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    Date: 2022-10-02 17:26:29.439158

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    Date: 2022-10-03 13:51:01.849133

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    Date: 2022-10-14 11:49:52.188189

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Philhealth circular number 2020-0011 vs. Philhealth circular number 2022-0003

Requested from PH by A. Aquino at 05:26 PM on Oct 02, 2022.
Purpose: Request for assistance regarding to Appeal / Motion for reconsideration
Date of Coverage: 03/18/2020 - 03/27/2020
Tracking no: #PH-264836830268

Aquino 05:26 PM, Oct 02, 2022

Hi I would like ask for assistance regarding to our denied philhealth benefit claim as probable case of covid 19 with confinement date of March 18-27,2020 and clinically manage as covid 19.

1. As per philhealth pro ncr, our reimbursement claim is denied due to philhealth circular number 2022-0003.

2.Ano pong nangyari dun sa unang inilabas  na circular # 2020-0011 na lahat ng naconfine sa hospital with the period of Feb. 01, 2020-April 14, 2020 ay pasok sa Full Financial Risk protection against covid 19 regardless the RT Pcr result. I believed nagkaroon po ng policy gap.

Macatangay Jr. 01:51 PM, Oct 03, 2022

October 3, 2022

Dear Alfer,

Thank you for your request dated Oct 02, 2022 under Executive Order No. 2 (s. 2016) on Freedom of Information in the Executive Branch, for Philhealth circular number 2020-0011 vs. Philhealth circular number 2022-0003.

We received your request on Oct 02, 2022 and will respond on or before Oct 21, 2022 05:26:29 PM, 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://pcoomaster02202018193000-dot-efoi-ph.appspot.com/requests/aglzfmVmb2ktcGhyHAsSB0NvbnRlbnQiD1BILTI2NDgzNjgzMDI2OAw, for request with ticket number #PH-264836830268.

Thank you.

Respectfully,

Zenaida Marron
FOI Officer

Ferwelo 11:25 AM, Oct 05, 2022

October 5, 2022

Dear Alfer Aquino,

I refer to my letter of Oct 02, 2022 05:26:29 PM about your request under Executive Order No. 2 (s. 2016) on Freedom of Information in the Executive Branch, for Philhealth circular number 2020-0011 vs. Philhealth circular number 2022-0003.

In order for us to work further on your request, we need more information from you regarding your query. <Patient Name, PhilHealth Number, Confinement Period>. In particular, it would be helpful to know <Clarified details will allow us to confirm your claims further.t>. You may use the reply function on the eFOI portal at http://www.foi.gov.ph/requests/aglzfmVmb2ktcGhyHAsSB0NvbnRlbnQiD1BILTI2NDgzNjgzMDI2OAw, for request with ticket number #PH-264836830268, to respond.

During the period of us awaiting your reply, your request will be put on hold. If we do not receive a reply on or before Dec 28, 2022 03:24:41 AM, your request will be closed.

We hope to hear from you at the soonest possible time.

Thank you.

Respectfully,

Patrick Collen Ferwelo
FOI Officer

Aquino 04:15 PM, Oct 05, 2022

Hi Madam/Sir,

Please see below details for your reference.

Philhealth Number:03-026101832-9
Estrella Soledad Aquino
Sept. 23, 1966
Hospital: Capitol Medical Center
Date of confinement: March 18-27,2020.

My mother's case is covid 19 probable case with severe pneumonia and clinically manage as covid 19 kaya po sobrang laki ng hospital bill namin. And philhealth announce sa public and news na lahat ng naconfine ng Feb. 01, 2020-April 14, 2020 ay pasok sa Full Financial Risk protection against covid 19 regardless the RT Pcr result as long as clinically manage as covid 19 and almost 2 yrs kaming nag hintay sa philhealth reimbursement claim and until this August 2022 lumabas yung result and only severe pneumonia case lang yung binayaran nila. Ang reason is dahil daw sa philhealth circular number 2022-0003 hindi daw kasama yung mga naconfine ng Feb. 01, 2020-April 14, 2020. I believe nag Karoon ng policy gap o nabalewa yung ni labas nilang philhealth circular number 2020-0011. Sana po ay matulungan nyo kami for appeal, motion for reconsideration. Thank you.

Aquino 02:00 PM, Oct 07, 2022

As the moment po may on-going appeal letter na po kami sa philhealth, seeking for your kindest assistance na makarating sa tamang kinauukulan yung policy gap na concern po kung kayat hindi po nila naibigay sa amin yung philhealth benefit na full financial protection risk against covid 19.

Aquino 10:04 AM, Oct 10, 2022

Sana po matulungan nyo kami na maresolve yung policy gap ng philhealth upang makuwa namn yung philhealth benefit claim po namn. Thank you

Ferwelo 10:48 AM, Oct 10, 2022

October 10, 2022

Dear Alfer Aquino,

Thank you for your response dated <Oct 5, 2022>, with regard to my letter regarding clarifying your request on Philhealth circular number 2020-0011 vs. Philhealth circular number 2022-0003, dated Oct 05, 2022 11:25 AM.

We have now continued processing your request. Kindly give us until Oct 21, 2022 05:26 PM to respond regarding our findings.

Should you have any questions regarding your request, kindly contact me using the reply function on the eFOI portal at https://realinagencies11072018-dot-efoi-ph.appspot.com/requests/aglzfmVmb2ktcGhyHAsSB0NvbnRlbnQiD1BILTI2NDgzNjgzMDI2OAw, for request with ticket number #PH-264836830268.

Thank you.

Respectfully,

Patrick Collen Ferwelo
FOI Officer

Ferwelo 11:49 AM, Oct 14, 2022

October 14, 2022

Dear Alfer Aquino,

Greetings!

Thank you for your request dated Oct 02, 2022, 05:26:29 PM under Executive Order No. 2 (s. 2016) on Freedom of Information in the Executive Branch.

Your Request

You asked for Philhealth circular number 2020-0011 vs. Philhealth circular number 2022-0003.

Response to Request

Your FOI request is approved. I enclose a copy of [sall] of the information you requested.

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).

Please be guided that the purpose of the information/data being requested should be solely used for the intent stated in your request.

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

Attachments:
 1410202211432500211.pdf

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