Wednesday, April 25, 2012
Sunday, April 22, 2012
Glossary of PhilHealth forms and download links
Membership
PMRF: PhilHealth Member Registration Form - Download
Claims
Claim Form 1: Member and Patient Information - Download
Claim Form 2: Provider Information - Download
Claim Form 3: Patient's Clinical Record - Download
Employers
ER1: Employer Data Record - Download
ER2: Report of Employee-Members - Download
ER3: Employer Data Amendment Form - Download
RF1: Employer's Remittance Report - Download
Accreditation
Institutional
IAF: Institutional Accreditation Form - Download
MMHR: Monthly Mandatory Hospital Report - Download
SOI: Statement of Intent for Hospital, ASC and FSDC - Download
SOI: Statement of Intent for OPB, MCP and DOTS Providers - Download
Professional
PAF: Professionals Accreditation Form with Warranties for Accreditation and Checklist of Requirements - Download
Collecting Agents
CAAF: Collecting Agents Accreditation Form - Download
Payment
PPPS: PhilHealth Premium Payment Slip - Download
eClaims
HCPAP: Health Care Provider Account Profile application form - Download
Reference: http://www.philhealth.gov.ph/downloads/
PMRF: PhilHealth Member Registration Form - Download
Claims
Claim Form 1: Member and Patient Information - Download
Claim Form 2: Provider Information - Download
Claim Form 3: Patient's Clinical Record - Download
Employers
ER1: Employer Data Record - Download
ER2: Report of Employee-Members - Download
ER3: Employer Data Amendment Form - Download
RF1: Employer's Remittance Report - Download
Accreditation
Institutional
IAF: Institutional Accreditation Form - Download
MMHR: Monthly Mandatory Hospital Report - Download
SOI: Statement of Intent for Hospital, ASC and FSDC - Download
SOI: Statement of Intent for OPB, MCP and DOTS Providers - Download
Professional
PAF: Professionals Accreditation Form with Warranties for Accreditation and Checklist of Requirements - Download
Collecting Agents
CAAF: Collecting Agents Accreditation Form - Download
Payment
PPPS: PhilHealth Premium Payment Slip - Download
eClaims
HCPAP: Health Care Provider Account Profile application form - Download
Reference: http://www.philhealth.gov.ph/downloads/