PhilHealth Annex G.2B: Checklist of Requirements for Reimbursement Using APD - Pediatric
Fill PhilHealth Annex G.2B: Checklist of Requirements for Reimbursement Using APD - Pediatric online and download the official form as a PDF, ready to print. Every input is mapped to its printed box, so IDs, dates and amounts land digit by digit in the right cells, and a value the form cannot hold is refused with the reason instead of being printed wrong.
What you will need: Case No, 1. Last Name, First Name, Suffix, Middle Name, 2. PhilHealth ID Number, Same as, B. Photocopy of the completely accomplished Checklist of Eligibility, C. Photocopy of completely accomplished Member Empowerment, C. Accomplished Checklist of Requirements for Reimbursement, D. Accomplished Checklist of List of Essential Health Services Using, E. Original or Certified true copy (CTC) of the Statement of Account, Date Completed (mm/dd/yyyy), Date Filed (mm/dd/yyyy), Certified correct by:*.
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