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    Mel PDF

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    Reslyn Yanoc
    The document is a certificate from the Philippine Health Insurance Corporation (PhilHealth) certifying that Jick Rubio Mellendez and his dependent Jade Boca Mellendez are eligible for PhilHealth benefits. It provides details of the member and patient, including names, dates of birth, sex, and hospital information. It confirms that the patient is eligible to avail of PhilHealth benefits for a hospital admission at Bindoy District Hospital from March 13 to March 17, 2017 under the member's individual paying category.

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    Mel PDF

    Uploaded by

    Reslyn Yanoc
    132 views1 page
    The document is a certificate from the Philippine Health Insurance Corporation (PhilHealth) certifying that Jick Rubio Mellendez and his dependent Jade Boca Mellendez are eligible for PhilHealth benefits. It provides details of the member and patient, including names, dates of birth, sex, and hospital information. It confirms that the patient is eligible to avail of PhilHealth benefits for a hospital admission at Bindoy District Hospital from March 13 to March 17, 2017 under the member's individual paying category.

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    The document is a certificate from the Philippine Health Insurance Corporation (PhilHealth) certifying that Jick Rubio Mellendez and his dependent Jade Boca Mellendez are eligible for PhilHealth benefits. It provides details of the member and patient, including names, dates of birth, sex, and hospital information. It confirms that the patient is eligible to avail of PhilHealth benefits for a hospital admission at Bindoy District Hospital from March 13 to March 17, 2017 under the member's individual paying category.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    132 views1 page

    Mel PDF

    Uploaded by

    Reslyn Yanoc
    The document is a certificate from the Philippine Health Insurance Corporation (PhilHealth) certifying that Jick Rubio Mellendez and his dependent Jade Boca Mellendez are eligible for PhilHealth benefits. It provides details of the member and patient, including names, dates of birth, sex, and hospital information. It confirms that the patient is eligible to avail of PhilHealth benefits for a hospital admission at Bindoy District Hospital from March 13 to March 17, 2017 under the member's individual paying category.

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    Republic of the Philippines

    PHILIPPINE HEALTH INSURANCE CORPORATION


    Citystate Centre Building, 709 Shaw Boulevard, Pasig City
    Healthline: 441-7444 Website: www.philhealth.gov.ph

    Date & Time of Generation : MARCH 17, 2017 01:03:49


    HCI Portal Reference No. : BEF100000018707626
    _________________________________________________________________________________
    HEALTH CARE INSTITUTION (HCI) INFORMATION
    Name of Institution : BINDOY DISTRICT HOSPITAL
    Accreditation No. : H07012682
    _________________________________________________________________________________
    MEMBER INFORMATION
    PhilHealth Identification No. : 120255487103
    Name of Member : MELLENDEZ , JICK RUBIO
    Sex : MALE
    Date of Birth : DECEMBER 02, 1971
    Member Category : INDIVIDUALLY PAYING
    _________________________________________________________________________________
    PATIENT INFORMATION
    Name of Patient : MELLENDEZ , JADE BOCA
    Date Admitted : MARCH 13, 2017
    Date Discharged : MARCH 17, 2017
    Sex : MALE
    Date of Birth : NOVEMBER 18, 2014
    _________________________________________________________________________________
    ELIGIBILITY INFORMATION
    ELIGIBLE TO AVAIL PHILHEALTH BENEFITS? = YES

    Reason/s: undefined
    _________________________________________________________________________________
    Attached Documents:
    N/A
    _________________________________________________________________________________
    Important Reminders:
    1. Generation and printing of this form is FREE for all PhilHealth Beneficiaries.
    2. This form shall be submitted along with the required PhilHealth claims forms and is valid only for the confinement/admission stated above.
    3. This does not include eligibility to the rule of SINGLE PERIOD OF CONFINEMENT(SPC). It shall be established when the claim is processed by PhilHealth.
    Non-qualification to the rule on SPCshall result to denial of this claim.
    _________________________________________________________________________________

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