PHILHEALTH ELIGBLE PATIENT- To become eligible to PhilHealth
benefits, members should have paid at least a total of nine (9) months
premium contributions within the immediate twelve (12)- month
period prior to the first day of confinement. The twelve (12)- month
period is inclusive of the confinement month.
https://www.philhealth.gov.ph.circulars/2017/18 circ2017-0021.pdf
PHIHEALTH NON ELIGIBLE PATIENT - Non-Phi!Health members shall be
interviewed and assessed by the Medical Social Welfare Officer
(MSWO) for NGFs, or by the Social Welfare Development Officer
(SWDO) for LGU facilities, using the assessment tool prescribed by the
DOH. Non-Phi!Health member patient classified as financially incapable
and his/her parent or guardian shall qualify for POS and may
immediately avail of benefits. https://www.google.com/url?
q=https://www.philhealth.gov.ph/circulars/2017/circ2017-
0011.pdf&sa=U&ved=2ahUKEwiG-
vuO7OiGAxUL3TgGHRh1OokQFnoECBoQAQ&usg=AOvVaw2b2lWeL3J
LiYn_1uiXigMb
PHILHEALTH INSURANCE CORP. It is a tax-exempt, government-owned
and controlled corporation (GOCC) of the Philippines, and is attached to
the Department of Health.
https://en.wikipedia.org/wiki/Philippine Health Insurance
Corporation-text The%20Philippine%20Health%20Insurance
%20Corporation.10%20the%20Depar tment%20of%20Health.
DOH-The Department of Health (DOH) is mandated to be the over-all
technical authority on health. The major mandate of DOH is to provide
national policy direction and develop national plans, technical
standards and guidelines on health It is also a regulator of all health
services and products; and provider of special or tertiary health care
services and of technical assistance to other health providers specially
to Local Government Units (LGU).
https://centralluzon.doh.gov.ph/index.php?
option=com_content&view=article&id =3&Itemid=185:text-The
%20Department%20of%20Health%20(DOH.standar ds%20and
%20guidelines%20on%20health.
NOTICE OF DISCHARGE BILLING-
COLLECTION OFFICIAL RECEIPT- A collection receipt is a document that
a business or individual uses to document the payments it receives
from its customers. This document is an official document that records
the amount paid, dates, payment methods and other details. It is part
of a business's financial records and allows the business 10 record all
payments it receives from its customers.
https://finrota.com/en/blog/tahsilat-makbuzu
PATIENT ADMISSION- is an essential element of a Provider's workflow
of serving the patients. It is defined as the process of entering and
allowing a patient to stay in the hospital for medical observation,
treatment, and care. Hospital admission typically refers to an inpatient
facility where the patient is allowed to stay overnight exceeding 24
hours, following a formal procedure of patient admission.
https://www.linkedin.com/pulse/patient-admission-data-analytics-
insight-action- maharshi-vyas
MEDICAL SOCIAL SERVICE- Medical social services addressing social and
emotional concerns related to the patient's illness and care; helping the
patient access community resources to assist in recovery; and
counseling for the patient and family.
https://www.medicareinteractive.org/glossary/medical-social-
services#text-Medical%20social%20services%20include
%20addressing.for%2 0the%20patient%20and%20family.
HOSPITAL CLEARANCE-A medical clearance will specify whether or not
the employee is medically fit to perform the essential job functions of
their position. The medical clearance includes an evaluation for
respiratory clearance as well. If the employee is cleared to wear a
respirator, a separate respiratory clearance statement will be issued.
Determinations will be made at time of evaluation.
https://publicsafetymed.com/fireems/medical-clearance/
#:-:text=4%20medical%20clearance%20will%20specify.for%20respir
atory%20clearance%20as%20well.
RETURN TO HOSPITAL-Return to Hospital (RTH) Claims a deficient claim
after due adjudication and validation, redirected back to HCI with
instructions to comply with certain requirements, but from which the
action of returning the complied claim to PhilHealth may result in the
reversal of the deficiency into a good claim or non-compliance that may
result into the denial of the claim.
PhilHealthhttps://www.philhealth.gov.ph › ...PDFProper Recording of
Return to Hospital and Denied Benefit Claims For Reconciliation ...
https://www.google.com/url?q=https://www.philhealth.gov.ph/
circulars/2019/circ2019-0001.pdf&sa=U&ved=2ahUKEwj_l_K-
8eiGAxXJ1DgGHbEWDo8QFnoECBoQAQ&usg=AOvVaw0VjSW4NqNGZ
riRAkHei6TK
DENIED CLAIMS- Denied Claims a claim that has been determined to be
invalid and unworthy of payment/reimbursement due to an absolute
deficiency that cannot be remedied through RTH or due to a finding of
an unmet requirement.
PhilHealthhttps://www.philhealth.gov.ph › ...PDFProper Recording of
Return to Hospital and Denied Benefit Claims For Reconciliation ...
https://www.google.com/url?q=https://www.philhealth.gov.ph/
circulars/2019/circ2019-0001.pdf&sa=U&ved=2ahUKEwj_l_K-
8eiGAxXJ1DgGHbEWDo8QFnoECBoQAQ&usg=AOvVaw0VjSW4NqNGZ
riRAkHei6TK
STATEMENT OF ACCOUNTS- A statement of accounts is a document
that reflects all transactions that took place between you and a
particular customer for a given period of time. Generally business
owners send statements of accounts to their customers to let them
know how much they owe for sales that took place on credit during
that period. The guide walks you through the contents of statement of
accounts and shows how to file this document for customers.
https://www.zoho.com/books/guides/what-is-a-statement-of-
accounts.html#::text=Time%3A%204%20minutes-What%20is%20a
%20statement%20of%20accounts%3F.a%20given%20period%20of
%20time.
CHARGE SLIP (MEDICAL SLIPS)- it is generated for each patient visit and
serves to communicate information about the number and type of
services provided and who provided them to the system that generates
bills. The health professional signature on the encounter form makes
this a legal billing document and attests to the fact that services were
performed and may be billed for.
https://www.dentalclinicmamual.com/4-adr 03.php:text-Also
%20called%20a%20charge%20slip,the%20system%20thar%20
generates%20bills.
