Title
Amendment to PhilHealth Claim Forms
Law
Philhealth Circular No. 03, S. 2011
Decision Date
Feb 17, 2011
PhilHealth Circular No. 03, S. 2011 mandates amendments to the Enhanced Claim Form 1, requiring employers to certify the collection and remittance of nine monthly premium contributions for members prior to confinement, effective for claims starting July 1, 2011.
A

Questions (PHILHEALTH CIRCULAR NO. 03, S. 2011)

It amends certain provisions of the “Enhanced PhilHealth Claim Forms” under PhilHealth Circular No. 12, s. 2010, in line with PhilHealth Circular No. 25, s. 2010 (the nine (9) months contribution requirement for benefit availment).

Claim Form I, Part II (Employer’s Certification). Specifically, Item number four (4) of the Employer’s Certification (Annex A).

The certification now expressly includes that all monthly premium contributions, including the applicable nine (9) monthly premium contributions within the past twelve (12) months period prior to the first day of confinement, have been deducted/collected and remitted to PhilHealth.

That the applicable nine (9) monthly premium contributions within the past twelve (12) months period prior to the first day of confinement were deducted/collected and remitted to PhilHealth.

Within the past twelve (12) months period prior to the first day of confinement.

The employer certifies that the information supplied by the member or his/her representative on Part I is consistent with the employer’s available records.

The certification of the employer portion (Annex B).

It is revised to require that the employer or authorized representative affix a signature certifying that monthly premium contributions, including the applicable nine (9) monthly premium contributions, were deducted/collected and remitted during the past twelve (12) months period prior to the first day of confinement, and that the member’s information is consistent with the employer’s available records.

The employer or his/her authorized representative.

For all claims with admission dates starting July 1, 2011.

They remain in full force and effect.

PhilHealth Circular No. 25, s. 2010, also known as the Nine (9) Months Contribution as a Requirement for Benefit Availment.

That all monthly premium contributions (including the applicable nine (9) monthly contributions) were deducted/collected and remitted within the required twelve (12)-month window, and that the member’s Part I information is consistent with the employer’s available records.


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