Evaluation of PhilHealth Eligibility for In-Patients and Out-Patients | APMC (unofficial RE:GOV concept) · RE:GOV

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GOVPH · Republic of the Philippines

Evaluation of PhilHealth Eligibility for In-Patients and Out-Patients

Office: Amai Pakpak Medical Center
Classification: Simple
Who may apply: All Patients or Authorized Representatives
Total fees: None
Total processing time: 11 Minutes

In-patients and out-patients get their PhilHealth eligibility checked and issued a benefit eligibility form.

At a glance

Requirement	Where to get it
Member's Data Record	Philhealth Main Office PRO BARMM
Philhealth ID	Philhealth Main Office PRO BARMM
PhilHealth Benefit and Eligibility Form (PBEF)	Billing and Claims Section

What you do	What the office does	Fee	Time
Authorized Representative approach the Billing / PhilHealth Evaluator window and present the patient's MDR / Philhealth ID.	Receive the Philhealth documents from the Authorized Representative, if any. If not a PhilHealth member, proceed to the Medical Social Service for Point of Service application. (Administrative Officer Billing and Claims)	None	2 Minutes
	Check the eligibility of the patient to avail of PhilHealth benefits using the SEGHIS. (Administrative Officer Billing and Claims)	None	2 Minutes
Receive the printed PhilHealth Benefit Eligibility Form (PBEF)	Print a copy of the generated PBEF/Portal to be presented upon discharge. (Administrative Officer Billing and Claims)	None	5 Minutes
	If not eligible due to errors, inconsistencies and deficiencies, advise the patient/ watcher on what to do to correct / complete the records / requirements. (Administrative Officer Billing and Claims)	None	2 Minutes