ROJ Life Moment Learning: PHIC – Computation of Professional Fees for Physicians’ Inpatient Visits

ROJ Life Moment Learning: PHIC – Computation of Professional Fees for Physicians’ Inpatient Visits

by Reynaldo O Joson on Sunday, July 3, 2011 at 3:52pm

ROJ Life Moment Learnings (LML)

 

ROJ Life Moment Learning: PHIC – Computation of Professional Fees for Physicians’ Inpatient Visits

 

Moment: June 26, 2011;  Manila Doctors Hospital

 

Circumstances: Mother PJoson confined at Manila Doctors Hospital; had PhilHealth benefits c/o sister MJoson; had 3 physicians who are accredited with PhilHealth and whom I wanted to get their share of the professional fee benefit from PhilHealth as they did NOT bill my mother.

 

Learning 1: The computation of the share of the professional fee benefit from PhilHealth shall consider both the daily inpatient visit rate and the maximum allowance or ceiling per confinement.

 

 

In Mother PJoson’s case, P500 per visit and maximum allowance or ceiling is P2000.

 

My mother was confined for 8 days.

 

Initially, I did the following computation: P500 x 8 days = P4,000 for each physician. Since the ceiling is P2000, I thought, each of the three (3) accredited physicians should receive P2000 each.  I was wrong.  I learned the right thing after discussing with the PhilHealth section of the hospital.

 

The P2000  was distributed among the three physicians.  Thus, each physician was credited with P666.66  (P2000 ÷ 3 = P666.66).

 

Learning 2: The maximum allowance or ceiling on the professional fees shall be distributed among all the PhilHealth – accredited physicians attending to an inpatient.  One distribution approach is to divide the ceiling amount by the number of physicians.  Or, there can an arrangement among the attending physicians on how much will be their share each.

Advertisements
This entry was posted in Hospitals. Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s