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GUIDELINES ON THE PROPER ACCOMPLISHMENT OF PHILOMATH CLAIM FORM 2 (November 2013) I. General Guidelines applicable to all Claim Forms: 1. Claim Form 2 (CF2) shall be accomplished and submitted for

How to fill out philhealth claim form 2

How to fill out PhilHealth claim form 2:

1. Obtain the PhilHealth claim form 2 from any PhilHealth office or download it from their official website.
2. Fill out the patient's information section, including their PhilHealth identification number, full name, address, and date of birth.
3. Provide the specific details of the illness or injury being claimed by indicating the diagnosis, date of onset, and the attending physician's name and license number.
4. Specify the hospitals, clinics, or healthcare facilities where the patient received treatment for the claimed illness or injury. Include the names, addresses, and PhilHealth identification numbers of these facilities.
5. Indicate the duration of confinement or outpatient treatment, providing the exact dates of admission and discharge or consultation.
6. Fill out the schedule of benefit payment section, specifying the total amount claimed, any deductions or adjustments, and the net amount payable to the healthcare facility or the patient.
7. If the patient is the PhilHealth member, sign the patient's signature portion. If someone else is authorizing the claim on behalf of the patient, that person should sign the appropriate part.
8. Prepare any necessary supporting documents such as medical certificates, hospital bills, receipts, and other relevant records to be attached to the claim form.
9. Double-check all the information provided and ensure that it is accurate and complete. Make photocopies of the filled-out form and the supporting documents for personal records.
10. Submit the completed PhilHealth claim form 2, along with the supporting documents, to the designated PhilHealth office or any accredited healthcare facility for processing.

Who needs PhilHealth claim form 2:

1. Individuals who are PhilHealth members and have received medical treatment or undergone hospitalization for a specific illness or injury.
2. Patients who have sought medical assistance from healthcare facilities that are accredited and recognized by PhilHealth.
3. Individuals who wish to claim reimbursement for their medical expenses covered by PhilHealth or have their benefits directly assigned to the healthcare facility.

Note: The specific requirements and procedures for using PhilHealth claim form 2 may vary, so it is advisable to consult the official PhilHealth website or contact their customer service for the most accurate and up-to-date information.

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What is philhealth claim form 2?

PhilHealth Claim Form 2 is a document used to file for reimbursement of medical expenses covered by PhilHealth.

Who is required to file philhealth claim form 2?

All PhilHealth members who have incurred medical expenses covered by PhilHealth are required to file PhilHealth Claim Form 2.

How to fill out philhealth claim form 2?

To fill out PhilHealth Claim Form 2, provide all necessary information such as personal details, medical expenses incurred, and supporting documents.

What is the purpose of philhealth claim form 2?

The purpose of PhilHealth Claim Form 2 is to request reimbursement for medical expenses covered by PhilHealth.

What information must be reported on philhealth claim form 2?

Information such as patient's details, attending physician, medical expenses incurred, and supporting documents must be reported on PhilHealth Claim Form 2.