[ PHILHEALTH CIRCULAR NO. 03, S. 2011, February 17, 2011 ]
AMENDMENT TO PHILHEALTH CIRCULAR NO. 12, S. 2010 (ENHANCED PHILHEALTH CLAIM FORMS)
In line with PhilHealth Circular No. 25, s. 2010 also known as the Nine (9) Months Contribution as a Requirement for Benefit Availment, amendments are hereby issued for certain provisions of the Enhanced Claim Form 1 and its implementing guidelines under PhilHealth Circular No. 12, s. 2010.
I. CLAIM FORM I - PART II (EMPLOYER S CERTIFICATION)
Item number four (4) of the Employer s Certification (Annex A* ) shall be amended as follows:
II. IMPLEMENTING GUIDELINES ON THE PROPER ACCOMPLISHMENT OF REVISED PHILHEALTH CLAIM I
The certification of employer portion (Annex B* ) shall be amended as follows:
This Circular shall take effect for all claims with admission dates starting July 1, 2011.
All other provisions of previous issuances that are not inconsistent with any provisions of this Circular remain in full force and effect.
(SGD.) DR. REY B. AQUINO
President and CEO
* Text Available at Office of the National Administrative Register, U.P. Law Complex, Diliman, Quezon City.
I. CLAIM FORM I - PART II (EMPLOYER S CERTIFICATION)
Item number four (4) of the Employer s Certification (Annex A* ) shall be amended as follows:
This is to certify that all monthly premium contributions for and in behalf of the member while employed in this company, including the applicable nine (9) monthly premium contributions within the past twelve (12) months period prior to the first day of this confinement, have been deducted/collected and remitted to PhilHealth, and that the information supplied by the member of his/her representative on Part I are consistent with our available records.
II. IMPLEMENTING GUIDELINES ON THE PROPER ACCOMPLISHMENT OF REVISED PHILHEALTH CLAIM I
The certification of employer portion (Annex B* ) shall be amended as follows:
The employer of his/her authorized representative shall affix his/her signature certifying that all monthly premium contributions for and in behalf of the member, while employed in their company, including the applicable nine (9) monthly premium contributions have been deducted/collected and remitted to PhilHealth during the past twelve (12) month period prior to the first day of confinement and the information supplied by the member or his/her representative are consistent with their available records.
This Circular shall take effect for all claims with admission dates starting July 1, 2011.
All other provisions of previous issuances that are not inconsistent with any provisions of this Circular remain in full force and effect.
President and CEO
* Text Available at Office of the National Administrative Register, U.P. Law Complex, Diliman, Quezon City.