PhilHealth Requirements

How to Accomplish PhilHealth Requirements

Eligible PhilHealth members can make use of their benefits in certain procedures and surgeries at MyHealth Clinic as long as the patient has submitted complete PhilHealth requirements at least two (2) days before their scheduled procedure. 

STEP 1: Accomplish one (1) printed copy each of the following documents:

  1. Properly accomplished Original Claim Form 1 (CF1)
    a. Part I, II, III – Member/Patient Information
    b. 
    Part IV – Employer Certification (if applicable)

  2. Properly accomplished Original Claim Signature Form (CSF)
    a. Part I, III – Member/Patient Information
    b. Part IV – Employer Certification (if applicable)

  3. Updated Member Data Record (MDR)

  4. Certificate of PhilHealth Contribution (for Employed) or Official Receipt of Premium Payment (for Individually Paying or Self-Employed)

  5. Proof of dependency and properly accomplished Original PhilHealth Membership Registration Form (PMRF) (for undeclared dependents)

STEP 2: Submit all the documents to the Operating Room staff at least two (2) days before your scheduled procedure or surgery.

You may do one of the following submission processes:

  • Go to the clinic branch and submit the printed documents to the Operating Room staff; or
  • Email a scanned copy of your printed documents to the clinic branch’s Operating Room staff (see their email addresses below), then make sure to bring and submit the hard copy of your documents on the day of your procedure/surgery.


    Festival Mall Alabang – alabangor@myhealth.ph
    Robinsons Place Manila – robmanilaor@myhealth.ph
    Shangri-La Plaza Mall – shangrilaor@myhealth.ph
    SM North EDSA – smnorthor@myhealth.ph

REMINDERS:
  • A patient with incomplete PhilHealth requirements on the day of the procedure/surgery will be asked to reschedule and complete the requirements first if they want to make use of their PhilHealth benefits. Otherwise, the patient shall pay the full amount without PhilHealth deductions should they still wish to proceed. 
  • All documents must be signed by hand. E-signatures will not be accepted.
  • For those emailing their requirements prior to their scheduled procedure/surgery, make sure that (1) the scanned documents are signed by hand, and (2) you bring the printed (hard copy) documents on the day of your procedure/surgery. 
  • FOR PATIENTS WITH HMO ACCOUNTS: A Letter of Authorization (LOA) will be issued if the procedure is covered by the HMO account.
  • FOR PATIENTS WITHOUT HMO ACCOUNTS / PRIVATE PAYING PATIENTS: Patients will discuss with the attending physician for co-payment of their Professional Fees on top of PhilHealth coverage.

Download the PhilHealth Forms

Click the buttons below to download the PhilHealth Forms.