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RNG Bank Salary Loan Table for DepEd Teachers

Salary Loan Table - RNG Coastal Bank RNG Bank offers salary loan for permanent DepEd teaching and non-teaching staff thru Automatic Payroll Deduction System (APDS). Features: 📍LOW INTEREST RATE 📍LOAN AMOUNT UP TO 500,000 📍5 YEARS MAXIMUM LOAN TERM 📍NO HIDDEN CHARGES 📍NO NEED TO GO TO THE OFFICE A Bank that is built with trust and integrity and committed to provide quality and safe banking services to its existing and future clients, RNG Coastal Bank, Inc . is a banking institution established in the year 1974. The Bank has 15 operating branches in the Visayas, 11 in Cebu and 4 in Bohol. Providing various financial products and services to its clients for almost 50 years, RNG Coastal Bank remains strong and continuously grows its number of branches to reach more Filipinos. Here are the branches of RNG Coastal Bank: RNG Coastal Bank Head Office Cor. Cabancalan Road, Talamban, Cebu City 6000 Labangon Branch Punta Princesa, (Labangon) Cebu City Asturias Branch Poblacion, Asturias, Ce...
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Understanding PhilHealth's Claims Filing and Payment Policies: A Comprehensive Guide

PhilHealth, the national health insurance provider in the Philippines, ensures that accredited healthcare facilities (HFs) strictly follow guidelines when filing and processing claims. This article provides a detailed breakdown of the claims filing, evaluation, and payment procedures, especially focusing on pneumonia high-risk cases.

📄 Claims Filing Guidelines

  1. Compliance with Policies and Proper Documentation

    • Accredited HFs must adhere strictly to current PhilHealth policies.
    • Proper ICD coding of the primary diagnosis and/or procedures is required.
    • Submission of properly accomplished claim forms (CFs), Statement of Account (SOA), and other supporting documents is mandatory.

  2. Radiographic Results for Pneumonia High-Risk

    • For pneumonia high-risk claims, a patient's radiographic results must be attached to the claim forms.
    • Repeat radiographic results should also be included if necessary.

  3. Compliance with Relevant Laws

    • HFs must comply with relevant laws such as:
      • RA No. 9994 (Expanded Senior Citizens Act of 2010)
      • RA No. 10754 (Benefits and Privileges of Persons with Disability)
      • RA No. 11463 (Malasakit Centers Act of 2019)
    • Mandatory discounts (senior citizens, PWDs) should be deducted first from the total hospital bill before applying benefits from private insurance, HMOs, or employee benefits.

  4. Case Rate Limitations

    • Case rates for pneumonia high-risk cannot be claimed as a “second” case rate.

  5. Indicating Out-of-Pocket (OOP) and Co-Payment

    • Proper indication of the member's OOP and/or co-payment must be reflected in Claim Form 2 (CF2) and the SOA.

  6. Filing Period for Claims

    • All claims should be filed within 60 calendar days.
    • Direct filing by members/beneficiaries is discouraged.

  7. Late Filing Exceptions

    • Delays due to natural calamities or fortuitous events may be excused under PhilHealth’s existing guidelines.

  8. Appeals and Motion for Reconsideration

    • Accredited HFs may file a motion for reconsideration (MR) or appeal denied claims, following PhilHealth’s existing policies.

  9. Claims for Confinement Abroad

    • Claims for confinements abroad will be paid based on the remaining balance after other funding sources, but not exceeding published case rates.

💸 Claims Evaluation and Payment Process

  1. Case-Based Payment Mechanism

    • PhilHealth reimburses HFs based on case rates for pneumonia high-risk using a case-based provider payment mechanism.
    • SOA amounts below or above the published rates are not interpreted as over or underpayment.

  2. Billing Audit and Compliance

    • PhilHealth reserves the right to conduct audits before and/or after payments to verify compliance.

  3. Return to Hospital (RTH) Policy

    • Claims with incomplete requirements, discrepancies, or errors in claim forms will be returned to the hospital for compliance.

  4. Referral Package for Transferred Patients

    • HFs that transfer high-risk pneumonia patients for further management may receive Php 4,000 under the Referral Package as per PhilHealth Circular No. 0035, s. 2013.

🏥 Special Cases and Reimbursement Rates

  1. Level 1 HFs and GIDA Areas

    • Accredited Level 1 HFs, including those in geographically isolated and disadvantaged areas (GIDA), may claim Php 32,000 for pneumonia high-risk cases based on clinical diagnosis.

  2. Primary Care Facilities and Infirmaries

    • These facilities may claim Php 15,000 for moderate to high-risk pneumonia cases.

  3. Claims for Less Than 24-Hour Length of Stay (LOS) Due to Death

    • Php 4,000 may be claimed for high-risk pneumonia cases with LOS of less than 24 hours due to patient death.

  4. Claims for LOS of More Than 24 Hours Before Death

    • Claims with a final disposition of "died" with LOS beyond 24 hours but not exceeding two days are reimbursed at Php 32,000.

  5. Non-Reimbursement for Short LOS and Improved Disposition

    • Claims with LOS of 2 days or less with a patient disposition of “improved” will not be reimbursed.

✅ Key Takeaways

  • Accredited HFs must comply with PhilHealth’s strict documentation, filing, and payment guidelines.
  • Proper filing and accurate coding are essential to avoid delays or claim denials.
  • PhilHealth encourages HFs to establish a system for timely referrals and proper documentation to ensure quality healthcare services and smooth claims processing.

Following these guidelines ensures that HFs receive appropriate reimbursement and that patients receive the benefits they are entitled to under the PhilHealth system.

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