Guide on PhilHealth Outpatient Blood Transfusion Benefit Coverage & Claims
PHILHEALTH OUTPATIENT BLOOD TRANSFUSION – Here are some details about the case rate and coverage of this PhilHealth benefit.
Millions of Pinoys in the country are PhilHealth members. PhilHealth or the Philippine Health Insurance Corporation is a state-run health insurance institution that offers both inpatient and outpatient benefits for its members with updated accounts.
One of the outpatient benefits offered by the health insurance agency is the PhilHealth Outpatient Blood Transfusion. Under it, the case rate is Php 3,640.00 (one or more units) and it is inclusive of drugs and medicine, x-ray, laboratory, operating room charges, and others.
According to PhilHealth, there is no limit to the number of bags as long as one day of transfusion is equivalent to one session. There is a 45-day limit set by the health insurance institution and one session for each transfusion is equivalent to one day deduction from the 45 days allowable days per year.
How to Process your Claim for PhilHealth Assistance?
- Step 1 – There are documents that you need to prepare and it is a case-to-case basis depending on the type of benefit you need to claim (inpatient, outpatient, or Z benefits). In the case of claiming a PhilHealth Inpatient Benefits, you should prepare the following:
- Step 2 – Present your document to the billing office of the accredited hospital or Health Care Institution (HCI) where you got confined or operated. The case rate amount will be deducted by the HCI from your total bill. The deduction includes both the case rate and the charges or professional fees of the attending physician(s).
- Step 3 – Pay for the remaining hospital bill.
It is important to keep your PhilHealth account updated to secure a turn to in times of medical emergencies and even on non-emergency situations relating to health. It does not only benefit the account holder but as well as the beneficiaries – the spouse, children, parents of the account owner.
You can apply for PhilHealth membership online. To check on the online application process, you may visit – How To Apply for PhilHealth Membership Online & the Requirements to Submit.
