Title
NHIP Claims Check Follow-up Guidelines
Law
Philhealth Office Order No. 196, S. 1999
Decision Date
May 10, 1999
PhilHealth Office Order No. 196 establishes streamlined guidelines for the follow-up of NHIP claims checks, limiting claimant interactions to two minutes and encouraging direct filing through hospitals to expedite reimbursements.
A

Q&A (PHILHEALTH OFFICE ORDER NO. 196, S. 1999)

The purpose is to provide guidelines to facilitate the release of checks for NHIP benefits claims and ensure an orderly follow-up process.

Each claimant is entertained for only 2 minutes during their personal follow-up.

The staff must note down the claimant's Name, Address, Contact Telephone Numbers, Name of Patient if different from the claimant, Name of Hospital where the patient was confined, and the Period of Confinement.

The claimant is advised to come back after one week or wait for a call from PhilHealth within one week for further instructions.

The staff commits to calling the claimant within one week to instruct them to be ready with the required data when they return.

No, direct filing of claims by NHIP members to PhilHealth is discouraged.

NHIP members are encouraged to file their claims with the hospital where the patient was confined.

The hospital shall deduct the expected reimbursement from the total hospital bills.

The guidelines were adopted and signed by Enrique M. Zalamea, President and CEO of PhilHealth, on 10 May 1999.

These guidelines serve as official procedures to ensure efficient processing and follow-up of NHIP claims checks, promoting compliance by claimants and hospitals.


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