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All legitimate members of the Philippine Health Insurance or PhilHealth are reminded of their duties and responsibilities to be able to enjoy the benefits to the fulest, said PhilHealth.

This surfaced during the monthly meeting of the Association of United Development Information Officers (AUDIO) in this agri-tourism town held last week, wherein a representative of PhilHealth came over to explain these things.

On membership, a member should have in possession at all times their respective PhilHealth Number Card or identification card; update membership data record (MDR) for any change in personal information, such as in civil status or addition of a new dependent; and request for a replacement in case of loss of PhilHealth Number Card of identification card.

Other things to do on their contribution, include: a) ensure that a member promptly and regularly pay their contributions to avoid suspension of the benefits; b) for newly hired, check if your name is reported by your employer to PhilHealth in the Er2 form; c) ensure that your monthly PhilHealth contributions are deducted from your salary and promptly remitted and reported by your employer; d) report to PhilHealth at once an employer who does not remit premium payments; e) ensure that you have sufficient qualifying contributions to avail of the benefits anytime.

To avail of the benefits, a member secures an updated list of PhilHealth-accredited facilities from any PhilHealth office; submit a properly and completely filled up PhilHealth claim form to the hospital and ensure that all the information stated in the form are true and factual; ensure you submit all the necessary documents to the hospital including a copy of your MDR; clarify with providers (hospital/doctor) the appropriate and final benefits deducted upon settlement of bills and charges; ask for a copy of your statement of account/billing statement from the hospital upon discharge; ask for an official receipt and waiver from the hospital and doctor for payments made in full; and ensure that your claim, if you opt for direct filing, is filed at OhilkHealth within sixty days (60) from the date of discharge for local confinements and with the hundred eighty (180) days for confinement abroad.

PhilHealth also urged members/beneficiaries to be aware of amendments and updates on PhilHealth policies and benefits schedules; to report from any PhilHealth office on any unclear policy or guideline; report at once to PhilHealth any hospital that fails to accommodate a PhilHealth member who wishes to avail of the benefits; and report at once to PhilHealth any fraudulent transaction that you know about; and observe and comply with PhilHealth’s rules and regulations. - Press Release


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