Philhealth Benefits — Medical and Surgical Cases to be Paid on Case Rate Basis
Matagal nang proposal ng Philippine Health Insurance Corp. (PHILHEALTH or PHIC) ang pagbabayad ng 22 medical and surgical cases on a Case-Rate Basis, at hindi na on a Fee-for-Service basis. Ibig sabihin, magkakaroon nang fixed Philhealth payment for each of the 22 cases, kahit saang accredited hospital, kahit sinong accredited doctor, at kahit ilang araw ang hospitalization or treatment.
Itong 22 cases ang pinakamadalas na binabayaran ng Philhealth for the past several years. Almost 50 percent daw ng Philhealth claims ay itong mga 22 cases na ito.
Proposal pa lang ito, at pinag-uusapan pa ng Philhealth board. According to some press releases, this Case-Rate-Basis will be implemented SOON.
UPDATE: Philhealth has already announced that it will start implementing the Case Rates Payment scheme for hospital/clinic admissions starting September 1, 2011. Certain proposed rates have been increased. The amounts in blue color are the final rates.
Another UPDATE: Philhealth announced that the Case Rates payments for surgical cases are applied to hospitalizations in Levels 2, 3 and 4 hospitals only (bigger hospitals), except for certain cases.
These are the surgical and medical cases, and the corresponding fixed rates or payments/reimbursements by Philhealth.
Medical Cases:
1. Dengue Fever and DHF Grades 1 and 2 — 8,000 pesos
2. DHF Grades 3 and 4 – 16,000
3. Pneumonia 1 – 15,000
4. Pneumonia 2 – 32,000
5. Essential hypertension – 9,000
6. Cerebral infarction (CVA I) – 28,000
7. Cerebro-vascular accident hemorrhage (CVA II) – 38,000
8. Acute gastroenteritis (AGE) – 6,000
9. Asthma – 9,000
10. Typhoid fever – 14,000
11. Newborn care package (NCP) – 1,000 – increased to 1,750
Surgical Cases:
1. Radiotherapy – 3,000 pesos
2. Hemodialysis – 4,000
3. Normal delivery or maternity care package (MCP) in maternity or lying-in clinics – 8,000
4. Delivery by caesarian section (CS) – 15,000 — increased to 19,000
5. Appendectomy – 26,000 — decreased to 24,000
6. Cholecystectomy – 31,000
7. Hysterectomy – 30,000
8. Dilatation and curettage – 11,000
9. Thyroidectomy – 31,000
10. Herniorrhapy — 21,000
11. Mastectomy – 22,000
* Note: For SURGERIES, the Case Rates payment will apply only to cases managed in Levels 2 to 4 hospitals, with certain exceptions.
According to Philhealth, the advantages of Case-Rate-Basis are the following:
- Fixed payments regardless of hospital size and length of treatment
- No more itemization of costs
- Reduction in claim processing costs
- Faster payment of claims
- Lower financial risk for Philhealth
- Reduction of fraud risk
This proposed Philhealth program is also called No Balance Bill Policy because it seeks to cover the full costs of the medical and surgical procedures in accredited government hospitals. Ang gusto nilang mangyari ay lalabas ang pasyente na walang babayaran sa government hospital na Philhealth-accredited.
Molino, Cavite
Photo Credit: glenmcbethlaw, CC-BY 2.0, via flickr
Good day.
Tanong ko lang po. I have a newborn daughter (22 days old) who is now confined due to pneumonia. magkano kaya maging discount namin sa hospital. maka avail pa ba kami ngayon since bago lang kami nakagamit during sa panganak ng misis ko.
Salamat po and God bless to all.
Hi Izy, nasa list ang para sa pneumonia, 15k and 32k, depende sa code na isusulat ng doctor sa claim form.
Pahabol what is the difference between Pneumonia 1 and Pneumonia II sa case rate coverage ng Philhealth?
Good morning..
How much will be or should be deducted if i will undergo tonsilectomy ?
tanong ko lang po seaman po ang asawa ko mag pasurgery po ako ng thyroid nxt week sabi po sa akin 120k po lahat ang tanong ko po magkano po ang mababawas dun ng philhealth thanks po
Hi mel, will you undergo thyroidectomy? Removal of the thyroid gland or part of the gland? If it is, Philhealth coverage is 31k. 18600 for the hospital, 12400 for the doctor.
Good day! My daughter was confined for pneumonia sometime in October 2011 to a community hospital. I had a private Philhealth accredited doctor but all the medicines were purchased outside the hospital amounting to more than 3, 000 pesos with receipts submitted to the hospital for reimbursement. The BPN said that the hospital was paid 15, 000 for my daughter’s case. Total amount of hospital bill was 3, 445 in which 2, 945 was deducted from as a result oh Philhealth benefits. I only received the reimburesed amount of medicines and laboratory with barely 903 pesos last February 14, 2013. I asked why too little, yun daw and assessment ng pharmacist. Ganun po ba talaga?
Hi Cristina, do you mean you spent 3k+ pesos for medicines and paid 500 to the hospital (3445-2945)? And Philhealth paid the hospital 15k. The hospital should refund you 500 pesos plus the 3k+ you spent for medicines. The hospital was paid under Case Rate, so they should consider all the medicines purchased. Philhealth did not reject any medicine you purchased since it’s Case Rate, so why should the hospital do so? I suggest you show again your BPN (keep a copy for yourself) and ask for additional refund.
Hi good am, nag inquire ako sa lying in kung magkano ang NSD nila sabi around 6500-7000 hindi kasali ang new born babayaran separately pati yung first vacine, then tinanung ko kung magkanu ang magiging deduction ng philhealth ko dun sa sa 6500-7000 bill nila, sabi ng dr. 40% daw, so kung 7000 less 40& 4200 ang babayaran ko, eh nakalagay dun sa bracket nyo pag level 1 6500 ang dapat na maging share sa akin ng philhealth, baki 2800 lang ang sinasabi sa akin ng OB and ibabayad ko ng hiwalay yung Newborn and first vacine. Anu poi bang gagawin ko?
Hi Alison, I’m not sure why many health facilities (even the big hospitals) do not comply with the correct amount of deductions. Maybe they need the cash, or maybe Philhealth takes a long time in paying them. If you like, you can try asking if they will help you with the Philhealth papers if you pay in cash, so you can get the refund in full. But you have to wait for many months. And sometimes the check or the mail gets lost, as some who are commenting here say. Please ask others too.
Hi good am yung husband ko both member kami ng philhealth na admit at naaooperahan sa isang private clinic regarding sa malaking ceast pero out patient sya, umuwi rin kami pagkatapos nya operahan HMO member din sya, wala kaming ginastos sa ospital at treatment.. pwede ba naming ireemberse yung mga binili naming gamot sa labas ang mamahal kasi ng mga niresatang antibiotic, pede ba naming ireembers yun? anung requirements? last January 27,2013 lang sya naoperahan. tnx
Hi Alison, what I know is that medicines are only covered by Philhealth if they’re used while in the hospital or during surgery. Please ask others too.
Good day, Inquire ko lang both member kami ng husband ko sa philhealt, last January 27, 2013 naaperahan sya sa malaking clinic out patient kami, so nakauwi din kami after ng operation wala kaming ginastos kahit piso during operation kasi HMO member din sya, inquire ko lang pwede ba naming mareimbuse yung mga gamot na binili nmin sa labas na required nya inumin.. ang mamahal kasi ng mga niresatang antibiotics, If ever na pwede mareemburse anung requirements ang kailangan namin isubmit sa clinic na pinag operahan sa kanya philhealth accredited din yun clinic. tnx
Good day po..I am above 10 years phlhealth member & only once avail the benefits during my CS-birth last 2010. And my second availment was last October, when my son confined at the semi public hospital for pneumonia case w/ acute exacerbation.Since we arrive late evening at the emergency room,we cashed out those medicines being told us to purchase & even the x-ray and other laboratory because there is no one can issue “phlhealth monitoring slip” (a requirement asked by their pharmacy in every phlhealth member) at the said hospital. We stayed at their service ward for six days.Estimated worth of medicines being charged to phlhealth was near 3k & laboratories @ 2k since most of the med used were salbutamol & generic antibiotics but when we go out at the hospital, we paid 9oo+ & we did not received any refund until now although we submitted the cashed out receipts to them that worth 5k. And as i saw at the hospital bill,why they charged us a doctor fee of 4500 each, i thought it was free when u are in service & why 1100/day for room since we stayed at the service ward where almost 20 patients who shared the poorest room. Please help me understand.thank you.
Hi vonz, how much was your total bill? And how much did you pay the hospital? Have you received the benefit payment notice (BPN) from Philhealth? This will show how much Philhealth paid the hospital. Xerox this BPN, and keep copies, and then ask for refund from the hospital. Did you pay the room rate of 1100 per day? Is this really their room rate for wards? This is a rate for semi-private rooms in other hospitals.
hi ask ko lang dependent ako ng mom ko sa philhealth so gagamitin nmn ung for maternal case ko then my philhealth din ako pero hnd ko natuloy pag hulog pwede bang i dependent ko ung baby ko sa philhealth ko pero sa mom ko muna iaawas ung kakulangan? tnx.
Hi Grace, I think if you want your baby to be covered, it should be your membership that should be used for both maternity and newborn, because you can not be a dependent and at the same time a member. But you have to fix your eligibility first, make the required payments.
If you can no longer complete your eligibility as a member because you’re already late, you have to use your mother’s membership, with you as her dependent. And it will only be for maternity. Ask others too. take care
my mother have been operated for cataract last january 15, 2013 and we did’nt claim philhealth
because my mdr is not yet updated can i still claim
the 16,000 allowed to be deducted by philhealth
Hi anna, yes, you’re still within the 60-day claim period. Obtain signed claim forms from your doctor/hospital. The new rule about the need for Philhealth authorization before cataract surgery is effective on February 1, so your case is not yet affected by this rule.
good day po. ask ko lng po kung kasama ang cataract surgery sa cases na saklaw po ng philhealth. thank you very much po
Hi jack, yes, covered ang cataract treatment. But you must ask your doctor first because Philhealth requires a pre-approval of cataract treatment before the actual operation takes place.
hi ask ko lang if ang minor surgeries like ugiectomy have also deductions if they have philhealth? tnx
Hi shiela, yes, most outpatient surgeries are covered, as long as they’re not for diagnostic purposes. It also depends on your surgeon, so ask your surgeon.
gud evening po, ask ko lang, if nag stop po ako ng payment sa philhealth last year, then nagtuloy po ako this year..pwde ko po ba xa magamit this year? if nakaka 6months pa lang po ng hulog sa philhealth, kasi nag stop ng hulog last year..pwde pa din po xa magamit and how much po kaya ang pwde ibawas if i have to undergo thyroidectomy?
thank you po.
Hi Claire, check if you have paid 9 of the past 12 months (12 months BEFORE month of surgery). If yes, your thyroidectomy can be covered at an accredited hospital and doctor. Coverage for thyroidectomy is 31k (18,600 for hospital and 12,400 for PF). Ask your surgeon too.
hi! po asked ko lang po mag 2 years pa lang ako member ng philhealth, then nagamit ko sa anak ko ng naconfined sya because of acute bronchitis this jan 2013 lang and this coming May 2013 manganganak naman ako cs ako magagamit ko ba ulit ang philhealth ko and sure ba 19,000 ang deductions sa level 2 hospital?
Hi sha, yes, you can avail of your maternity benefit. What is not covered for the 2nd time is the same person with the same illness within 90 days. Yes, your CS coverage is 19k (11400 for hospital cost and 7600 for the doctors). It should be Indicated CS, meaning it’s your doctor that decides. Yes, it’s covered in a level 2 Philhealth-accredited hospital by an accredited doctor. In some hospitals, they deduct only 11400 and you refund the 7600 later on.
hi everyone i hope you can help me answer my question regarding philhealth..I have a bro-in-law needing a surgery to remove kidney stone.The procedure called laser wave shock. My sis said that they have a philhealth insurance. How much discount they will save for this procedure? What are the services covered with philhealth? Im live in the US but im not sure how this philhealth insurance works. Thanks a lot.
Hi alice, sorry, that procedure is not under the Case Rate scheme, so the benefit is not fixed, so I cannot give you the exact amount. It would be covered under the fee-for-service system, in which benefits for room, OR, meds, PF, lab have limits depending on hospital level and illness severity. Your sis needs to ask their surgeon about Philhealth before surgery.
hi, is there a website that explains fee-for-service system ng philhealth. my wife is due for surgery also on kidney stone sa NKTI (Tertiary hospital). need to know how philhealth will do the calculations po. thanks and more power!
Hi alex, the Philhealth website presents the chart for fee-for-service. Your coverage would depend on the severity of the illness and the specialty levels of the doctors
Chart of Fee-for-Service Benefits – Tertiary Hospitals
Good day, In Nov 2011 I undergo Open Heart Surgery (PHC).Sa bill namin na 350k philhealth deduct 33k. May 2012, I received a check(refund)amounting to 27k.
After a year, I got pregnant and since high risk pregnancy we paid 140k, nadeduct lang is 11k since package daw un sa CS,
Ask ko lang my makukuha paba ako na na refund?same sa operation ko?
Hi karen, you should be able to refund 8k from the hospital after you receive your benefit notice from Philhealth. The coverage for CS is 19k (11,400 for hospital and 7,600 for doctors). Xerox your hospital receipt and benefit notice so you have copies.
Good Day!
I was admitted this month at a govt hospital here in our place for hysterectomy. most of my medication were bought outside the hospital and my bill was only 5,360. When I submitted the Ors to the hospital clerk, she refused to attach it to the claim since it will not be refunded. I further asked for her explanation because this is unfair for my part that they will be paid far more than what they have provided. she said they also cannot reimburse the medications that i have purchased outside since the money that Philhealth will pay will directly go to the province and they cannot easily dispense money of the hospital. Please help me with this situation. thank you!
Hi nikki, the coverage for hysterectomy is 30k, further allocated as 18k for hospital costs and 12k for the doctors. Did you pay the 5,360? It’s good they did not accept your receipts, so you still have your receipts with you. They don’t need the receipts for their Philhealth filing because hysterectomy is under Case Rate — has fixed rate. Wait for your benefit notice from Philhealth and then when you get it, xerox it (also your receipts) and go to the hospital and ask for your refund.
Hello! I have myoma that needs to be removed through abdominal myomectomy. Can i check with you how much can i claim from Philhealth for this case? Can the claim be automatically deducted from the hospital bills or i have to wait for reimbursement? Thank you so much for being helpful. – angie
Hi Nelita, that procedure is not in the Case Rate list, so the coverage is not fixed, so, am sorry, I can’t give you the coverage amount. Your case will be covered under the old Fee-for-Service scheme — you have coverage for room, OR, PF, medicines with maximum limits, based on hospital and treatment category. Submit your complete documents before discharge, so your Philhealth coverage will be deducted outright.
Hi, ask ko lang if My marefund kmi n doctors fee Worth 30k,di daw accredited ng philhealth ung doctor. And why 24k ang charge nila sa PHILHEALTH for the hospital bill Eh 2days n 2nights lng sya s hospital tpos hiwalay p ung doctors fee.
Thanks
Hi judi, what surgery was performed? Appendectomy? If yes, 14,400 (24k x 60%) should have been deducted from the hospital bill. Why is the hospital able to deduct Philhealth if the doctor is not accredited? Was there an accredited doctor who helped the main doctor? If so, then 9,600 (24k x 40%) should have been deducted from the doctors’ fees.
If the treatment or illness is under the Case Rate scheme, Philhealth gives the full coverage amount to the hospital, whether the full amount was used or spent for the patient or not.
Hello, would just like to ask how much is Philhealth’s fixed rate for cataract operation? Thank you!
Hi Tony, it’s 16k for both eyes if done for both eyes at one time. 16k for each eye, if done separately and in certain cases. Just ask your doctor about the difference. Starting May 2013, this coverage needs approval from Philhealth before it’s performed.
hello gud pm po,,wla po akong work pero active member po ako ng philhealth 2 years napo,,buntis po ako ngayon 8 months napo 1st baby,,at manganganak po sa st. martin hospital ng san juan,public lang po.ang tanong ko po pano po ako makakaavail ng malaking discount kung halimbawang normal delivery po ako at kung sakaling cs naman po ako?bale magiging single parent po ako,hindi ko po kasi alam kung pano kalakaran kung ano po ba dapat kong unahin or aasikasuhin tulad ng pag normal delivery po ba or cs then pano kung ang ibang gamot ay hindi available sa hospital sympre bibili po ako sa labas ano po gagawin ko para marefund ko po yung nagastos ko sa gamot at sa bill ko sa hospital?
Hi lin, it’s sad but usually at government hospitals, patients buy medicines and supplies for their treatment even if they have Philhealth. Just be ready with your MDR, premium receipts and IDs and keep the receipts of whatever you buy outside. You can refund these later on after you receive your benefit payment notice from Philhealth. So be ready with some money for medicines and supplies and have someone with you who will buy medicines. You can also ask the hospital about how much you will spend if you have Philhealth
hi i have an concern, almost 9year napo akong member ng philhealth.my question is tuwing nag prenatal po ako dito sa ibang bansa kasi OFW po ako.pwedi kopo ba ma-refund ang mga nagastus ko sa mga nagastus ko dito sa pre-natal ko.o yung mga vit.vacine na sinagawa dito. at ito bay may limit na ilan buwan valid. at mga ilan buwan po bago namin makuha ag refund nyo.thank you nad god Bless u……..
Hi Jane, you can claim only for your most recent prenatal expenses up to 1500 pesos; you include your receipts worth at least 1500 in your maternity claim. Claiming for overseas hospitalization is within 180 days. For local hospitalization, claiming should be within 60 days. Claim processing can take from 3 to 5 or more months.
HI
My wife had caesarian delivery last Sept.2011
we’ve paid 25k for professional fee and almost
7k for hospital bill.When we ff-up for the refund they told us we cannot avail refund kasi daw package daw po.is it possible?
thanks.
Hi Gil, did you submit Philhealth documents in Sep 2011? Because claim filing should be within 60 days after discharge. Did you receive a benefit payment notice from Philhealth? “Package” is only possible if they explained it clearly to you before your wife had CS there, and you consented — like they asked you something like “okay, you will pay only 7k amount for the hospital and 25k for PF, and Philhealth will take care of the other expenses.” Did that happen?
My wife had a gall bladder operation, I paid all the bills in cash including the private doctor, I finally refunded 18,600 pesos from the hospital bills, do I have to claim refund of 12,400 pesos also to the doctor, because I already paid him in cash the doctor’s bill? As it is mentioned that Gallbladder operation is 31,000 pesos. More power to Philhealth!
Hi Francisco, yes, you should be able to refund 12,400 from the doctor (if he got the separate PF check from Philhealth) or from the hospital (if the 31k check was sent to the hospital). The hospital’s accounting/collection dept should be able to advise you about it.
Hi…nakaschedule po ako for thyroidectomy private doctor level 2 hospital gagawin sabi ng brother ko mas maganda kung i package deal na lang para wala na kaming poproblemahin sa lahat yun doctor na rin ang magaasikaso ng philhealth wala ako idea mga ganitong bagay…. ibig sabihin ba nun yung babayaran namin kung magkano man yon kasama na yung philhealth….mas mainam ba yun o wag na lang namin i package deal…thank
Hi ann, it would depend on the package deal. The advantage of a package deal is you already know the exact amount you will pay. Or you already know that you will not pay anything, if that’s the agreement. Just make sure that everything is clear, that hospital costs, meds, supplies and all professional fees are included in the package deal. The Philhealth coverage for thyroidectomy is 31k (18600 for hospital and 12400 for PF), so if this is enough for your operation, and you won’t pay anything, or you add just a little, then that’s good.
hi…tinanong q yung doctor na gagawa ng thyroidectomy kung magkano magagasta namin sa ask nya kung may philhealth sabii q meron mga 25k daw prepare q nakapackage deal kc kami…. yung 25k na babayaran namin …kinaltas na ba yung sa philhealth q dun?
Hi ann, I wish you asked the doctor. But based on the flow of your conversation, I think you need to prepare 25k. I guess the cost in that hospital with your doctor for those without Philhealth is about 56k. So 56k minus 31k (Philhealth coverage) = 25k. But I’m not sure. You should ask the doctor. If you’re shy about asking the doctor again, you can ask the accounting/collection of that hospital the cost of thyroidectomy for those with and without Philhealth.
kanina nag punta aq sa philhealth office para kumuha ng MDR para maayos na lumabas inactive member daw aq eh monthly naman ako pinagbabayad kahit nung nasa private school me nagtuturo hanggang sa ngayon na nasa government na aq…di ba e2 centralized kc nagfile aq sa bulacan sa manila aq nagtuturo dun public sch. kailangan ko pa ba tlagang magpapirma ng Er2 para maayos yun ….di ba magagamit yung philhealth kung d q pa maayos bi4 my operation which schedule on tuesday ?..thank you in advance
Hi ann, Philhealth has centralized records. It could be that your school is late in remitting Philhealth payments. If you cannot show the hospital your updated MDR, the hospital will not make outright deductions. You need to get certification of premium payments from your school including OR nos. for at least 3 of the past 6 months. If you can’t give the hospital the required documents, get your signed claim forms plus surgical records plus bill payment OR from the hospital before leaving the hospital so you will file directly with Philhealth. If you plan to return to the hospital to get the forms at a later date, it’s often difficult to find the doctors for signing of forms.
Also, you will wait for months for the refund.
hi…goodday po nagthyroidectomy po aq nakapackage deal kami sa doc. nasa bill namin 41075.94 less kasama yung philhealth nagbayad kami ng 15.000 sa hospital bale nasa 26.0000 yung philhealth kung pagbabasehan yung case rate ng thyroidectomy na 31k ang cover ng operation q ask q lang possible ba na may marefund pa aq?…tnx po
Hi ann, it depends on the doctor and your agreement since this is a deal. The difference of 5k (31k – 26k) will go to the doctor, since your 26k deduction exceeded that allotted for the hospital (18600). If your package deal went something like this: “Okay, just pay 15k, submit your Philhealth documents, and we’ll take care of the rest”, it means your total expense is 15k. Ask the doctor or the hospital. Or after receiving your benefit payment notice from Philhealth, you can go to the hospital and ask for your refund.
Hi ann, it depends on the doctor and your agreement since this is a deal. The difference of 5k (31k – 26k) will go to the doctor, since your 26k deduction exceeded that allotted for the hospital (18600). If your package deal went something like this: “Okay, just pay 15k, submit your Philhealth documents, and we’ll take care of the rest”, it means your total expense is 15k and the doctor might no longer refund the 5k. But ask the doctor or the hospital. Or after receiving your benefit payment notice from Philhealth, you can go to the hospital and ask for your refund.
Hi ann, it depends on the doctor and your agreement since this is a deal. The difference of 5k (31k – 26k) will go to the doctor, since your 26k deduction exceeded that allotted for the hospital (18600). If your package deal went something like this: “Okay, just pay 15k, submit your Philhealth documents, and we’ll take care of the rest”, it means your total expense is 15k. Is this the same doctor who initially quoted 25k? If yes, then you got a good deal. But ask the doctor or the hospital. Or after receiving your benefit payment notice from Philhealth, you can go to the hospital and ask for your refund.
Hi ann, it depends on the doctor and your agreement since this is a deal. The difference of 5k (31k – 26k) will most likely go to the doctor, since your 26k deduction exceeded that allotted for the hospital (18600). If your package deal went something like this: “Okay, just pay 15k, submit your Philhealth documents, and we’ll take care of the rest”, it means your total expense is 15k. Is this the same doctor who initially quoted 25k? If yes, then you got a good deal. But ask the doctor or the hospital. Or after receiving your benefit payment notice from Philhealth, you can go to the hospital and ask for your refund.
Sir
ask q yng case ng anak q kng coverd ang gamot na factor 8 nya na ginagamit, hemophilia ang sakit nya and he was admitted last two weeks at ust mla for 4days.
Slmt,
Hi rodito, sorry po, kung ang gamot ay bibilhin at gagamitin outside the hospital, it’s not covered by Philhealth. But there’s also the 90-day rule ang Philhealth so hindi rin covered ang the same cause of hospitalization within 90 days. I hope lang na maraming susulat sa Philhealth at hingin na isali sa factor infusion ang outpatient coverage kagaya ng coverage ng hemodialysis. You can go to PCSO and ask assistance. Sa unang request, parang maraming docs required, pero later on, pag nasanay na, alam mo na ang pasikot-sikot. Go there as early as 5 am.
Letter Request to Chairman/General Manager
Medical Abstract
Bill/Quotation/Costing from Hospital Pharmacy/Supplies
Laboratory Request/Medicine Prescription
Endorsement/Acceptance letter from Hospital Social Services/Credit Collection Office
Paano hihingi ng tulong sa PCSO?
hi, naka schedule po nanay ko for gall bladder operation, magkano po ba ang makukuha namin sa philhealth nya?
Hi Menjie, is this removal of the gallbladder? Is the procedure called cholecystectomy? If yes, the coverage is 31k (18,600 for the hospital and 12,400 for the doctors). The hospital should be level 2 to 4.
Hi po,
Please let me know how much will be covered by philhealth for my mother’s gall bladder operation?
Thanks po.
Hi my husband had his operation last April herniaplasty how much will be the philhealth refund. Thanks
Hi Tata, sorry I’m not a doctor, so I looked up for the definition of herniaplasty, and it’s the same as herniorrhaphy — which is covered under Case Rate. The coverage is 21k (12600 for hospital cost and 8400 doctor’s fee).