PhilHealth Annex A 2: Preauthorization Checklist -Rectal CA
Fill PhilHealth Annex A 2: Preauthorization Checklist -Rectal CA 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, Last Name, First Name, Suffix, Middle Name, PhilHealth ID Number, Fulfilled selections criteria, If no, specify reason/s, Biopsy proven tissue diagnosis of rectal cancer, No evidence of systemic metastasis from chest x-ray and abdominal ultrasound or, No previous pelvic radiation, cecum, ascending colon, hepatic flexure, transverse colon.
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