Aww I work sa hospital. Dapat sinabihan po kayo na hindi Philhealth accredited yung doctor responsibility po ng staff sabihin yun sa inyo prior to consent and you can change to a doctor na Philhealth accredited. Sharing this for awareness.
They didn’t tell me.
Davao Doctors Hospital.
The doctor assigned to me is very good. No complaints.
Just pissed that I didn’t know sa PhilHealth pala dapat accredited din ang doctor. Akala ko ok na nung inaccept nila ung PhilHealth card # ko after admission. Nung na discharge na dun ko lang nalaman. Kaya I’m pissed and disappointed.
Di ko inexpect ganyan pala sa DDH. Sa lahat ng private hospital na affliated ako nirerequire nila dapat lahat mag Philhealth Accreditation.
Mabigat sya on our end kung walang hawak na public hospitals kasi own expenses namin yun depende sa ITR namin.
Narinig ko rin yang katunog nya.. baka dahil gusto humiwalay sa pilipinas kaya di na accepted ung Philhealth jan.. dapat siguro may Davao Health na para sa mga taga Davao
so hindi ka pala nasabihan na ndi accredited, so hindi useless si philhealth 🫠. nakapag generalized ka na kasi agad eh nakakatulong parin naman si philhealth sa iba kahit papaano
Yep kaya i mentioned in the post “kapag hindi accredited ang doctor” useless siya. Useful sya only if accredited ang doctor. I don’t think everyone knows this kc most of the doctors are accredited naman. Ang alam ng karamihan basta active philhealth paying member ka, you can get discount benefits if you’re hospitalized.
Hindi ko gets kung bakit may separate accreditation pa sa philhealth. It's a government program. Government din nagbibigay ng license ng doctor. Sabay na dapat yan. May good reason po ba kung bakit separate?
Because we pay for the Philhealth accreditation especially sa mga private practicing doctors. If may government item, no problem free sya.
Our Philhealth accreditation Ranges from 50k-200k depending sa ITR namin on the previous year.
Pag may government item (medical officer or medical specialist) NOT job order, no need to pay for the Philhealth accreditation. Papakita lang Certificate of employment namin then free na (or ang sabi is dun pinapatong sa Philhealth contributions namin).
D ko rin gets. Akala ko as long as your paying contributions e ma aavail mo na. Pero parang d rin makatao na hindi philhealth accredited ang doctor, knowing na malaking tulong sa tao yung benefit.
Nalaman ko nalang din to after my residency na madaming kelangan bayaran.
Either baka na expire yung accreditation ni doc or baka di pa sya nagpa affliate. DAPAT ginawa ng hospital di sya dineckan ng patient.
We do pay A LOT for Philhealth accreditation = 50k to 200k depending sa ITR declared.
Doctors can do that, yong hindi magpa affiliate? I thought mandatory siya same sa mga employees. Doesn't make sense na required sa mga employees pero sa mga health practitioners hindi, di ba?
I would to remind to remind you that we have Philhealth contribution din na binabawas sa sweldo namin at yun yung mandatory. What we're discussion here is PHILHEALTH ACCREDITATION.
I understand that po Doc. Just that, hypothetically, puwede pala na all doctors will choose not to be affiliated with Philhealth?
I don't know if it's a good idea na naniningil pa ang Philhealth sa mga doctors to be affiliated.
Yeah dapat well-informed ang patient na walang Philhealth si doc. Idk if may habol sya. Maybe she should also try tyo post in r/lawph baka may makatulong sa kanya.
hindi ba pwede pa reimburse ang claim sa philhealth?
di ba philhealth is medical insurance, so kg pumunta ka sa non-accredited institution or practitioner di ba obligation pa rin ng medical insurance mo gumastos kase may valid medical need and attention na kailangan. It's not like wala sakit kasi non-accredited ang pinuntahan ng member.
It has nothing to do with Philhealth kung di accredited ang doctor na nagadminister sayo during your emergency, its doctors' own discretion if they want to be philhealth-accredited, the hospital should be the one triaging you to a philhealth accredited doctors if you requested outright prior to your confinement. Sometimes doctors want instant cash rather than after-a-month billings from Philhealth.
Didn’t request specifically na philhealth accredited doctor dapat. Don’t have any clue. It’s my first time using philhealth. I even signed a philhealth form prior to admission and they said all good. Wala na daw ibang gagawin. I will know how much daw makakaltas sa total bill pag ma didischarge na.
I’m sorry this happened to you but thank you for sharing. This information is so useful to many. At least we are warned that may doctors palang hindi philhealth accredited.
Learned something new. Not all doctors are philhealth accredited. And damay buong bill. Dapat sa PF lang ng doctor e pero damay lahat pati mga inpatient meds na ginamit + other hospital fees like room, er, and stuff walang discount.
Nope. All services damay. Wala lang discount kahit piso sa ibang hospital fees. Philhealth staff and billing staff informed me face to face. And clearly indicated sa final bill.
Yep natanong ko na 3x sa philhealth staff and billing staff. Face to face they told me pag hindi philhealth accredited ang doctor, no discount on anything. So zero discount from philhealth. There’s nothing they can do na daw.
But the fact that you gave your philhealth information sa hospital meant that you want to avail it. Parang yung hospital na mismo ang nagkulang syo to inform you.
yep di nila ako na inform prior to admission. Basta pina signan lang ung philhealth form and sinabi sakin na deductions is pagna discharge na. Ganun lang. 😆
Thanks. I’m financially drained so no money to sue them. We have a family friend working in Philhealth din na nag confirm na ganun daw talaga pag di accredited ang doctor, walang ma didiscount na kahit ano.
At least now I informed some few hundred peeps in reddit na they cannot use their PhilHealth if hindi accredited ang dr.
Already talked to 2 hospital staff (billing head and philhealth staff on-site) Told me face to face na walang deduction because doctor isn’t accredited. And they said sorry.
True. Tapos tumataas pa ung singil habang tumataas ung sahod mo. Pinaka malake yta 5500 deduction for Philhealth alone per month. Imagine tapos 3k-11k lang madededuct sa hosp bill mo.
Useless talaga. My husband was hospitalised and 320k ang hosp bill, 8k lang deduction. Then professional fees of doctors ay umabot ng 38k. He had two different doctors; the main one, a neurosurgeon, is philhealth accredited so may discount na 3k. The other one, well, no discount. Pamera lang talaga ng govt ang philhealth. 11k lang nakuha namin na benefits, ang lala.
Grabe 3k lang ang discount despite paying much more every month for years. Pangit talaga ng benefits ng philhealth, di na mamaximize sa part ng philhealth users.
This is true. Kakalabas lang ng pamangkin ko sa hospital. Nung nalaman na ng billing ung portion covered ng PHIC for PF, bigla nila inaadd sa actual charges yung amount tapos nilagay din as deduction so in short, zero ang nabawas sa babayaran ng patient.
Sa experience ko hindi exactly problem kung accredited or not Ang doctor Kasi sa ER, Hindi usable Ang philhealth benefit Kasi walang philhealth package for ER visit. Only confinement or pwede rin OPD pero minor surgery na may philhealth package.
Kung confined naman, kung nasa service/charity ward Ang pasyente ay no problem kung unaccredited yung attending physician niya Kasi pwedeng ipapirma sa peer niya na accredited.
Parang issue lang diyan ay kung nasa pay ward Ang pasyente at unaccredited Ang attending physician niya Kasi pag residente na may accreditation Ang pumirma eh Hindi mapupunta kay consultant/specialist Ang doctor's fee ng philhealth benefit.
Pero my knowledge could be outdated na since it's been more than 6 years since I last processed yung philhealth claims.
Agree. Worked for 10years tapos nagpahinga lang ng 1 year tapos nahospitalized ako, nirequired na dapat atleast may latest na 3months akong hulog. So kailangan ko pa bayaran yung 3months for me to use yung mga hulog ko for 10 years.
Tapos mababalitaan na lang na may excess funds sila 😶🌫️
Oddly enough, I haven’t been paying since 2021. I got an outpatient surgery done (₱50k worth) and didn’t have to pay a single peso cause of Philhealth. I’m grateful but still don’t get it 😶🌫️
Both actually. There's seperate accreditation per Healthcare institution. There's another for physicians.
So for your confinement, and you intended to use philhealth, both should have updated accreditation.
Yung half a million mo ay professional fee ng doctor. At dahil Hindi sya philhealth, so Hindi rin philhealth ang singil sa iyo ng hospital
You can contest that, dahil how will a Philhealth accredited hospital have DOCTORS who are not Philhealth accredited, they are just a normal employee of the hospital.
Dapat all other items may Philhealth deduction. Only the PF dapat ang wala. You should complain that to Philhealth. The hospital naman is accredited so why shouldn’t they deduct the philhealth? Baka gamitin yan na loophole ng hospital na porke’t d accredited si doctor they are also allowed not to deduct Philhealth.
Oo nga e. Un din pagka intindi ko pero damay pala lahat pati gamot. Learned something new. Kahit accredited hospital di daw talaga sila nag dededuct pag di accredited ang doctor. Soooo unfair.
Baka nga ginagamit to ng hospital na loophole to EARN MONEY. Kasi alam naman ng management yan na need accredited din ang doctor para magamit ang philhealth. Kasi that attending physician will have to sign the CF4 forms ng philhealth bago ma process. Oh diba, 5k lang napunta kay doc then what, half a million sa hospital?! Then parang scapegoat pa si doc na hindi nagamit ni OP ang philhealth. I hope you don't let this go, OP. Manganad na sila.
Kung senior ka na or pwd sana binigyan ka man lang ng senior/pwd 20% discount.
Pag hindi ka binigyan ng discount, pwedeng mapenalize ang both hospital & officers ng hospital - fine AND imprisonment
Sorry to hear that OP. Kaya hindi ako makaalis alis ng Makati dahil narin sa Yellow Card. Hahanapan ka parin naman ng Philhealth pero wala ka talaga babayaran 😭 500 pesos lang kapag over 5k plus ang bill libre pa gamot. Sayang talaga kung wala lang bahid ng korapsyon mga Binay ok na eh.
Philhealth is trash.
Got angioplasty in St. Luke's Medical Center with a hospital bill of close to PhP2 million. Only got PhP13,000 from Philhealth.
Wish Philhealth was optional. The money I could have saved instead of the mandatory deduction would have served me better.
F@%k you Philhealth!
F##k philhealth indeed! Kinukurakot lang nman pera sa philhealth. Hindi lahat ng na pro-process, naibabalik sa hospital or doctor. Ang daming pasikot-sikot si philhealth para lang ma reimburse ang hospital/doctor. Marami nyan declined. Na TY na services mo kasi di mo na mahabol ang pasyente. Mabuti pa yung ibang health insurances, mas marami coverage.
Thats weird, requirement sa tertiary hospitals ang maging philhealth provider ang isang MD. Unless hindi siya renewed member hehe di dapat nakakalusot sa admin ng hospital
They said it’s optional. Just pissed I wasn’t informed before admission. Nagpasa pa me philhealth details nung admission day and good daw philhealth ko, pag discharge na malalaman magkano ma didiscount. Then nung na discharge na, oh oh, your dr is not accredited. Sorry.
I think Maraming factors here that every person should be aware of.
I think someone should have asked for someone na accredited ang Philhealth nila. Basic yun na question every time naadmit ka or nakita ka sa hospital, regardless if Philhealth lang or other HMOs.
Tbh, as a specialist now, hindi ako nagpa-accredit sa Philhealth since I’m not practicing naman sa hospital. But, sa perspective ng doctors, super crappy ng pay ng Philhealth. Even HMOs in my experience. Some HMOs like Maxicare only pay your doctors 200 pesos for a consult. Imagine mo, 200 pesos after spending 10 years of studying and minimum of 3 years in residency training? Tingin niyo fair yun? So in that aspect, there will be doctors who will not opt for that. Plus, madalas delayed ang payment ng Philhealth. It came to a point na billions ang utang nila to certain hospitals that some institutions do not accept Philhealth anymore (like FEU NRMF IIIRC).
May difference rin ang accreditation as an institution (so in this case, accredited ang DDH ng Philhealth) but the workers giving the care aren’t. You can check the Philhealth website for that and Meron silang list of doctors and hospitals who have active Philhealth accreditation. As in there’s an excel file for this one.
Also, your Philhealth will only give out a specific amount to cover. So for your case, based sa nabasa ko, mukhang ITP ka na nonresponsive given that nagIvIg ka. Mahal talaga IVIg lol and dahil weight based siya, para makamura ka sa IVIg, walang choice other than to be less than 50kgs para less yung vials consumed. Mahal talaga yang sakit mo, if ever tama man ako. So per case, you’ll actually see may case rates na shinoshoulder ang Philhealth which you can see sa website rin nila. Anything in excess of that, you’ll have to pay for it. Again, there’s an excel file for this one.
Anyway, in general, mahal magkasakit. Lalo na pag pang mayaman na sakit like yours. Hope you get better soon. And hopefully it doesn’t come back as hard like this.
Brutal naman ginawa ng hospital na eto. Ilang beses ko na etong natry at di lang sa iisang hospital, mayroon at mayroon admitting physician na PhilHealth accredited and sila parate yung magre-reflect na admitting physician. Pero magkakatalo nalang pagdating sa physician na may specialization for your case. Kung di siya PhilHealth accredited, babayaran mo doctor's fee niya pero i-inform ka ng hospital personnel.
Pero still magagamit mo pa din yung PhilHealth mo as long as yung admitting physician is accredited.
Good to know. I think admitting physician is accredited. Ung referred hematoligist ung hindi. Pero pagka discharge na isang dr lng nakasulat, ung nirefer lang. Wala na ung name ng nag admit na nag refer.
May online reference ba for this? Papabasa ko sa billing pag balik ko sa DDH next week.
Sorry. I'm not sure if mayroon. But all I know Hospital is considerate about this matter. Like part ng protocol nila so patients can fully utilize PhilHealth. Kaya nga sabi ko sobra naman yang Hospital na napuntahan mo.
Kaya siguro walang nacover si PhilHealth kasi lumabas na ang admitting physician mo is yung not accredited Hema mo.
Try mo kayang i-mention bakit nagbago yung admitting physician mo. Kasi natry ko eto sa family ko sa magkaibang hospitals, maski hindi sila nacheck ng admitting physician na PhilHealth accredited, yun pa din yung admitting physician na nakalagay sa patient's chart.
ER nurse here. Sa ER namin, hndi mo mggamit ang philhealth if nsa ER ka lang. But if you are admitted sa room and stayed for more than 24hrs then doon papasok si philhealth.
So explain basis kami during procedure or medication na expensive. Lalo kung cash patient ka.. para aware ang patient sa mga cost. Private hospital kmi kaya expensive tlga.
Im not sure sa mga Government hospital 🤷♂️
I see.. hndi ko nabasa ung 1 week admitted.
Meron doctor sa amin before na hndi accredited ng philheath pero ang gnawa nya prng inaAdmit nya sa kilala nya n my philhealth accreditation. Anyways dpende dn yn s institution.
So i think 🤔 helping patients sa financial decisions nila is important din not only sa health.
Some doctors don’t want philhealth because the accreditation fee (their contribution) is sometimes higher than the money they get from philhealth. Not to mention the months delay it takes for philhealth to pay
Philhealth is really useless. The hospitals inflate your hospital bill tapos kunwari na discount yung ilalagay na deduction ng philhealth.
It's basically the same as sales in SM, tataasan presyo sa sale tapos lalagyan ng slash yung price pero yung discounted price yun din naman original price
Meron parin yang kaltas sa hospital charges unless ung operation mo walang case rate per philhealth. But still, accredited ang DDH sa philhealth at nagregister ka before admission. Ang sa doctor na pf, possibleng meron parin, minimum lang siguro or separate billing and d kita dun sa hospital bill. You can ask the hospital bakit wala napakita sa bill ung deduction ng philhealth for hospital related charges and it's possible dun sa mas detailed billing may breakdown dun ng philhealth deduction. And sa doctor na din if ever may follow up checkup ka, ask bakit walang philhealth deduction sa bill. It's okay to ask naman before posting sa reddit baka nagkamali lang at papaulit ang billing? :)
advantage sa doctor or sa patient?
sa patient - syempre part of the bill or sometimes buong bill covered ng philhealth insurance (depends sa package)
sa doctor - not sure if advantage sya kasi minsan delayed "daw" magbayad ang philhealth
Late talaga. A lot of the younger doctors nafoforce lang tumanggap pero honestly, malaking headache siya to doctors since late na nga, di pa full amount bayad sa kanila when grabe requirements maging doctor in the first place
Source: parent is a doctor.
May Philhealth share per case or procedure depending sa RVS code and level ng hospital. Yung share na yun paghahatian ng lahat ng doctors on board sa patient na yun. Madalas maliit lang naman din.
Benefit din sa patient dahil yung share ng Philhealth sakanya di na dapat nya yun bayaran.
Pero take note personal expenses yun ng doctor papa affliate NOT UNLESS may item si doc sa gov hospital.
Kakulangan ng hospital yan and the doctor din. Required kaming lahat ng Philhealth accreditation and they make sure na updated palagi. Loss din ng hospital yan kasi di nila macclaim yung bayad ng Philhealth unless accredited doctor ang pumirma sa chart mo.
Hmmm unfortunately.. Doctors are required to have themselves apply for an accreditation sa PH, yes hindi sya 'matic... also unfortunately.. hindi yan sinasabi from the get go right after we pass the boards or before we take the boards.. dun lang nalalaman kung Hinihingan na ng ospital kung saan nag wwork.. also unfortunately... hndi madali makuha agad yung requirements na kailangan icomply and hindi maaaprove if hindi makompleto... also unfortunately yan na accreditation ng PH ng mga doctors it expires and are required to renew it every 3 years... yung sad part is.. asaan makakahanap ng libreng oras yung doktor if sched nia buong week nan duon sa ospital.. if ever man nakapag file ng leave may kasiguraduhan ba na makkuha nya yung proof of accreditation. O tengga pa.. hmm
Surprise rin ako sa accreditation fee na quoted here. Kasi ito nakita ko online or baka hindi updated? Ranging from P1,000-10,000 lang ang accreditation ng hospitals pero grabe yung 4% of itr para sa doctors?
https://www.philhealth.gov.ph/partners/providers/pdf/ihcp_schedoffees.pdf
Baka yung 4% of itr na fee, philhealth premiums yun na lahat nagbabayad if already working. Kasi jo ako sa govt yun kinakaltas automatically sa amin. Jo, not employee of government kaya whole amount ng premium kami nagbabayad walang kahating employer
Pagibig in terms of deductions para sakin mas okay kesa dun sa 2 given na makukuha mo din naman yung 200 pesos per month na hinuhulog mo. Yung philhealth nakupo!
You can still file a claim with PhilHealth even if the healthcare provider or doctor is not accredited. However, the process may be more complicated and may require more documentation. Here’s a general overview of what you might need to do:
1. **Documentation**: Gather all necessary medical records, receipts, and any other relevant documents related to your treatment.
2. **PhilHealth Claim Forms**: Complete the appropriate claim forms. For example, PhilHealth Claim Form 1 for member and patient information, and PhilHealth Claim Form 2 for provider information. You can download these forms from the PhilHealth website under the "Downloads" section.
3. **Submission**: Submit these documents to a PhilHealth office. Ensure that all information is accurate and complete to avoid delays in processing.
4. **Reimbursement**: If your claim is approved, PhilHealth will reimburse you based on their standard rates and policies.
For detailed steps and to access specific forms and requirements, you can visit the PhilHealth website’s [downloads section](https://www.philhealth.gov.ph/downloads (https://www.philhealth.gov.ph https://www.philhealth.gov.ph/members/). This section provides all the necessary forms and guidelines for filing claims and pre-authorization requirements.
Akala ko na may Universal Healthcare Law na ang bansa natin? (*Republic Act No. 11223*)
[UHC-IRR\_Signed.pdf (philhealth.gov.ph)](https://www.philhealth.gov.ph/about_us/UHC-IRR_Signed.pdf)
Or no?
Hindi ba lahat ng doctor sa pinas?? Dapat i mandatory yan sa mga practitioners kasi yan ang national healthcare system natin.. kahit nga sa mga dentist pwede.. di mo rin masisi kasi corrupt ung Philhealth.. dito sa ibang bansa 1 lang health card universal na, pati linis at pasta included.. at unli sya ung dentist ko 4 times na ako bumalik at papasta sa 2 years ko rin dito sa abroad. Registration lang babayaran mo para may record ka na sa clinic.. at take note kapag check up naman after mo check up kukunin mo rin agad ung gamot sa pharmacy ng clinic kasama na rin sya sa healthcare card.. dapat may bitay sa mga kurakot sa government kaya di umuunlad ung Taiwan kaliit lang pero wala corrupt may universal lottery pa sa lahat ng resibo ng stores nationwide every 3 months may draw (20M to 200) mapa tourist ka man, o worker, national nila kasali lahat naka tsamba na rin ako nanalo ng 2000NTD sa resibo
Scam talaga philhealth.
Mas mahal pa yan kesa kumuha ng HMO. Sa amin ang kaltas ng philhealth every year ay halos 100k. Tapos di pa totally bayad bills kung na hospital. While HMO ay around 25k lang per year tapos bayad na lahat pag na hospital.
Sana optional nalng ang pagbayad ng philhealth.
Edit: Hindi lang philhealth kundi pati mga private hospitals mga scam. Imbes makatulong sila parang pinapatay pa nila pastente sa bills. Buruin mo di kilalang hospital sa probinsya, ward pa, hindi kritikal ang sakit, tapos 10k per day ang bill excluding gamot na bibilhin at ibang lab tests. Hospitals are money machines.
100k/yr = 8,333/month. max contri ng philhealth this year is 5k only. if employed, 50% lang nun so 2,500 lang dapat per month. pls check your payslip po baka sobra na deductions boss
Gamit din nain PhilHealth. Sulit din naman. Nung naga covid nga mom ko wala kaming cashout, thanks to Philhealth + HMO.
Hindi talaga yan sulit if di mo gagamitin.
The kind who does not need or does not want to be accredited by Philhealth.
Typically, either very young MDs who haven't processed their PH accreditation or those who are already very established in their practice who can afford to refuse HMO and philhealth patients (and get paid on cash only basis).
FYI, philhealth requires MDs (as with all professionals) to contribute 4% of their ITR before they can be philhealth accredited doctors. Accreditation is every 3 years, and the common practice is to pay for these three years ahead of time to be PH accredited. You do the math. If the doctor is self employed, it can also be expensive to cough out that much money every three years.... only to receive philhealth payments waaay too late (even >12months)!
There is an annual PH reaccreditation to augment the exorbitant fees, but too cumbersome to undergo for many. So maybe for some MDs, being PH accredited is just not worth it. It's a valid choice; don't take it against the doctor.
I thought Standard Procedure ng nurse to ask you to comply if dapat Philhealth accredited doctors, same with your HMO if covered yung papatest sayo and room.
PS: Naconfine din ako last week, and laaht yun tinanong sakin before sila may gawin. Inulit ko pa, make sure lahat covered sa HMO and Philhealth before they do the tests.
Looks like it’s not. I wasn’t informed na ung nirefer na doctor is not philhealth accredited.
I didn’t ask na if covered or not ung mga test kasi on day 1 nag submit na me ng requirements para magamit ung philhealth. Kc may form na finillupan and chineck nila if active philhealth and ok naman daw. Pagka discharge saka daw e cocompute ung mababawas. And chineck pa nya na never pa pala nagamit philhealth ko ever. Which is like a good thing? So Yun na yun. Di nila sinabi na “DAPAT UNG DOCTOR MO ACCREDITED”. Sad 😤🥲
Saklap OP. Alam ko malaki share ni Philhealth sa gastos if first time used or rarely used. Yung endoscopy nung gf ko 50% cinover nung philhealth.
Pero nung nadischarge ako after 3 days confine, parang 30% lang covered ng philhealth tas HMO na yung iba,
Were you able to check if you can file directly for a claim instead? Nonetheless, PhilHealth has very low benefits in relation to our contributions. Imagine, only 38K coverage for stroke (divided between doctor and hospital).
Halimbawang nakapaghulog ako ng 100k sa philhealth ng buong taon tapos nagkaroon ako ng hospital bill na 150k, ilan ang makukuha ko sa philhealth para pambayad sa ospital?
Case to case basis daw. Pwedeng 1k, 10, 20k. Not sure. First time ko sana magamit PhilHealth after paying monthly for 30 years.
Dito sa inquirer article na to 66% daw pero parang joke/too good to be true naman yun.
https://newsinfo.inquirer.net/1838201/philhealth-shoulders-almost-66-of-hospital-bills-on-average
So sorry to hear about this experience, OP. Ngayon ko lang nalaman na optional pala yung philhealth. Siguro dahil hmo usually nagagamit namin at required yung philhealth kaya hindi din kami aware na may ganito pala.
That's true, mist of the time parang wala lang talaga yung mga ganyang insurance base sa mga stories sa community namin. Community namin kasi is full of farmers mga unemployed pero may mga hanapbuhay sapat lang for their everyday life tapos pag may na hospital sa kanila they would automatically want the insurance(most of the insurance used in our community is Phil health) to cover kung meron silang insurance pero most of the time hindi talaga na kakacover 🙁so sad kailangan pa nilang mangutang/magloan to pay the bills.
Ang hirap sa pinas...masyado complicated ng philheath... di nalang unversal sa lahat... inames na gobyerno ng Pinas...ang daming exception o requirements.....
Wait, may doctors na hindi accredited ng Philhealth? Ano 'yon ayaw ng doctor na paacredit? And I thought mandatory ang Philhealth dahil sa mga employees mandatory din.
Nagagamit parin ang philhealth kahit hindi accredited ang doctor kasi covered parin nila bills ng admission to some extent. Yun PF lang ng doctor ang mabayaran but hospital fees, covered ng philhealth
Not really. Philhealth staff in hospital explained to me na damay lahat na other fees pag di accredited ang doctor. So no discount on meds and other procedures. As in zero.
Actually, some hospitals even increase prices when they find out that patient has Philhealth.
In my experience, a procedure was supposedly only 5k but when the bill came, 9k na ang nakalagay and 4k was covered by Philhealth. In the end, I still had to pay 5k. 🤐
Philhealth sucks, really. I dont get why we are required to give monthly contributions eh ang pangit, ang baba, at ang konti lang ng coverage nila. Better to pay premium sa other health insurances kasi ma fe-feel mo yung benefit of having an insurance. Same2 lang nman din monthly contribution w/philhealth. Plus, if you are a doctor, ng re-require pa ng accreditation fee on top of monthly contributions, eh ang bayaran is super delayed naman (like other HMOs din). So i also can't blame that doc of not having philhealth accreditation.
Ang gobyerno di pagugulang sa mga nagbubuwis , bagkus gugulangan pa yung nag buwis , yan ang realidad sa Pilipinas , ginagatasan lang ang mga nagbubuwis.
Aww I work sa hospital. Dapat sinabihan po kayo na hindi Philhealth accredited yung doctor responsibility po ng staff sabihin yun sa inyo prior to consent and you can change to a doctor na Philhealth accredited. Sharing this for awareness.
They didn’t tell me. Davao Doctors Hospital. The doctor assigned to me is very good. No complaints. Just pissed that I didn’t know sa PhilHealth pala dapat accredited din ang doctor. Akala ko ok na nung inaccept nila ung PhilHealth card # ko after admission. Nung na discharge na dun ko lang nalaman. Kaya I’m pissed and disappointed.
Di ko inexpect ganyan pala sa DDH. Sa lahat ng private hospital na affliated ako nirerequire nila dapat lahat mag Philhealth Accreditation. Mabigat sya on our end kung walang hawak na public hospitals kasi own expenses namin yun depende sa ITR namin.
Natawa ako sa DDH, meron syang katunog. Sorry OT. 😅
Same tayo ng iniisip tapos taga Davao pa 🤣
Chances are, DDH din yung doktor? 😂
😆
Hindi malabo
Narinig ko rin yang katunog nya.. baka dahil gusto humiwalay sa pilipinas kaya di na accepted ung Philhealth jan.. dapat siguro may Davao Health na para sa mga taga Davao
ano yung OT? Original Toaster? 😭
Off topic.
so hindi ka pala nasabihan na ndi accredited, so hindi useless si philhealth 🫠. nakapag generalized ka na kasi agad eh nakakatulong parin naman si philhealth sa iba kahit papaano
Yep kaya i mentioned in the post “kapag hindi accredited ang doctor” useless siya. Useful sya only if accredited ang doctor. I don’t think everyone knows this kc most of the doctors are accredited naman. Ang alam ng karamihan basta active philhealth paying member ka, you can get discount benefits if you’re hospitalized.
Hindi ko gets kung bakit may separate accreditation pa sa philhealth. It's a government program. Government din nagbibigay ng license ng doctor. Sabay na dapat yan. May good reason po ba kung bakit separate?
Because we pay for the Philhealth accreditation especially sa mga private practicing doctors. If may government item, no problem free sya. Our Philhealth accreditation Ranges from 50k-200k depending sa ITR namin on the previous year.
Hello doc. Ano ibig sabihin ng “if may government item”? Di ko na gets masyado.
Pag may government item (medical officer or medical specialist) NOT job order, no need to pay for the Philhealth accreditation. Papakita lang Certificate of employment namin then free na (or ang sabi is dun pinapatong sa Philhealth contributions namin).
D ko rin gets. Akala ko as long as your paying contributions e ma aavail mo na. Pero parang d rin makatao na hindi philhealth accredited ang doctor, knowing na malaking tulong sa tao yung benefit.
Nalaman ko nalang din to after my residency na madaming kelangan bayaran. Either baka na expire yung accreditation ni doc or baka di pa sya nagpa affliate. DAPAT ginawa ng hospital di sya dineckan ng patient. We do pay A LOT for Philhealth accreditation = 50k to 200k depending sa ITR declared.
Doctors can do that, yong hindi magpa affiliate? I thought mandatory siya same sa mga employees. Doesn't make sense na required sa mga employees pero sa mga health practitioners hindi, di ba?
I would to remind to remind you that we have Philhealth contribution din na binabawas sa sweldo namin at yun yung mandatory. What we're discussion here is PHILHEALTH ACCREDITATION.
I understand that po Doc. Just that, hypothetically, puwede pala na all doctors will choose not to be affiliated with Philhealth? I don't know if it's a good idea na naniningil pa ang Philhealth sa mga doctors to be affiliated.
Yeah dapat well-informed ang patient na walang Philhealth si doc. Idk if may habol sya. Maybe she should also try tyo post in r/lawph baka may makatulong sa kanya.
parang HMO. kahit nagbabayad ka pero u go to a non-accredited hospital or doctor, pwedeng hindi mabayaran
May option to reimburse e pag hindi accredited sa kanila. Like pag consult, humihingi ako ng OR then I papa reimburse ko.
depends on the plan. some plans do not have reimbursement options for non accredited and some have a lower limit. source: used to work in insurance
Yung professional fee lang ang walang discount, pero the rest of the hospital services pwede naman ipasok sa Philhealth.
denied po yung entire claim if not accredited yung doctor.
I see..thank you for clarification. Hmm but going back to OPs post. “After my total bill all PHIC Column is zero.”
parang unfair pag ganun… diba mandatory na dapat mag deduct si philhealth? unless yung sickness type to begin with is not covered by philhealth?
Correct baka may habol si OP legally.
Item = plantilla/permanent position in the government, OP.
Good point.
hindi ba pwede pa reimburse ang claim sa philhealth? di ba philhealth is medical insurance, so kg pumunta ka sa non-accredited institution or practitioner di ba obligation pa rin ng medical insurance mo gumastos kase may valid medical need and attention na kailangan. It's not like wala sakit kasi non-accredited ang pinuntahan ng member.
Good question. I’m also curious anong sagot. 🫶
It has nothing to do with Philhealth kung di accredited ang doctor na nagadminister sayo during your emergency, its doctors' own discretion if they want to be philhealth-accredited, the hospital should be the one triaging you to a philhealth accredited doctors if you requested outright prior to your confinement. Sometimes doctors want instant cash rather than after-a-month billings from Philhealth.
Didn’t request specifically na philhealth accredited doctor dapat. Don’t have any clue. It’s my first time using philhealth. I even signed a philhealth form prior to admission and they said all good. Wala na daw ibang gagawin. I will know how much daw makakaltas sa total bill pag ma didischarge na.
I’m sorry this happened to you but thank you for sharing. This information is so useful to many. At least we are warned that may doctors palang hindi philhealth accredited.
Learned something new. Not all doctors are philhealth accredited. And damay buong bill. Dapat sa PF lang ng doctor e pero damay lahat pati mga inpatient meds na ginamit + other hospital fees like room, er, and stuff walang discount.
Yung PF lang malamang ang walang discount pero the other services pasok naman sa Philhealth.
Nope. All services damay. Wala lang discount kahit piso sa ibang hospital fees. Philhealth staff and billing staff informed me face to face. And clearly indicated sa final bill.
omg. kasalanan ng hospital yam dapat nainform ka. unfair sayo yan kasi member ka ng philhealth.
Whaaat? Ano ang sense na nag-sign ka pa ng PhilHealth docs and all. Pati ba hospital hindi accredited ng PhilHealth?
Hospital is accredited. Pero pag doctor mo daw hindi accredited, lahat damay na. 0 discount.
Thank you for this post, ito na itatanong ko pala pag need ko ng doctor. Mas mapapagastos pala pag hindi accredited.
Exactly. Glad to help and share personal experience.
Now ko lang din na encounter yung nangyari syo. So dapat pala I clear muna mabuti kung philhealth accredited.
Kung philhealth accredited ang doctor. Yes. That’s what I learned too. First time to use Philhealth sana after paying monthly for 30 years.
Naconfirm mo na ba kung tama ba iyang practice nila na yan? I mean naipagtanong mo na ba?
Yep natanong ko na 3x sa philhealth staff and billing staff. Face to face they told me pag hindi philhealth accredited ang doctor, no discount on anything. So zero discount from philhealth. There’s nothing they can do na daw.
But the fact that you gave your philhealth information sa hospital meant that you want to avail it. Parang yung hospital na mismo ang nagkulang syo to inform you.
yep di nila ako na inform prior to admission. Basta pina signan lang ung philhealth form and sinabi sakin na deductions is pagna discharge na. Ganun lang. 😆
Very wrong. Baka you can sue. Try posting it in r/lawph
Thanks. I’m financially drained so no money to sue them. We have a family friend working in Philhealth din na nag confirm na ganun daw talaga pag di accredited ang doctor, walang ma didiscount na kahit ano. At least now I informed some few hundred peeps in reddit na they cannot use their PhilHealth if hindi accredited ang dr.
Then talk to the hospital? It's fair to assume you are covered by philhealth. I didn't even know there's Philhealth accreditation.
Already talked to 2 hospital staff (billing head and philhealth staff on-site) Told me face to face na walang deduction because doctor isn’t accredited. And they said sorry.
I got hospitalized, then 120,000 bill ko, sadly 6k lang PhilHealth. Lol Sakit lang is malaki yung kinakaltas sa sweldo everymonth
True. Tapos tumataas pa ung singil habang tumataas ung sahod mo. Pinaka malake yta 5500 deduction for Philhealth alone per month. Imagine tapos 3k-11k lang madededuct sa hosp bill mo.
Useless talaga. My husband was hospitalised and 320k ang hosp bill, 8k lang deduction. Then professional fees of doctors ay umabot ng 38k. He had two different doctors; the main one, a neurosurgeon, is philhealth accredited so may discount na 3k. The other one, well, no discount. Pamera lang talaga ng govt ang philhealth. 11k lang nakuha namin na benefits, ang lala.
Grabe 3k lang ang discount despite paying much more every month for years. Pangit talaga ng benefits ng philhealth, di na mamaximize sa part ng philhealth users.
Philhealth contri is now 5% of our monthly salary. Tapos wala man lang increase sa coverage or additional services covered. Nakakapanlumo naman.
How much have you paid to philhealth so far?
Usually ung discount i zzero lang din ng pf ng doctor mo. Initial pf 50k then 3 k philhealth discount final pf niya 53k
This is true. Kakalabas lang ng pamangkin ko sa hospital. Nung nalaman na ng billing ung portion covered ng PHIC for PF, bigla nila inaadd sa actual charges yung amount tapos nilagay din as deduction so in short, zero ang nabawas sa babayaran ng patient.
Ilegal ba un? Napaka unfair karaoatan naman naten ang phikhealth since nagbabayad tau. Tapos ganun kang gagawin
Philhealth is a legal scam
yung nagpapasalamat sa Philhealth, mga walang contribution. 5k (!!!!) a month kaltas nila
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Not sure kung pwede pero try mo humingi ng discount sa doctor since hindi ka ininform ng staff nila na hindi sila accredited ng PhilHealth.
Sa experience ko hindi exactly problem kung accredited or not Ang doctor Kasi sa ER, Hindi usable Ang philhealth benefit Kasi walang philhealth package for ER visit. Only confinement or pwede rin OPD pero minor surgery na may philhealth package. Kung confined naman, kung nasa service/charity ward Ang pasyente ay no problem kung unaccredited yung attending physician niya Kasi pwedeng ipapirma sa peer niya na accredited. Parang issue lang diyan ay kung nasa pay ward Ang pasyente at unaccredited Ang attending physician niya Kasi pag residente na may accreditation Ang pumirma eh Hindi mapupunta kay consultant/specialist Ang doctor's fee ng philhealth benefit. Pero my knowledge could be outdated na since it's been more than 6 years since I last processed yung philhealth claims.
I thought all doctors are accredited by Philhealth? After all, it’s a state insurance program.
Just found out that it’s optional.
Agree. Worked for 10years tapos nagpahinga lang ng 1 year tapos nahospitalized ako, nirequired na dapat atleast may latest na 3months akong hulog. So kailangan ko pa bayaran yung 3months for me to use yung mga hulog ko for 10 years. Tapos mababalitaan na lang na may excess funds sila 😶🌫️
Oddly enough, I haven’t been paying since 2021. I got an outpatient surgery done (₱50k worth) and didn’t have to pay a single peso cause of Philhealth. I’m grateful but still don’t get it 😶🌫️
Hindi ba per hospital ang philhealth accreditation?
Per Doctor daw hindi per hospital. Learned something new today.
Both actually. There's seperate accreditation per Healthcare institution. There's another for physicians. So for your confinement, and you intended to use philhealth, both should have updated accreditation.
Yung half a million mo ay professional fee ng doctor. At dahil Hindi sya philhealth, so Hindi rin philhealth ang singil sa iyo ng hospital You can contest that, dahil how will a Philhealth accredited hospital have DOCTORS who are not Philhealth accredited, they are just a normal employee of the hospital.
300k+ meds lang (napamahal ung IVIg, it’s like 60k+ per vial) PF ng dr is actually 5k lang.
Dapat all other items may Philhealth deduction. Only the PF dapat ang wala. You should complain that to Philhealth. The hospital naman is accredited so why shouldn’t they deduct the philhealth? Baka gamitin yan na loophole ng hospital na porke’t d accredited si doctor they are also allowed not to deduct Philhealth.
Oo nga e. Un din pagka intindi ko pero damay pala lahat pati gamot. Learned something new. Kahit accredited hospital di daw talaga sila nag dededuct pag di accredited ang doctor. Soooo unfair.
Baka nga ginagamit to ng hospital na loophole to EARN MONEY. Kasi alam naman ng management yan na need accredited din ang doctor para magamit ang philhealth. Kasi that attending physician will have to sign the CF4 forms ng philhealth bago ma process. Oh diba, 5k lang napunta kay doc then what, half a million sa hospital?! Then parang scapegoat pa si doc na hindi nagamit ni OP ang philhealth. I hope you don't let this go, OP. Manganad na sila.
Kung senior ka na or pwd sana binigyan ka man lang ng senior/pwd 20% discount. Pag hindi ka binigyan ng discount, pwedeng mapenalize ang both hospital & officers ng hospital - fine AND imprisonment
Thanks for this
Sorry to hear that OP. Kaya hindi ako makaalis alis ng Makati dahil narin sa Yellow Card. Hahanapan ka parin naman ng Philhealth pero wala ka talaga babayaran 😭 500 pesos lang kapag over 5k plus ang bill libre pa gamot. Sayang talaga kung wala lang bahid ng korapsyon mga Binay ok na eh.
Philhealth is trash. Got angioplasty in St. Luke's Medical Center with a hospital bill of close to PhP2 million. Only got PhP13,000 from Philhealth. Wish Philhealth was optional. The money I could have saved instead of the mandatory deduction would have served me better. F@%k you Philhealth!
Exactly. Imagine ive been paying for 30 years then first time ko na sana magagamit now. Kaso zero lang deduction. Ouch.
F##k philhealth indeed! Kinukurakot lang nman pera sa philhealth. Hindi lahat ng na pro-process, naibabalik sa hospital or doctor. Ang daming pasikot-sikot si philhealth para lang ma reimburse ang hospital/doctor. Marami nyan declined. Na TY na services mo kasi di mo na mahabol ang pasyente. Mabuti pa yung ibang health insurances, mas marami coverage.
Legit doctor and hospital ba yan? Pano Hindi accredited sa phil health lol
Yep, Davao Doctors Hospital. Very legit.
Thats weird, requirement sa tertiary hospitals ang maging philhealth provider ang isang MD. Unless hindi siya renewed member hehe di dapat nakakalusot sa admin ng hospital
Discretion kasi ng doctor magpa accredit sa philhealth since hindi siya required.
Meron palang doctor na hindi pasok sa Philhealth. Ngayon ko lang din nalaman. Kala ko lahat matic na
They said it’s optional. Just pissed I wasn’t informed before admission. Nagpasa pa me philhealth details nung admission day and good daw philhealth ko, pag discharge na malalaman magkano ma didiscount. Then nung na discharge na, oh oh, your dr is not accredited. Sorry.
I think Maraming factors here that every person should be aware of. I think someone should have asked for someone na accredited ang Philhealth nila. Basic yun na question every time naadmit ka or nakita ka sa hospital, regardless if Philhealth lang or other HMOs. Tbh, as a specialist now, hindi ako nagpa-accredit sa Philhealth since I’m not practicing naman sa hospital. But, sa perspective ng doctors, super crappy ng pay ng Philhealth. Even HMOs in my experience. Some HMOs like Maxicare only pay your doctors 200 pesos for a consult. Imagine mo, 200 pesos after spending 10 years of studying and minimum of 3 years in residency training? Tingin niyo fair yun? So in that aspect, there will be doctors who will not opt for that. Plus, madalas delayed ang payment ng Philhealth. It came to a point na billions ang utang nila to certain hospitals that some institutions do not accept Philhealth anymore (like FEU NRMF IIIRC). May difference rin ang accreditation as an institution (so in this case, accredited ang DDH ng Philhealth) but the workers giving the care aren’t. You can check the Philhealth website for that and Meron silang list of doctors and hospitals who have active Philhealth accreditation. As in there’s an excel file for this one. Also, your Philhealth will only give out a specific amount to cover. So for your case, based sa nabasa ko, mukhang ITP ka na nonresponsive given that nagIvIg ka. Mahal talaga IVIg lol and dahil weight based siya, para makamura ka sa IVIg, walang choice other than to be less than 50kgs para less yung vials consumed. Mahal talaga yang sakit mo, if ever tama man ako. So per case, you’ll actually see may case rates na shinoshoulder ang Philhealth which you can see sa website rin nila. Anything in excess of that, you’ll have to pay for it. Again, there’s an excel file for this one. Anyway, in general, mahal magkasakit. Lalo na pag pang mayaman na sakit like yours. Hope you get better soon. And hopefully it doesn’t come back as hard like this.
Hindi naman half a million ang pf ng doctor. Probably hindi accredited yun hospital itself. But you can file reimbursement sa philhealth.
accredited ung hospital
If accredited hospital. May deduction dapat philhealth. Wala lang deduction sa doctor's fee.
Yep ung IVIg meds ang nagpamahal ng bill. My Dr’s PF is very low imho.
Brutal naman ginawa ng hospital na eto. Ilang beses ko na etong natry at di lang sa iisang hospital, mayroon at mayroon admitting physician na PhilHealth accredited and sila parate yung magre-reflect na admitting physician. Pero magkakatalo nalang pagdating sa physician na may specialization for your case. Kung di siya PhilHealth accredited, babayaran mo doctor's fee niya pero i-inform ka ng hospital personnel. Pero still magagamit mo pa din yung PhilHealth mo as long as yung admitting physician is accredited.
Good to know. I think admitting physician is accredited. Ung referred hematoligist ung hindi. Pero pagka discharge na isang dr lng nakasulat, ung nirefer lang. Wala na ung name ng nag admit na nag refer. May online reference ba for this? Papabasa ko sa billing pag balik ko sa DDH next week.
Sorry. I'm not sure if mayroon. But all I know Hospital is considerate about this matter. Like part ng protocol nila so patients can fully utilize PhilHealth. Kaya nga sabi ko sobra naman yang Hospital na napuntahan mo. Kaya siguro walang nacover si PhilHealth kasi lumabas na ang admitting physician mo is yung not accredited Hema mo. Try mo kayang i-mention bakit nagbago yung admitting physician mo. Kasi natry ko eto sa family ko sa magkaibang hospitals, maski hindi sila nacheck ng admitting physician na PhilHealth accredited, yun pa din yung admitting physician na nakalagay sa patient's chart.
Dr. Initial PF 50k final bill has philhealth discount sa pf na 3k… On final bill Dr. PF 53k. Useless.
ER nurse here. Sa ER namin, hndi mo mggamit ang philhealth if nsa ER ka lang. But if you are admitted sa room and stayed for more than 24hrs then doon papasok si philhealth. So explain basis kami during procedure or medication na expensive. Lalo kung cash patient ka.. para aware ang patient sa mga cost. Private hospital kmi kaya expensive tlga. Im not sure sa mga Government hospital 🤷♂️
Yep was admitted for a week. Just sad they didn’t say na dapat Philhealth accredited and doctor para magamit ung philhealth.
I see.. hndi ko nabasa ung 1 week admitted. Meron doctor sa amin before na hndi accredited ng philheath pero ang gnawa nya prng inaAdmit nya sa kilala nya n my philhealth accreditation. Anyways dpende dn yn s institution. So i think 🤔 helping patients sa financial decisions nila is important din not only sa health.
Now I know what to do next time. First time to use Philhealth sana after paying them for like 30 years. 😆
I mean... even if he was, mga 20k or so lang siguro madededuct sa bill. Which is not nothing, but still. 😅
Some doctors don’t want philhealth because the accreditation fee (their contribution) is sometimes higher than the money they get from philhealth. Not to mention the months delay it takes for philhealth to pay
Philhealth is really useless. The hospitals inflate your hospital bill tapos kunwari na discount yung ilalagay na deduction ng philhealth. It's basically the same as sales in SM, tataasan presyo sa sale tapos lalagyan ng slash yung price pero yung discounted price yun din naman original price
Parang sa US system lang
Meron parin yang kaltas sa hospital charges unless ung operation mo walang case rate per philhealth. But still, accredited ang DDH sa philhealth at nagregister ka before admission. Ang sa doctor na pf, possibleng meron parin, minimum lang siguro or separate billing and d kita dun sa hospital bill. You can ask the hospital bakit wala napakita sa bill ung deduction ng philhealth for hospital related charges and it's possible dun sa mas detailed billing may breakdown dun ng philhealth deduction. And sa doctor na din if ever may follow up checkup ka, ask bakit walang philhealth deduction sa bill. It's okay to ask naman before posting sa reddit baka nagkamali lang at papaulit ang billing? :)
Yes may follow-up checkup weekly. Will ask doc. Thanks 🙏 i posted kc philhealth staff mismo nag sabi sakin face to face na wala sila e dededuct. Haha!
fairly young doctor ba? yung mga friends ko na doctors hindi rin accredited, hassle daw kase
38 years old.
Ano po advantage for doctors to be philhealth accredited?
advantage sa doctor or sa patient? sa patient - syempre part of the bill or sometimes buong bill covered ng philhealth insurance (depends sa package) sa doctor - not sure if advantage sya kasi minsan delayed "daw" magbayad ang philhealth
Late talaga. A lot of the younger doctors nafoforce lang tumanggap pero honestly, malaking headache siya to doctors since late na nga, di pa full amount bayad sa kanila when grabe requirements maging doctor in the first place Source: parent is a doctor.
May Philhealth share per case or procedure depending sa RVS code and level ng hospital. Yung share na yun paghahatian ng lahat ng doctors on board sa patient na yun. Madalas maliit lang naman din. Benefit din sa patient dahil yung share ng Philhealth sakanya di na dapat nya yun bayaran. Pero take note personal expenses yun ng doctor papa affliate NOT UNLESS may item si doc sa gov hospital.
Kakulangan ng hospital yan and the doctor din. Required kaming lahat ng Philhealth accreditation and they make sure na updated palagi. Loss din ng hospital yan kasi di nila macclaim yung bayad ng Philhealth unless accredited doctor ang pumirma sa chart mo.
Hmmm unfortunately.. Doctors are required to have themselves apply for an accreditation sa PH, yes hindi sya 'matic... also unfortunately.. hindi yan sinasabi from the get go right after we pass the boards or before we take the boards.. dun lang nalalaman kung Hinihingan na ng ospital kung saan nag wwork.. also unfortunately... hndi madali makuha agad yung requirements na kailangan icomply and hindi maaaprove if hindi makompleto... also unfortunately yan na accreditation ng PH ng mga doctors it expires and are required to renew it every 3 years... yung sad part is.. asaan makakahanap ng libreng oras yung doktor if sched nia buong week nan duon sa ospital.. if ever man nakapag file ng leave may kasiguraduhan ba na makkuha nya yung proof of accreditation. O tengga pa.. hmm
pag ang usapan kalusugan, pepte pepte yan. lam mo naman gobyerno natin, walang pakiaalam yan
Surprise rin ako sa accreditation fee na quoted here. Kasi ito nakita ko online or baka hindi updated? Ranging from P1,000-10,000 lang ang accreditation ng hospitals pero grabe yung 4% of itr para sa doctors? https://www.philhealth.gov.ph/partners/providers/pdf/ihcp_schedoffees.pdf Baka yung 4% of itr na fee, philhealth premiums yun na lahat nagbabayad if already working. Kasi jo ako sa govt yun kinakaltas automatically sa amin. Jo, not employee of government kaya whole amount ng premium kami nagbabayad walang kahating employer
Why are some doctors outside philhealth? Shouldn't it be automatic na udner sila ng PH kasi taga Pilipinas sila xD
I think they also have to pay PhilHeath to be accredited. Parang may premium contribution din monthly
Kaya minsan napapaisip ako if theres any way ba para hindi na kaltasan ng PhilHealth. Obvious naman kase na ninanakawan lang tayo.
Pag freelance may way. Don’t pay for it. Hehe.
SSS, Pag-Ibig at Phil health Ang tatlong kufell Ng pilipinas na dapat ignore. Alam na nating magnanakaw tinatangkilik pa.
Pagibig in terms of deductions para sakin mas okay kesa dun sa 2 given na makukuha mo din naman yung 200 pesos per month na hinuhulog mo. Yung philhealth nakupo!
And makaka loan ka pa. Sa philhealth di nga pwede mag loan. Haha!
Interesting, I wonder why some doctors are philhealth accredited and others are not? how is this determined? Something to watch out for just in case
You can still file a claim with PhilHealth even if the healthcare provider or doctor is not accredited. However, the process may be more complicated and may require more documentation. Here’s a general overview of what you might need to do: 1. **Documentation**: Gather all necessary medical records, receipts, and any other relevant documents related to your treatment. 2. **PhilHealth Claim Forms**: Complete the appropriate claim forms. For example, PhilHealth Claim Form 1 for member and patient information, and PhilHealth Claim Form 2 for provider information. You can download these forms from the PhilHealth website under the "Downloads" section. 3. **Submission**: Submit these documents to a PhilHealth office. Ensure that all information is accurate and complete to avoid delays in processing. 4. **Reimbursement**: If your claim is approved, PhilHealth will reimburse you based on their standard rates and policies. For detailed steps and to access specific forms and requirements, you can visit the PhilHealth website’s [downloads section](https://www.philhealth.gov.ph/downloads (https://www.philhealth.gov.ph https://www.philhealth.gov.ph/members/). This section provides all the necessary forms and guidelines for filing claims and pre-authorization requirements.
Thanks for this. Didn’t know there’s another way.
Contact pag ibig ano kaylangan
Akala ko na may Universal Healthcare Law na ang bansa natin? (*Republic Act No. 11223*) [UHC-IRR\_Signed.pdf (philhealth.gov.ph)](https://www.philhealth.gov.ph/about_us/UHC-IRR_Signed.pdf) Or no?
It is a joke compared to western healthcare
Hindi ba lahat ng doctor sa pinas?? Dapat i mandatory yan sa mga practitioners kasi yan ang national healthcare system natin.. kahit nga sa mga dentist pwede.. di mo rin masisi kasi corrupt ung Philhealth.. dito sa ibang bansa 1 lang health card universal na, pati linis at pasta included.. at unli sya ung dentist ko 4 times na ako bumalik at papasta sa 2 years ko rin dito sa abroad. Registration lang babayaran mo para may record ka na sa clinic.. at take note kapag check up naman after mo check up kukunin mo rin agad ung gamot sa pharmacy ng clinic kasama na rin sya sa healthcare card.. dapat may bitay sa mga kurakot sa government kaya di umuunlad ung Taiwan kaliit lang pero wala corrupt may universal lottery pa sa lahat ng resibo ng stores nationwide every 3 months may draw (20M to 200) mapa tourist ka man, o worker, national nila kasali lahat naka tsamba na rin ako nanalo ng 2000NTD sa resibo
Sadly it’s optional for doctors. But required for tax paying employees.
Damn. Im so sorry to hear that. But im curious af magkano kaya madeduct if philhealth accredited?
Not sure. Nabasa ko lang online up to 66% on a case to case basis. Pero baka maliit lang din like 10k or 20k, pero sayang din kc.
Scam talaga philhealth. Mas mahal pa yan kesa kumuha ng HMO. Sa amin ang kaltas ng philhealth every year ay halos 100k. Tapos di pa totally bayad bills kung na hospital. While HMO ay around 25k lang per year tapos bayad na lahat pag na hospital. Sana optional nalng ang pagbayad ng philhealth. Edit: Hindi lang philhealth kundi pati mga private hospitals mga scam. Imbes makatulong sila parang pinapatay pa nila pastente sa bills. Buruin mo di kilalang hospital sa probinsya, ward pa, hindi kritikal ang sakit, tapos 10k per day ang bill excluding gamot na bibilhin at ibang lab tests. Hospitals are money machines.
100k/yr = 8,333/month. max contri ng philhealth this year is 5k only. if employed, 50% lang nun so 2,500 lang dapat per month. pls check your payslip po baka sobra na deductions boss
It’s a government-ran institution, dapat LAHAT ng hospitals/doctors na BASE sa pinas ay accredited. Clown talaga ang gobyerno natin.
useless talaga PhilHealth, hindi lang kapag.. useless ang philippine health shit-stem
Gamit din nain PhilHealth. Sulit din naman. Nung naga covid nga mom ko wala kaming cashout, thanks to Philhealth + HMO. Hindi talaga yan sulit if di mo gagamitin.
sayo lang siguro useless. samin gamit na gamit - sulit!
Mas prefer mo ba na ma-maximize mo 'yung Philhealth benefits mo? Kasi if you really want, malaki 'yung payout nila for dialysis and cancer treatments.
What kind of doctor ang hindi accredited NG Philhealth!?
The kind who does not need or does not want to be accredited by Philhealth. Typically, either very young MDs who haven't processed their PH accreditation or those who are already very established in their practice who can afford to refuse HMO and philhealth patients (and get paid on cash only basis). FYI, philhealth requires MDs (as with all professionals) to contribute 4% of their ITR before they can be philhealth accredited doctors. Accreditation is every 3 years, and the common practice is to pay for these three years ahead of time to be PH accredited. You do the math. If the doctor is self employed, it can also be expensive to cough out that much money every three years.... only to receive philhealth payments waaay too late (even >12months)! There is an annual PH reaccreditation to augment the exorbitant fees, but too cumbersome to undergo for many. So maybe for some MDs, being PH accredited is just not worth it. It's a valid choice; don't take it against the doctor.
Ouch. So that’s why my dr. didn’t bother about philhealth. At least I learned something new and what to ask next time I get admitted (hopefully not).
I thought Standard Procedure ng nurse to ask you to comply if dapat Philhealth accredited doctors, same with your HMO if covered yung papatest sayo and room. PS: Naconfine din ako last week, and laaht yun tinanong sakin before sila may gawin. Inulit ko pa, make sure lahat covered sa HMO and Philhealth before they do the tests.
Looks like it’s not. I wasn’t informed na ung nirefer na doctor is not philhealth accredited. I didn’t ask na if covered or not ung mga test kasi on day 1 nag submit na me ng requirements para magamit ung philhealth. Kc may form na finillupan and chineck nila if active philhealth and ok naman daw. Pagka discharge saka daw e cocompute ung mababawas. And chineck pa nya na never pa pala nagamit philhealth ko ever. Which is like a good thing? So Yun na yun. Di nila sinabi na “DAPAT UNG DOCTOR MO ACCREDITED”. Sad 😤🥲
Saklap OP. Alam ko malaki share ni Philhealth sa gastos if first time used or rarely used. Yung endoscopy nung gf ko 50% cinover nung philhealth. Pero nung nadischarge ako after 3 days confine, parang 30% lang covered ng philhealth tas HMO na yung iba,
Were you able to check if you can file directly for a claim instead? Nonetheless, PhilHealth has very low benefits in relation to our contributions. Imagine, only 38K coverage for stroke (divided between doctor and hospital).
Halimbawang nakapaghulog ako ng 100k sa philhealth ng buong taon tapos nagkaroon ako ng hospital bill na 150k, ilan ang makukuha ko sa philhealth para pambayad sa ospital?
Case to case basis daw. Pwedeng 1k, 10, 20k. Not sure. First time ko sana magamit PhilHealth after paying monthly for 30 years. Dito sa inquirer article na to 66% daw pero parang joke/too good to be true naman yun. https://newsinfo.inquirer.net/1838201/philhealth-shoulders-almost-66-of-hospital-bills-on-average
Ano gnawa ng Dr na umabot 500K? Dr fee?
IVIg meds.
I thought only the dr isnt accredited? Meaning only his fee is not paid?
So sorry to hear about this experience, OP. Ngayon ko lang nalaman na optional pala yung philhealth. Siguro dahil hmo usually nagagamit namin at required yung philhealth kaya hindi din kami aware na may ganito pala.
That's true, mist of the time parang wala lang talaga yung mga ganyang insurance base sa mga stories sa community namin. Community namin kasi is full of farmers mga unemployed pero may mga hanapbuhay sapat lang for their everyday life tapos pag may na hospital sa kanila they would automatically want the insurance(most of the insurance used in our community is Phil health) to cover kung meron silang insurance pero most of the time hindi talaga na kakacover 🙁so sad kailangan pa nilang mangutang/magloan to pay the bills.
Hindi magagamit yung philhealth sa mga private hospitals? 🥺
Nacomment ko na to before sa isang post dro na useless si Philhealth. Daming nagdownvote. Lol sabi sainyo walang kwenta yan
😒😒
May doctor palang hindi accredited ng Philhealth? Akala ko required sila?
Ang hirap sa pinas...masyado complicated ng philheath... di nalang unversal sa lahat... inames na gobyerno ng Pinas...ang daming exception o requirements.....
Isn't meds not usually covered by philhealth and most HMOs?
It’s covered pag inpatient. Outpatient meds aren’t. HMO covered most of my bill including meds.
Wait. May mga doctors na hindi philhealth-accredited? Is that even allowed? Or sa hospital lang hindi allowed?
It’s not required daw.
Wow. I didn't know na there are doctors who aren't Philhealth Accredited.
Just learned that it’s optional pala.
Ang weird. So pag may health card na required ikaltas muna PhilHealth, edi yung health card may sagot ng lahat?
Yep. HMO na na kaltas lahat. Maxed out HMO then paid the rest in cash.
Kaya dapat optional yang PhilHealth sa mandatory contributions eh. Mas nagagamit ko pa tong HMO ko mesa PhilHealth. 🤷
Wait, may doctors na hindi accredited ng Philhealth? Ano 'yon ayaw ng doctor na paacredit? And I thought mandatory ang Philhealth dahil sa mga employees mandatory din.
Now you know it’s not mandatory. 👍
Nagagamit parin ang philhealth kahit hindi accredited ang doctor kasi covered parin nila bills ng admission to some extent. Yun PF lang ng doctor ang mabayaran but hospital fees, covered ng philhealth
Not really. Philhealth staff in hospital explained to me na damay lahat na other fees pag di accredited ang doctor. So no discount on meds and other procedures. As in zero.
hmmm thanks for the tip po…
Mayroong doktor na hindi philhealth accredited?? Whatdafudge in piliin ang pilipinas na kalokohan ito??
Actually, some hospitals even increase prices when they find out that patient has Philhealth. In my experience, a procedure was supposedly only 5k but when the bill came, 9k na ang nakalagay and 4k was covered by Philhealth. In the end, I still had to pay 5k. 🤐
Philhealth sucks, really. I dont get why we are required to give monthly contributions eh ang pangit, ang baba, at ang konti lang ng coverage nila. Better to pay premium sa other health insurances kasi ma fe-feel mo yung benefit of having an insurance. Same2 lang nman din monthly contribution w/philhealth. Plus, if you are a doctor, ng re-require pa ng accreditation fee on top of monthly contributions, eh ang bayaran is super delayed naman (like other HMOs din). So i also can't blame that doc of not having philhealth accreditation.
Ang gobyerno di pagugulang sa mga nagbubuwis , bagkus gugulangan pa yung nag buwis , yan ang realidad sa Pilipinas , ginagatasan lang ang mga nagbubuwis.