PHIC PHILHEALTH CIRCULAR NO. 36, S. 2010, December 30, 2010

[ PHIC PHILHEALTH CIRCULAR NO. 36, S. 2010, December 30, 2010 ]

CLARIFICATION TO PHILHEALTH CIRCULAR 16, S. 2009

Taking into consideration the basis of disallowing claims for vitrectomy procedure after cataract surgery, the Corporation hereby clarifies Section D, Item No. 3b of PhilHealth Circular 16, series of 2009 as follows:

A claim for vitrectomy procedure performed within 90 days from date of discharge for a cataract surgery shall be disallowed payment. For example:

Date of Cataract Surgery

Date of Vitrectomy

Claim of Vitrectomy

July 1, 2011

August 6, 2011

Denied

July 1, 2011

November 5, 2011

Paid

Vitrectomy done during the same confinement period shall also be disallowed.

All other issuances not inconsistent with the provisions of this issuance shall remain in full force and effect.

This Circular shall take effect fifteen (15) days after its publication in the Official Gazette or in a newspaper of general circulation.

Adopted: 30 December 2010

(SGD.) DR. REY B. AQUINO President and CEO