PhilHealth

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  • REQUEST SUBMITTED

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    Date: 2022-11-23 08:01:01.382180

  • PROCESSING REQUEST

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    Date: 2022-11-23 11:09:03.003844

  • REQUEST SUCCESSFUL

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    Date: 2023-03-13 09:31:48.616952

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Decined Reimbursement benefit claim due to Policy gap of Philhealth circular number 2020-0011

Requested from PH by A. Aquino at 08:01 AM on Nov 23, 2022.
Purpose: For Immediate action/result please.
Date of Coverage: 03/18/2020 - 03/27/2020
Tracking no: #PH-535235690767

Aquino 08:01 AM, Nov 23, 2022

Hi I would like to request for kind assistance regarding to our declined philhealth reimbursement benefit claim under Covid 19 probable case.
Our Philhealth benefit reimbursement claim is subject for processing to final appeal, as per PRO NCR Motion for Reconsideration Unit our documents is already transmitted to Process Appeals and Review Department last November 4,2022 but i called PARD as per them and data base wala pa daw silang narereceive its been 2 weeks na po since na natransmit yung documents. 
Philhealth number:03-026101832-9
Estrella Soledad Aquino
Confinement date:03/18-27/2020

Aquino 08:28 AM, Nov 23, 2022

Declined Reimbursement benefit claim due to Policy gap of Philhealth circular number 2020-0011

Macatangay Jr. 11:09 AM, Nov 23, 2022

November 23, 2022

Dear Alfer,

Thank you for your request dated Nov 23, 2022 under Executive Order No. 2 (s. 2016) on Freedom of Information in the Executive Branch, for Decined Reimbursement benefit claim due to Policy  gap of  Philhealth circular number 2020-0011.

We received your request on Nov 23, 2022 and will respond on or before Dec 14, 2022 08:01:01 AM, in accordance with the Executive Order's implementing rules and regulations.

Should you have any questions regarding your request, kindly contact me using the reply function on the eFOI portal at https://www.foi.gov.ph/requests/aglzfmVmb2ktcGhyHAsSB0NvbnRlbnQiD1BILTUzNTIzNTY5MDc2Nww, for request with ticket number #PH-535235690767.

Thank you.

Respectfully,

Zenaida Marron
FOI Officer

Ferwelo 09:35 AM, Dec 14, 2022

December 14, 2022

Dear Alfer Aquino,

I refer to my letter of Nov 23, 2022 08:01:01 AM; about your request under Executive Order No. 2 (s. 2016) on Freedom of Information in the Executive Branch, for Decined Reimbursement benefit claim due to Policy  gap of  Philhealth circular number 2020-0011.

Our response to your request is due on Dec 14, 2022 08:01:01 AM. Unfortunately, it is taking longer than expected to deal with your request because <information/data being requested still in the processing unit>.

I apologize for this delay but have applied for an extension so we could work further on your request. We hope to be able to send you a response on or before Jan 11, 2023 08:01:01 AM.

Should you have any questions regarding your request, kindly contact me using the reply function on the eFOI portal at https://foipmo01032020174159-dot-efoi-ph.appspot.com/requests/aglzfmVmb2ktcGhyHAsSB0NvbnRlbnQiD1BILTUzNTIzNTY5MDc2Nww, for request with ticket number #PH-535235690767.

Thank you.

Respectfully,

Patrick Collen Ferwelo
FOI Officer

Aquino 07:17 PM, Jan 06, 2023

Good day Ma'am/Sir, I hope that you can really help us to get the philhealth reimbursement benefit claims regarding to our concern of policy gap to philhealth circular number 2020-0011(Full Financial protection risk against covid 19 for all filipino). We're already submitted all the necessary documents and i believe na di namn kami magkakaroon ng high hospital bill kung di kami natagged as probable case ng covid 19 which is sabi ng philhealth is covered nila. Hoping for a good result on or before Jan. 11, 2023 as you promised. Thank you for your assistance.

Aquino 07:25 PM, Jan 06, 2023

Please see attached the philhealth circular number 2020-0011 policy regarding to our appeal bali nawala po itong policy na ito vs. Sa paglabas ng philhealth policy number 2022-0003 na sinasabi nilang nagkaroon ng policy gap na which is hindi po dapat  si patient or member ang nag sa suffer given namn po yung all valid and legit documents namin. Thanks.

Aquino 07:47 AM, Jan 12, 2023

Good day! A gentle follow up please. Thanks.

Ferwelo 09:31 AM, Mar 13, 2023

March 13, 2023

Dear Alfer Aquino,

Greetings!

Thank you for your request dated Nov 23, 2022, 08:01:01 AM under Executive Order No. 2 (s. 2016) on Freedom of Information in the Executive Branch.

Your Request

You asked for a Decined Reimbursement benefit claim due to the Policy gap of  Philhealth circular number 2020-0011.

Response to Request

As per the Protest and Appeals Review Department (PARD), the appeal claim filed had already been resolved as of January 31, 2022.

Your right to request a review

If you are unhappy with this response to your FOI request, you may ask us to carry out an internal review of the response by writing to <ATTY.ELI DINO SANTOS - OIC, President and Chief Executive Officer (OIC-PCEO), nrsantiago@philhealth.gov.ph, or privacy.dpo@philhealth.gov.ph>. 

Your review request should explain why you are dissatisfied with this response and should be made within 15 calendar days from the date when you received this letter. We will complete the review and tell you the result within 30 calendar days from the date when we receive your review request.

If you are not satisfied with the result of the review, you then have the right to appeal to the Office of the President under Administrative Order No. 22 (s. 2011).

Help us also improve our services by answering a quick survey at https://tinyurl.com/FOI-Request-Feedback.

Thank you.

Respectfully,

Patrick Collen Ferwelo
FOI Receiving Officer

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