base
commonly
observed not
updated. Thus,
forcing the
member to submit
additional
requirements
(Certificate of
Contribution) in
addition to the
minimum
requirement being
required.
-THE CLERK OF
THE HOSPITAL
STILL ASKED
FOR UPDATED
MDR EVEN THE
MEMBER
(PATIENT) HAD
PHILHEALTH ID.
-SOME MDR
SPECIALLY THE
SPONSORED/INDIGENT
MEMBER HAS
DISCREPANCIES
IN THEIR NAMES
AND OTHER
DATAS.
Benefits
Out of pocket
expenses for
medicines/supplies
due to
hospital.
Laboratory
was not available
during my stay in
the hospital due to
unavailability of
electric power in
some parts of the
hospital buildings
including the
laboratory section.
Water to drink
was not provided
curtains to
in the ward and
the member are
poor ventilation
not maximized on
was observed.
case rates.
New Entry
New Entry
We can't use
the portal once we
need during
Saturday because
the staff who uses
the computer were
only present during
weekdays.
New Entry
-REQUEST FOR
HAZARD PAY
AND FLU,
MENINGGOCOCCEMIA,
PNEUMONIA
VACCINE,
PROTECTIVE
EQUIPMENT LIKE
MASK.
-THE POST OF
CARES IN THE
HOSPITAL WAS
AT THE
INFORMATION
AREA, WHEREIN
THE CLIENTS
THOUGHT US
INFORMATION
CLERK, AND THE
AREA WAS NEAR
THE OUT
PATIENT AREA
OF THE CLINICAL
DOCTORS WERE
MOST OF THE
PATIENTS HAS
PULMO CASES
LIKE TB.
PNEUMONIA
CASES, AND NO
CLIENT ASKED
FOR
ASSISTANCE
BECAUSE MOST
OF THE CLIENTS
DIRECTLY WENT
TO THE
PHILHEALTH
OFFICE THAT'S
WHY MAKE A
POINT TO DO
ROUNDS.
New Entry
Timestamp
First Name
12/1/2013 19:01:
16 ALLEN AUBREY
12/1/2013 19:02:
14 JAN BERRAY
Last Name
ARAJA
ALDABA
Region
4b
4b
Email Address
araja.rn@gmail.
com
Status
Permanent
Roving
Hospital Covered
MAHAL NA
VIRGEN MARIA
STO. ROSARIO
DISTRICT
HOPITAL
ORIENTAL
MINDORO
PROVINCIAL
HOSPITAL
Hospital Category
Government
Government
Hospital Level
Formal Economy
11/1/2013
11/30/2013
17
11/11 to 16 & 25 to
30/2013
37
38
Indigents (NHTSPR)
22
51
Sponsored
Member
No. of
during ward
member/dependent
classes, mother's
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
benefits
Non-Member
34
48
26
17
67
103
102
678
304
970
Hospital's Best
Practices
Membership
Contribution
ACAs
THE CHIEF OF
HOSPITAL WAS
VERY
ACCOMMODATING
AS WELL AS THE
STAFFS. THEY
WELCOME THE
COMMENTS AND
SUGGESTIONS
MADE FOR THE
IMPROVEMENT
OF THE
PHILHEALTH
ACCREDITED
FACILITY.
ALTHOUGH,
SOME OF THE
NOT ALL THE INCLAIM FORMS
PATIENTS ARE
WERE NOT
MEMBERS.
ACCEPTED
SIMPLIFIED
SPECIALLY OF
MEANS OF
THOSE OF THE
BEING A
SPONSORED
MEMBER
MEMBERS,
SPECIFICALLY
CARES NURSE
THE REVISED
IMMEDIATELY
PMRF AND NO
3/6 OR PAYING
TALKED TO THE NEED FOR THE
THE WHOLE
PHILHEALTH
SUPPORTING
YEAR GIVES
CLERK FOR
DOCUMENTS IS EFFECTIVENESS
CLARIFICATIONS A MUCH BETTR
AND TO OBTAIN
AND
WAY OF BEING A THE UNIVERSAL
304 CORRECTIONS. MEMBER.
HEALTHCARE.
NONE
Erroneous
member data
record specially
4ps member and
LGU Sponsored.
MDR showing
varying degrees of
discrepancies.
Shifting of
membership from
one category to
another. Usually
employed
members dont
know how to shift.
4P's member
without ID to
IPP lost their
provide, they only receipt of premium
have the
contributions.
Most of my
that they are part clients was still not
of the program.
aware of the
Unfortunately,
increase of
what we honor is premium
just the idetification contribution by
898
card.
next year.
-Misconception
about unmarried
parents are not
allowed to declare
their children as
dependent
Healthcare
Provider Relations
Members are
not aware where to
get their
reimbursements.
The benefits of
the member are
not maximized on
case rates.
Most of my
clients were not
aware of the new
3/6 policy for all
cases and the new
policy wherein you
need to pay the
whole year for you
to avail the
benefits.
-Difficulty availing
benefits when the
member is abroad
and no nearest kin
available to sign
on claim form 1
12/1/2013 19:13: RACHELLE

26 MOREEN
12/1/2013 19:24: RACHELLE

15 MOREEN
12/1/2013 19:39:
01 EUNISE GRACE
PEDRAJA
BATHAN
BATHAN
PEDRAJA
4b
4b
4b
4b
uniz1227@gmail.
com
atribirn08@gmail.
com
atribirn08@gmail.
com
uniz1227@gmail.
com
Roving
Roving
Roving
Roving
Private
METRO LEMERY
MEDICAL
CENTER
Private
OUR LADY OF
CAYSASAY
MEDICAL
CENTER
ST. CABRINI
MEDICAL
CENTER
Private
Private
11/17 to 23 /2013
11/11 TO 16/2013
11/18 TO
11/23/2013
11/25 to 30 /2013
72
11
87
37
20
28
10
33
37
27
43
45
35
78
35
94
-CLIENT WHO
WANTS TO
ENROLL IN
PHILHEALTH I
GAVE HIM PMRF
AND
INSTRUCTED TO
GO TO LHIO, THE
CLIENT CAME
BACK AND THE
LHIO
PERSONNEL
ASKED FOR
DOCUMENTARY
REQUIREMENTS,
EVEN IF PC # 22
WAS ALREADY
IMPLEMENTED,
SO I CALLED THE
LHIO OFFICE
AND ASKED WHY
ARE THEY
ASKING
DOCUMENTS
WHERE IN THE
CLIENT TO
WANTS TO
ENROLL ALSO
THE PERSON
WHO WENT TO
THEIR OFFICE.
-THE CLERKS
STILL ASKED
FOR UPDATED
MDR AND NOT
ACCEPTED
SUPPORTING
DOCUMENTS
FOR THE
ELIGIBLE
DEPENDENTS
AND FOR
CORRECTION OF
THE DETAILS OF
MEMEBERS AND
DEPENDENTS.
CONTRIBUTIONS
OF EMPLOYED
MEMBERS ARE
NOT UPDATED IN
THE ICARES,
THATS WHY
SOME OF THE
RTH CLAIMS ARE
DUE TO LATE
POSTING OF
CONTRIBUTION
-MDR SHOWING EVEN IF THE
DISCREPANCIES EMPLOYER
IN THE
ALREADY PAID
MEMBERS NAME FOR THE
AND
INTENDED
DEPENDENTS.
MONTHS.
59
-Married child
below 21 years old
a dependent of
both her husband -Questionable
and her parents
monthly Philhealth
deduction for
-Lack of
employed
knowledge on how members
to deactivate
membership in
-Some private
order to be
companies will
declared as
only remit
dependent
Philhealth
contribution when
-Live-in partner
the employee is
declared as
asking certificate
dependent
of contribution
89
298
265
On site Point of
Care
Internal
THE HOSPITALS
SEE TO IT THAT
THEY WILL GIVE
THE MAXIMUM
POINT OF CARE
TO PATIENTS.
THERE IS A LACK
OF SUPPLIES
AND DRUGS
THAT IS A
HINDRANCE TO
GIVING THE
MAXIMUM POINT
OF CARE.
NONE.
Out of pocket
expenses for
medicines/supplies
due to
hospital.
Water to drink
was not provided
curtains to
in the ward and
the member are
poor ventilation
not maximized on
was observed.
case rates.
PLEASE SELECT
ONE
New Entry
New Entry
-Lack of
knowledge about
new IRR
-Too expensive
professional fees
of private doctors
72
All Case Rates
-Too many
requirements to
avail benefits
-Late remittance of
private companies
12/1/2013 19:09:
42 EUNISE GRACE
No Balance Billing
NOT ON TIME
THE
RELEASE OF
HEALTHCARE
BENEFIT
PROVIDER
PAYMENT
(HOSPITAL &
NOTICE AND THE
DOCTORS) ARE RELEASE OF
VERY
REIMBURSEMENTS
ACCOMMODATINGTO MEMBERS
AND OPEN TO
DUE TO THE
ISSUES AND
REMITTANCES
CONCERNS
OF THE
THE NO
BEING BROUGHT HOSPITALS ARE BALANCE
UP. THEY ARE
BEING BROUGHT BILLING IS NOT
WILLING TO
TO THE
YET
NEGOTIATE AND PROVINCIAL
IMPLEMENTED.
IMPROVE THE
GOVERNMENT
LACK OF
QUALITY OF
AND AFTER A
MEDICINES AND
HEALTH SO AS
WEEK OR SO
SUPPLIES GIVEN
TO GIVE A
THERE WILL BE TO HOSPITALS
BETTER ACCESS THE RELEASING BY THE
NOT BEING
TO HEALTH
OF THE
PROVINCIAL
IMPLEMENTED
CARE.
REIMBURSEMENTS.
HEALTH OFFICE. SO FAR.
-Multiple
membership
(sponsored
member is also an
employed
-Doubled
member/ an active contribution for
member is also a employed member
dependent)
with two active job
DANIEL O.
MERCADO
MEDICAL
CENTER
Benefits
-Private
companies not
releasing
certificate of
Philhealth
contribution if the
member is already
resigned
-HAZARD PAY
FOR US
BECAUSE
WHERE AT RISK
TO DIFFERENT
DISEASES
ESPECIALLY
DURING WARD
ROUNDS.
-PROTECTIVE
MASK.
-THEY ARE
GOOD
-THEY ARE NICE

AND GOOD TO
US AND THEY
TRUST CARES
-Personal
computer with
internet access
should be provided
in every hospital
where CARES are
assigned for more
effective delivery
of services
New Entry
-MOST OF THE
DIALYSIS
PHILHEALTH
PATIENT HAS
EXHAUSTED
THEIR 45 DAYS
LIMIT/YEAR,
THATS WHY
THEY ARE
ASKING FOR
ADDITIONAL
ALLOWANCE
FOR THEIR
CASE.
-Unawareness
about 45 days
benefit
allowanceper year
of member and
dependent
New Entry
-SINCE WE
WHERE ASKED
FOR THE WARD
ROUNDS WE
ARE ALSO
ASKING FOR
HAZARD PAY,
FLU ,PNEUMONIA
VACCINES,
PROTECTIVE
WEARS(MASK)
FOR OUR
PROTECTION.
New Entry
-Lack of
knowledge about
direct filing
-Questionable
Philhealth
deduction when
under Fee-forService
-A lot of
requirements too
avail benefits
- Too expensive
professional fees
of private doctors
-Unawareness
about the new IRR
-Personal
computer with
internet access
should be provided
at every hospital
where CARES are
assigned to
promote full
function of CARES New Entry
Timestamp
First Name
12/1/2013 19:54: JOSEPH

01 HARROLD
12/1/2013 19:55: MARIA

22 ROSAPHIA
12/1/2013 20:00: RACHELLE

08 MOREEN
12/1/2013 20:21: JOSEPH

55 HARROLD
12/1/2013 20:35:
02 VENANCIO
12/1/2013 21:39:
45 Barbie Joy
12/1/2013 21:20:
48 VENANCIO
Last Name
SULIT
GONZALES
BATHAN
SULIT
ALCAIDE
Malinao
ALCAIDE
Region
4b
4b
4b
4b
4b
4b
4b
Email Address
Status
harroldsulit@gmail.com
Roving
genyle16@gmail.
com
atribirn08@gmail.
com
Hospital Covered
BATANGAS
HEALTH CARE
(JESUS OF
NAZARETH
HOSPITAL)
Permanent
LAUREL
MEMORIAL
DISTRICT
HOSPITAL
Roving
TAAL
POLYMEDIC
HOSPITAL AND
MEDICAL
CENTER
harroldsulit@gmail.com
Roving
bench_via@yahoo.com
Roving
babygk05@gmail.
com
Roving
bench_via@yahoo.com
Roving
FERNANDO AIR
BASE HOSPITAL
OCCIDENTAL
MINDORO
PROVINCIAL
HOSPITAL
Hospital Category
Private
Government
Private
Formal Economy
11/01 to 11/15
11/4/2013
11/29/2013
24
154
11/25 TO
11/30/2013
13
16
98
11
Indigents (NHTSPR)
14
12
Sponsored
Member
No. of
during ward
member/dependent
classes, mother's
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
benefits
Non-Member
38
69
18
33
24
368
31
398
46
43
252
212
Hospital's Best
Practices
Membership
Upon
admission/arrival
at the ER, the
patient would
already be
determined if
he/she is a
Philhealth
member/dependent.
Then the admitting
clerk would then
refer the relative or
the patient to us
CARES in order
for us to explain
what they could
expect from
Philhealth and at
the same time
clarify questions
- erroneous data
regarding needed on the member's
requirements for
MDR (name,age,
availment.
date of birth etc)
multiple PIN for
The CARES Is
members
situated at the
- dependents
admitting section declared on their
together with the
MDRs are not
EBD health card
legal dependents
(local government (sponsored
financial aid for
members)
indigent people
- inquiries about
BATANGAS
the process of
CITY). This was an shifting from one
effective location
membership
since we could
category to
work together with another
the EBD personnel - confusion on the
and they would
PMRF as the sole
endorse to us their source of
patients without
information of an
Philhealth so we
applicant member
could talk to them was resolved and
and tell them the
coordinated with
benefits of being
the PRO
30 members.
Some non
Philhealth
Members were
referred by Social
Worker to CARES
for educating and
encourage client to
be a PhilHealth
209 member.
-THEY MAKE A
POINT THAT THE
CLERKS HAD
THEIR ROUNDS
TO CHECK THE
PHILHEALTH
REQUIREMENTS
OF THEIR
CLIENTS AND TO
CHECK THE
NONE
PHILHEALTH
MEMBERS AND
THEY
DISTRIBUTE
PMRF OR
INSTRUCT THEM
TO GO TO LHIO
OFFICE FOR
ENROLLMENT IN
234 PHILHEALTH
Government
Government
Government
PCF (Primary Care

Facility)
11/16 to 29/2013
11/4 to 11/16
11/14-16, 21-22,
27-29/2013
11/18 TO 11/29
36
15
39
12
27
18
48
17
32
48
174
31
50
250
50
43
30
14
1. Sample copy of
MDR ( ofw,
Private,
Govetrnment, IPM,
Lifetime) are
posted in the
bulletin board of
the Emergency
Room. In this way
the NOD can
easily recognize
the type of
membership of the
clients who are
admiited in the
hospital. The NOD
also thought on
what are the
necessary
documents needed
in order to avail of
the benefits, such
as MDR, properly
filled-up CF1 for all
types of
membership,.
Copy of ID for the
lifetime members
and Marriage
Contract for the
OFW members
2. Hospital
Administration are
given a cd
compilation of
Philhealth These
cd are played in
the OPD and ER
department.
3. PMRF and
Philhealth Leaflets
are given to the
patients
campanion or
relatives in order to
encourage them to
enroll in philhealth.
Clients who are
willing to enroll on
the spot are
referred to the
LHIO office for
12 their payment.
335
14
335
12 none
Contribution
ACAs
Healthcare
Provider Relations
Benefits
- cleared
contribution issues
to Informal and
Formal members
- cleared
contribution
requirements for
newly enrolled
members for them
to immediately
avail their benefits N/A
-SOME MDR
SHOWING
DISCREPANCIES
IN THE MEMBER
AND
DEPENDENTS
DATA'S.
- discussed the
difference between
the FFS scheme
and the Case Rate
Payment scheme
to members.
- Explained the
- Informed
change in
members the
requirements for
possibility of
Physician who are immediate benefit
applying or
availment if they
renewing
would pay for the
Philhealth
entire calendar
Accreditation
year
On site Point of
Care
Internal
PLEASE SELECT
ONE
There is a
computer provided
exclusively for the
CARES on duty.
The Hospital tries

to comply with the
NBB however
sometime some
medications are
needed to be
bought outside of not yet
No On site Point of
the hospital.
implementing ACR Care
All specialist are
private doctors, out
of pocket
professional fee
are paid by the
member.
Newborn
screening should
be paid first and
payment will be
reimburse after
PHIC paid the
hospital.
Medicines and
laboratory are also
out of pocket, it
either medicine are
not available in the
pharmacy or the
member needs to
complete the
Philhealth
requirement first.
The Philhealth
section prefers the
issuance of PCF1
even if the
member has an
MDR on hand if
there would be
adding of
dependents thru
attachment of
supporting
documents
New Entry
New Entry
-HAZARD PAY,
PROTECTIVE
WEARS.
New Entry
- discussed the
difference between
the FFS scheme
and the Case Rate
Payment scheme
to members.
- Informed
members the
possibility of
immediate benefit
availment if they
would pay for the
entire calendar
year
- tried to explain
why at times the
members
contributions are
not posted on our
system (iCARES)
-explained the
upcoming bracket
for Philhealth
Formal sector for
2014
1. 3/6 in all cases

is strictly
emphasized to the
hospital. Clients
with lapses in their
payment are
advised to pay at
least one year of
their premiums to
avail of the
benefits. New
members can also
enjoy benefits
provided that they
pay at least one
year of their
contributions
none
- Explained the
change in
requirements for
Physician who are
applying or
renewing
Philhealth
Accreditation
none
There still a lot of

incorrect info and
mispelled names
in MDR of Ingents
and Sponsored
Members.
During ward
rounds patients
who are non
members are
given PMRF to
enroll. and advised
to go to LHIO
office for their
payments.
All Case Rates
- THEY ARE
GOOD AND
TRUST US..
no issues
1. Admitted clients
with lapses to their
payments, are
referred to the
LHIO office for
their payments.
2. Clients who are
willing to enroll are
given PMRF and
advised to go the
LHIO office for
their automatic
enrollment without
any documents
needed.
3. 4PS member
but without
Philhealth number,
These clients will
be given PMRF,
together with the
basic requirements
such as copy of
Birth Certificates,
Marriage contract
for married
members, Copy of
Birth Certificate of
children, Senior ID
or if with Copy of
Birth Certificate for
parents 60 year
old and above, and
the Xerox copy of
their 4ps ID. These
will serve as their
MDR, in order to
claim of the
benefits in
Philhealth.
No Balance Billing
The hospital are

accommodating to
the CARES project
information.
However at some
instances the
Philhealth section's
advise to the client
would differ the
advise of the
Philhealth CARES
on duty in order for
the member to
avail his/her
benefits
Philhealth
Coverage for PF
were not deducted
but added to
excess
Professional fee.
Admitted patient
without IVF were
not having their
daily food
supplied.
- erroneous data
on the member's
MDR (name,age,
date of birth etc)
- dependents
declared on their
Since patients
MDRs are not
here are most
legal dependents
often times military (sponsored
personnel or their members)
dependents,
- confusion on the
sometimes the
PMRF as the sole
Philhealth desk
source of
officer takes care information of an
of acquiring the
applicant member
signature for the
was resolved and
PART 2 of the CF1 coordinated with
of members.
the PRO
Dr. Damian
STA CRUZ
COMMUNITY
HOSPITAL
Hospital Level
Clients who are

willing to pay are
advised to go the
Lhio Office for thier
payments
none
none
- reiterate that now

everything is 3/6
mos requirement
for benefit
availment whether
medical or surgical
case
The Hospital tries

to comply with the
NBB however
sometime some
medications are
needed to be
NOT YET
bought outside of IMPLEMENTING
the hospital.
ACR
Lack of laboratory
services. Clients
need to go to the
private laboratory
and out of pocket
Reimbursements expenses also
are done 3-4
happen.
months to the
Charity beds are
clients who bought being used as
their medicines
NBB room
outside the
especially in OB
hospitsl
cases
none
There are patients
confined every
month with the
Lack of medicines
same illness
and supplies.
(Hypertension).
They want to
This month
expand benefits of DDRPH include
philhealth in this
the User's Fee if
case of illness,
Case rate benefits.
high numbers of
Lack of laboratory
RTS. The hospital services. Clients
together with its
need to go to the
Philhealth clerk are private laboratory
taught on how to
and out of pocket
accomplish thier
expenses also
claim form
happen.
correctly to avoid Charity beds are
RTS in future
being used as
claims
NBB room
none
NO
IMPLEMENTING
POINT OF CARE
The hospital is
accommodating to
the CARES
project, they
provided a shared
computer but at
the time of my stay
there, there was
not internet
connection
therefore I was not
able to access my
iCARES account
and was not able
to release PCF1s. New Entry
Occidental
Mindoro Provincial
Hospital expresses
their willingness to
implement the
Point of Care
System. They are
advised to make a
letter addressed to
the President and
CEO of Philhealth
expressing their
willingness. as per
advised by the
Regional Office.
none
New Entry
New Entry
none
none
New Entry
Timestamp
First Name
12/1/2013 21:21:
35 Gertrude
Last Name
Edusma
12/1/2013 21:45:
35 MARK ANTHONY VASQUEZ
12/1/2013 21:49:
58 Barbie Joy
12/1/2013 22:14:
21 Gertrude
Malinao
Edusma
Region
4b
4b
4b
4b
Email Address
Status
gertzedusma@gmail.com
Roving
mavasquez021086.mav@gmail.com
Roving
babygk05@gmail.
com
Roving
gertzedusma@gmail.com
Roving
Hospital Covered
Hospital Category
Balayan Bayview
Hospital & Medical
Center
Private
ABORLAN
MEDICARE
HOSPITAL
Sta. Cruz District

Hospital
Government
Government
Apacible Memorial
District Hospital
Government
Hospital Level
Formal Economy
11-04 to 1116/2013
11/04-29/2013
11/4, 11,13,1820,25, 2013
11-18 to 1130/2013
16
16
21
11
Indigents (NHTSPR)
46
21
18
Sponsored
Member
No. of
during ward
member/dependent
classes, mother's
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
benefits
Non-Member
28
18
12
10
12
25
10
46
106
62
40
70
Hospital's Best
Practices
Membership
The hospital
personnel gives
information on
phihealth
requirements and
availment right
after admission.
The patient can
prepare the
No problems
requirements
encountered about
44 ahead of time.
membership.
1. Provide
PhilHealth patient
on semi private
accommodation as
long as rooms are
available.
58
NONE
ACAs
The receipts kept
were not visible.
Clients had to go
Patients are
to ACA's for
informed about
copies. These
IRR during rounds. ACA's shoud be
Non members and advised to
those with missed improved their
contribution were official receipts to
able to use the
be used for long
benefit.
term.
NONE
No Accredited
Collecting Agent
available in the
locality.
Healthcare
Provider Relations
Accreditation of
Doctors was
informed to the
philhealth clerk
and was followed
up.
NONE
Some members
have difficulty
updating their
MDR because it is
far from the LHIO.
90
62
Contribution
54
The philheath
personnel
entertains
questions of the
Philhealth
52 members.
I encountered
many membership
problems
especially spelling
and multiple
membership data.
Another problem
encountered most
of time is the wife
is a 4P's member
and the husband
has a sponsored
philhealth.
Members who
have missed
contribution and
nterested non
philhealth
members are
informed about
IRR.
I had client who
was emplyed who
missed his
payment last
August 2013. He
was able to use his
Philhealth because
of the 3/6 policy. It
was also used
because it was not
mentioned at the
IRR that the 3/6
months dosnt need
to be consecutive
months.
Almost all the

patients are
referred to a
private doctor.
Even those in the
ward rooms have
their private
doctor.
I had a client who
The ACA's receipt has a private
are not visible.
doctor but another
Members are
doctor gave birth
having a hard time to her.
to get a duplicate I submitted a
of the receipts.
written report of
They should be
the complains I got
advised to improve from patients with
their receipts.
their doctors.
Benefits
Benefit availment
was explained to
each client and
leaflets were
given. Members
were able to
understood and
maximze their
benefits without
complains
encountered.
1. Incomplete
medicines and
medical supplies.
2. Incomplete
laboratory exam.
(Typhoid test,
Blood chemistry)
There is no doctor
Obstetrician in this
hospital that is why
our members are
forced to get their
private doctor
especially when
Cesarean and D
and C are needed
by our members.
Indigents are my
concerned.
Leaflets are given

to each client
encountered.
Clients lack
information
expecting they can
reimburse the
whole amount
listed in the leaflet
given. Benefit
availment for
medicines &
supplies is not
maximized.
No Balance Billing
- The clerks asked

the PCARES
about their
PhilHealth
concerns and
showed trust on
almost all of the
given data by the
PCARES.
- There were few
times that
PCARES had
confirmed to the
clerk the member's
claim on the nonacceptance of a
requirement that
was supposed to
be valid and the
clerk had been
quite hesitant of
such even if the
CARES already
confirmed it with
the PRO. The clerk
had been telling
that they had RTH
claims because of
the same instance,
but when asked of
the said RTH
claim, she could
not show one. But
still, she'll agree at
the end with the
PCARES and
would let the
member avail of
PhilHealth
benefits.
- There were a lot

of erroneous on
the MDR
especially that of
the sponsored
members.
12/2/2013 0:23:45 EBEAUVELIZA
12/2/2013 4:28:46 RELAN
BLAY
MAPA
4b
4b
ebeauveliza_blay@yahoo.com
Permanent
mapa_relan@yahoo.com
Permanent
LIPA CITY
DISTRICT
HOSPITAL
NORTHERN
PALAWAN
PROVINCIAL
HOSPITAL
Government
Government
11/1/2013
11/1/2013
11/30/2013
11/30/2013
22
14
20
30
65
13
14
30
75
37
476
137
500
127
587
120
- Several members
were unaware of
how to add
dependents and
- Contributions
who are their valid from past and
dependents.
present employers
were not reflected
- Non-members
in the member's
were unaware of
contribution history
how to become
as seen on the
PhilHealth
iCARES.
members.
Erroneous record
commonly
encountered to
those under the
NHTS and
sponsored
program.
Referring to
members under
the formal sector,
posting of
contribution on
data base
commonly
observed not
updated. Thus,
forcing the
member to submit
additional
requirements
(Certificate of
Contribution) in
addition to the
minimum
requirement being
required.
- The hospital
provided WiFi
connection but no
computer unit. We
used a mobile
phone to provide
our member their
needed data from
iCARES. The WiFi
connection wasn't
very stable.
On site Point of
Care
Internal
PLEASE SELECT
ONE
NBB is not applied

because it is a
ACR no yet
private hospital.
implemented.
"Point of Care" not

applicable
None
Corrected Entry
Non compliant to
NBB policy.
NONE
New Entry
NONE
NONE
Lack of medicines
and supplies.
User's fee are
excess of our
indigent members
even if case rate
NBB
NBB is not seen to

be practiced.
Patients buy all the
medicines and
needed supplies at
the hospital's
Coop. Their
pharmacy does not ACR noot yet
have supplies.
applicable
- The hospital
pharmacy wasn't
fully equipped with
medicines and
supplies needed
by the sponsored
patients which
entailed them to
buy these outside
the hospital usually
at the hospital's
cooperative
pharmacy.
- The hospital staff

was supportive of
the duties and
goals of PCARES
Nurses.
All Case Rates
- There had been

sponsored
members who
were still asked to
pay for their blood
tests, Xray and
ultrasound exams
which were all
done inside the
hospital. They
were asked to pay
at the hospital's
cooperative
pharmacy. But
there were also
members who told
us that they had
been permitted
that the charges
for the said be
exams be just part
of the Philhealth
deductions.
- The hospital had
no resident OBgynecologists to
cater for cesarean
surgery and other
surgical
procedures under
case rates that
made our
sponsored
members pay
more than P20,000
for each case rate
surgery as they
were left of no
choice but to have
a surgeon
considered to be
private.
- There were some
complaining about
the said matter.
According to them,
PhilHealth had not
been of help in
decreasing their
financial burden.
One even
mentioned " Sa
halip na
makatulong ang
PhilHealth ay lalo
pang
napapamahal."
The other one said
"Parang balewala
ang PhilHealth."
1. Under utilization
of NHIP benefits.
Case rate cannot
maximize due to
unavailability of
hospital supplies,
drugs and
medicines.
2.
Misrepresentation
by Furnishing
False or Incorrect
Information.
Changing/substitution
not compensable
diagnosis into
compensable one
for claiming
purposes.
3. Charging
qualified patients Non - compliance
for services
to NBB policy. ALL
(LABORATORY)
qualified NHIP
which are legally
patients spent out
chargeable to and of pocket for
covered by the
drugs/medicines
Program.
and laboratory.
New Entry
Point of Care not

applicable.
No problem
encountered.
New Entry
- An Android tablet
should be provided
to all PCARES as
not all hospitals
provide a
computer and
internet connection
for iCARES'
access. This will
help us to
immediately
provide the service
needed by our
clients especially
about their
PhilHealth data.
- provision of
board and lodging
allowance
- We are assigned
to some hospitals
more than 50
kilometers away
from our residence
and would require
us not only one or
two transportation
means to get to
our destination.
Some would prefer
to stay just around
the hospital area
which we are not
really familiar of
and others would
choose to travel for
hours from
residence to
hospital and viceversa. Any of
these two may
compromise our
safety. Although
there are quite a
few healthcare
institutions that
volunteer to give
us a place in their
hospitals to
accommodate us
such as a vacant
delivery room with
no bed or even a
fan, comfort of the
PhilHealth
employee is in
question which
may also affect the
health and even
the quality of work.
Staying in this kind
of hospital
accommodation
may also warrant
our family
members worrying
about our condition
for the whole
hospital stay. If
there will be board
and lodging
allowance for
PCARES assigned
to hospitals 30kms
away from
residence,
PCARES will not
come to and from
- As observed, the work exhausted
hospital wasn't
which may
implementing the compromise
Point-of-Care
his/her
Enrolment
effectiveness and
Program at the
even health and
moment.
safety.
New Entry
Corrected Entry
Timestamp
First Name
Last Name
Region
Email Address
Status
Hospital Covered
Hospital Category
Hospital Level
Formal Economy
Indigents (NHTSPR)
Sponsored
Member
No. of
during ward
member/dependent
classes, mother's
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
benefits
Non-Member
Hospital's Best
Practices
Membership
Contribution
Erroneous
Member Data
Record. Members'
name reflected in
MDR were
misspelled and
some of them have
incorrect birth
date.
12/2/2013 6:02:26 MADONA
ALMERO
4b
madona.
almero@gmail.
com
Roving
N.L. VILLA
MEMORIAL
MEDICAL
CENTER
Private
11/04 to 9/2013
Multiple
declaration. A child
confined last
month used his
father's Philhealth
benefits and the
mother wants to
use her Philhealth
for this
confinement
because according
to her, the child
was also her
dependent in her
MDR.
The list of
contribution for
most of the OFW
and employed
members was not
updated.
Members thought
that they can pay
their premiums
through CARES.
According to them
it would be better if
we could receive
their payments for
them to save time.
ACAs
Healthcare
Provider Relations
Benefits
No Balance Billing
A member inquired
regarding the
status of
reimbursement
since his
husband's
confinement last
march 2012.
According to her,
she always verify
the claim through
the regional office
and the last time
she inquired, she
was informed to
verify her claim to
the hospital where
her husband was
confined, but the
hospital cannot
provide any
information
regarding the
claim. CARES
checked the status
of reimbursement
through the
regional office and
found out that the
claim was not yet
paid because it
was sent back to
the hospital due to
lack of a laboratory
exam requirement.
She waited for so
long without
knowing that it was
the reason for the
unpaid claim for
more than a year.
Members consult
CARES regarding
status of
reimbursement.
According to them,
they were not able
to receive their
BPN though they
were confined a
year or several
months ago.
Employed
members where
always required to
provide the signed
CF1 though they
presented the
certificate of
contribution
originally signed by
the employer.
According to the
medical clerks,
there is no
instance where in
she allowed
contribution of the
employed
members alone to
avail of Philhealth
benefits.
All Case Rates
On site Point of
Care
Internal
PLEASE SELECT
ONE
The hospital
inquired regarding
the implementation
of All case rates
and its guidelines.
CARES was
stationed at the
information
department, the
reason for clients
to ask questions
not related to
Philhealth. They
inquired regarding
the schedule of
physicians, room
of the patient and
other concerns.
New Entry
The hospital
inquired regarding
when will be the All
case rates be
implemented.
New Entry
No Balance Billing
was implemented
by the hospital.
Clients do not
have an out of
pocket spending
The hospital
for benefit
inquired regarding
availment in most the implementation
cases.
of All case rates.
New Entry
Members consult
CARES regarding
status of
reimbursement.
According to them,
they were not able
to receive their
BPN though they
were confined a
year or several
months ago.
12/2/2013 6:22:36 MADONA
ALMERO
4b
madona.
almero@gmail.
com
Roving
SAN ANTONIO
MEDICAL
CENTER
Erroneous
Member Data
Record. Members'
name reflected in
MDR were
misspelled and
some of them have
incorrect birth
date.
Private
11/11 to 16/2013
12
Members posted
contribution was
not updated
through icares
Confusion
regarding the 3/6
months of
premium payment
for benefit
availment.
The medicare clerk

inquired on how to
avoid denied
claims for dialysis
patients. She was
asking on a
possible way for
them to avoid
unpaid claims due
to exhausted
benefits. For her,
the confinement
history of the client
or the availment
history should be
updated.
The hospital caters
free executive
check up for senior
citizens. Some of
the members
thought that
executive check up
will be covered.
There was an
instance where in
requirements for
benefit availment
was checked and
found out that it
was for executive
check up so the
client was
informed regarding
the case.
Upon room to
room visit, i was
able to talk with
patients for
executive check
up. According to
them, it was free of
charge and they
were just informed
to present their
Philhealth
requirements.
They were advised
to stay for 24
hours and they
were also given 1
small sack of free
rice. It was not yet
confirmed if the
hospital was filing
the executive
check up cases for
Philhealth but most
of the observations
lead it there.
A client inquired
regarding
registration for
Philhealth because
she wants to use it
for executive
check up. The
client was
informed that it
was not
compensable but
the client insists on
applying for
Philhealth because
according to her,
she knew a lot of
clients who was
able to avail of the
free executive
check up provided
that they
presented the
Philhealth
requirement.
Erroneous
Member Data
Record. Members'
name reflected in
MDR were
misspelled and
some of them have
incorrect birth
date.
4ps members
inquired why their
grandchildren
aren't covered/
allowed for
Philhealth benefits.
4ps members,
when checked
through icares
have existing
Philhealth
members.
12/2/2013 7:04:09 MADONA
ALMERO
4b
madona.
almero@gmail.
com
Roving
OSPITAL NG LIPA Government
PCF (Primary Care

Facility)
11/18 to 29/2013
18
23
59
78
175
175
Non members
were advised to
register for
Philhealth but they
chose to use the
membership card
sponsored by the
local government.
Contributions
posted at icares
was not updated
especially for
employed
members.
Sponsored
members were not
advised to attach
the receipts of
medicines or
laboratories
brought or done
outside of the
facility though No
balance billing was
implemented.
Timestamp
First Name
Last Name
Region
Email Address
Status
Hospital Covered
Hospital Category
Hospital Level
Formal Economy
Indigents (NHTSPR)
Sponsored
Member
No. of
during ward
member/dependent
classes, mother's
class, opd
PhilHealth
No. of PhilHealth
avail of the
lectures,etc.
benefits
Non-Member
Hospital's Best
Practices
Membership
Contribution
ACAs
Healthcare
Provider Relations
Few admissions.
12/2/2013 8:58:52 CARMI
FABICULANA
4b
carmie_fabiculana@yahoo.com
Roving
MALIPAYON
DISTRICT
HOSPITAL
Government
11/4, 5 &6/2013
Incorrect input of
data of most
Non-availability of
Sponsored/Indigentscollecting agent or
members and their Bayad center in
dependents.
the municipality
thus inability to pay
for their quarterly
remittances.
None.
Confusion of the
philhealth clerk in
attaching an
official receipt
versus sales
invoice receipt for
philhealth claim
files for members
reimbursement.
Benefits
Very few
admissions and
mostly were for
observation only.
No Balance Billing
All Case Rates
On site Point of
Care
Most Philhealth
members assumed
of getting the
whole amount
written on the BPN
they received.
According to
Hospital staff most
clients complained
of no Philhealth
reimbursement
received even if
they attached n
official receipt of
what they bought
outside the
hospital.
Internal
PLEASE SELECT
ONE
Extension of
Philhealth Cares
project.
More
trainings/forums
for us CARES.
ON TIME and
ADDITIONAL
travel allowances
when we had our
duty at far flung
areas.
Not complaint due

to unavailability of
all medicines
needed for a
certain case/illness
for confinement.
none.
none.
New Entry
Non-availment of
some Philhealth
members due to
unprocessed
papers and
confinement for
less than 24 hours.
Incorrect input of
members/dependents
data.
12/2/2013 9:45:25 CARMI
12/2/2013 11:04:
55 John Joseph
FABICULANA
Rivadenera
4b
4b
carmie_fabiculana@yahoo.com
Roving
jeykrivedenera@yahoo.com
Roving
DON MODESTO
FORMILLEZA SR.
MEMORIAL
HOSPITAL
Government
Paluan Community
Hospital
Government
11/7 to 30/2013
11/4 to 15 /2013
28
11
32
23
96
12
54
40
74
Inactive
membership of
some
Sponsored/Indigent
members,
previously
employed member
and an IPP
member who didn't
continue to pay
Do Modesto
their remittances.
Hospital do have a Encouragement for
team (Doctor and activating it was
Non-availability of
the Pharmacist) in done.
collecting agents
planning and
Contributions and or bayad center in
strategize in
where to pay was each municipality.
having enough
further explained.
supply of
Loss of receipt of
medicines for
Some members do some IPP
philhealth use of
not have a
members.
all philhealth
declared
members until they dependent.
Negative feedback
would come up
Updating of
on the increase of
with the
members data
philhealth
implementation of record was
69 NBB policy.
explained.
next year.
none.
Sometimes they're
having a problem
regarding their
premium
contribution or
payments in order
to avoid miss
quarter especially
to self employed,
Because there is
no collecting
agency, or
collector for any
payment in Paluan
Correction or
Community
mispelled appears hospital. They
on the MDR of the have no choice to
members data and travel atleast 1-2
their dependents, hours before they
get in LHIO and it
Sometimes the
was located to
patients are not
Mamburao
officially declared Occidental
0
in the MDR.
Mindoro.
No certain
Philhealth ward for
philhealth
Exhaustion of 45
members.
days allowance
benefit of a
Not enough
sponsored
Private rooms
member.
which formal,
informal and
Philhealth
lifetime members members
like/prefer to be
complained of
placed on a
having a long time
comfortable and
in waiting for their
have a privacy
reimbursement.
within their
Explanation on the
confinement.
process or flow of
their
Some philhealth
reimbursement
claim files was
was done.
forwarded to PRO
by the medical
Hospital do not
clerk even if the
have an Xray tech
papers was lacking reliever thus
(just not to exhaust patients who need
the 60 days given to undergone Xray
to the hospital to
had a hard time in
process/complete traveling to
the claim files)
provincial hospital
thus a reason for just to undergo
hospital's RTH
with the said
files.
procedure and go
back again to Don
Modesto.
DMFSMH is not
complaint with the
NBB policy. They
do have medicines
but the supply is
not enough to
cover all philhealth
members being
confined in the
said hospital.
Philhealth
members need to
buy other medicine
outside the
hospital and
secure an official
receipt for
Not yet
reimbursement.
implemented.
Not all the case

rates package are
covered or
available in Paluan
Community
Hospital because
sometimes the
laboratory or other
exams are not
Out of pocket
They are always in available.
expenses still
contact regarding
happens in Paluan
the policies,
Sometimes the
Community
updates, and other clients are not
Hospital as
concerns about
satisfied to the
verbalized by the
claims and other
hospital services. clients or the
problems or
Because of lack of members.
issues.
medicines and
Insufficient
Not implemented
poor facility.
medicines supply. until now
Provision of PC
with internet
connection in order
to access the
icares.
More
trainings/forums
for us CARES.
Extension of
service as CARES.
Not implemented.
ON TIME
ALLOWANCES.
Not implemented
until now
May we request
the feedback from
the IT regarding
the request letter
of portal system in
Paluan Community
Hospital.
New Entry
New Entry

4b (Responses)

Diunggah oleh

Informasi Dokumen

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

4b (Responses)

Diunggah oleh

Hak Cipta:

Format Tersedia

Timestamp

Informal Economy Lifetime Members

-The hospital is not

Many of our clients

Many of our clients

11/29/2013 15:05: PAMFILO

There were some

All Case Rates

NBB is still not fully

Cares Post is not

Informal Economy Lifetime Members

All Case Rates

Informing the non

Hospital did not

Dr. Cruz told me

clients can avail

they practice the

PCF (Primary Care

11/04 to 16/ 2013

11/18 TO 30/ 2013

Informal Economy Lifetime Members

One client did not

All Case Rates

12/1/2013 2:21:27 MILAFLOR

All case Rates is

> Members under

> Hazard pay

11/4 to9 2013;

12/1/2013 9:29:46 MARY GRACE

Informal Economy Lifetime Members

12/1/2013 7:28:51 MARY GRACE

11/1 to 2/2013 &

12/1/2013 8:43:18 EVA

12/1/2013 2:41:43 MILAFLOR

12/1/2013 8:37:48 MARY GRACE

11/4 to9 2013;

There are some

All Case Rates

> Hazard pay

Informal Economy Lifetime Members

All Case Rates

12/1/2013 12:53: ISAGANI

12/1/2013 13:09: ISAGANI

PCF (Primary Care

The hospital were

Informed the 3/6

Since the location

> Members and

Members are not

Informed the Case

NBB not fully

12/1/2013 18:47: RACHELLE

Informal Economy Lifetime Members

All Case Rates

IPP lost their

The hospital just

Informal Economy Lifetime Members

12/1/2013 19:13: RACHELLE

12/1/2013 19:24: RACHELLE

All Case Rates

-THEY ARE NICE

12/1/2013 19:54: JOSEPH

12/1/2013 19:55: MARIA

12/1/2013 20:00: RACHELLE