| GENERAL INFORMATION |
|
- The hospital’s
policies and procedures will be explained to you
briefly by our
--information assistant
to make your stay with us as convenient as possible.
- Philhealth forms
1, 2 and 3 will be given to you to accomplish during
your stay in
the hospital.
- Please accomplish
your Philhealth benefit requirements while still
in the hospital
not when you are going home already
to avoid inconvenience.
- During your stay
with us you will be given a regular update of your
hospital bill
for your perusal.
|
GUIDELINES FOR EMERGENCY CASES |
|
If a call for reservation
is made, room reservation will be kept for two to
three
hours only.
While the patient is
in the emergency room, the companion is requested
to go to
the Admitting section for the following:
|
a. Make a choice
of Room Accommodation (depending on availability).
b. Provide the admitting assistant the patient’s
pertinent information for
proper
documentation and recording
|
| _(1)
CORPORATE or HMO |
- Company/HMO/SSS/GSIS/OWWA
Member/Dependent/Pensioner, etc.
- Please present a Letter of Authority from the
Company/HMO or a
membership/company identification
card for emergency admission
|
| _(2)
PERSONAL |
- Cash or Credit
Card
- An initial payment is required which is relative
to room of choice as well
as the case of admission.
|
| GUIDELINES FOR NON-EMERGENCY
CASES |
| I. PRE-ADMISSION
|
a. Room Reservation
|
- You may call
the hospital information assistant for your
room reservation before coming for admission.
Reservations can only be kept overnight prior
to admission. Please advise the exact date of
your arrival at the hospital.
- Inquiries regarding room rates and amenities
will be gladly entertained.
|
b. You may
call our Hospital Information Assistant at (6332)
232-2437 or
233-8620
locals 100, 107 or 150.
|
| __(1)
CORPORATE or HMO |
- Availment
of Health Insurance Benefits
|
Our
Hospital Information Assistant can give you information
on what documents to prepare if your hospital
expenses are taken cared of by your Health Insurance,
by a Company, by Philhealth (Medicare).
|
The
hospital will bill your insurance company directly.
We will bill you for any hospital fees not covered
by your insurance or by your company or by Philhealth.
|
| __(2)
PERSONAL – Cash or Credit Card |
- We will
be asking for an initial payment which is relative
to the case and
room availed of.
|
| TIPS
FOR A HASSLE-FREE DISCHARGE |
_1.
The doctor gives you the order to go home. Before
going down to the Billing
Section, please
verify first from the Nurses’ Station if the
following have been
submitted to the
Billing Section: |
-
Notice of Discharge
- Professional Fee/s of your Doctor/s
- Philhealth Forms 2 and 3 (if patient has Medicare)
duly signed by
--the Attending Physician
or Resident
- Photocopy of Surgical techniques or Operating
Room Records
(if applicable)
- Labor Record and OB History (if applicable)
- If unused medicines and supplies have been returned
so that they will be not be included
in the computation of the final hospital bill
|
_2.
If the above documents have been submitted to the
Billing Section you may
go down to the Philhealth
Assistance Counter found inside the hospital
Business Office and
submit your Philhealth Form 1 (if not yet submitted)
for
evaluation and computation
of the amount of benefit you can avail of.
_3. Go to the Billing
Counter for your final Hospital Billing Statement.
_4. Proceed to Cashier
for payment. Always ask for an Official Receipt and
count your change before
leaving the counter.
_5. You will be given
2 copies of Discharge Slip. Please give one (1) copy
to the
Nurses’ Station
and the other (1) copy to the security guard. |
| WHAT ARE YOUR POSSIBLE
BENEFITS? |
|
_1.
For Currently Employed Member:
The original
and properly accomplished Form 1 is sufficient.
If in case the
Certification
of Employer is not properly accomplished due to
separation
from employment,
but contribution is still qualified for the confinement
period, submit
RF-1 and ME-5 and/or applicable receipts of at least
six (6)
months prior
to admission. See below for the additional requirements.
|
_2.
Beneficiary/Hospital representative to attach the
following supporting
document/s for: |
a.)
Individually paying (voluntary, self-employed or OFW
members), any of the
______following: |
| -
Official Receipts of Philhealth accredited collecting
banks or |
| -
Philhealth Bank Receipts (PBR) |
| -
Duly Validated MI – 5 (Contributions Payment
Return Form) for |
| -
individually paying members starting January 2000 |
| -
Official Receipts issued by Philhealth (for over the
counter payments) |
| b.)
SSS/GSIS Retirees, any of the following: |
| -
SSS PRINT OUT – DDR |
| -
Retirement Certificate issued by GSIS |
| -
Insert GSIS process |
| c.)
AFP/PNP Retirees, any of the following: |
| -
General or Special Orders |
| -
Certification of 120 monthly Medicare/NHIP contributions
from |
| GSIS
or from previous employer |
| -
Service Record |
| d.)
Retired Judges, any of the following: |
| -
Certificate of Retirement from the Office of the Court
Administration |
| (OCA)
|
| -
Certification of 120 monthly Medicare/NHIP contributions
from the |
| GSIS
or from the employer |
| -
Service Record |
| e.)
SSS Partial Disability Pensioner – certificate
from SSS indicating coverage/ |
| period
of pension |
| Note:
For disability and survivorship pensioner after March
4, 1995 is no |
| longer
compensable. |
| f.)
Dependents of a, b, c, and e – approved M1b or
E1/E4 for SS members or |
| NEWBORN
- Medical Certificate |
| SPOUSE
– copy of marriage contract |
| CHILD
– copy of birth or baptismal certificate |
| -
Illegitimate/Legitimate child – birth certificate
acknowledged |
| by
the father/mother or notarized affidavit of support
|
| -
Legally adopted child – legal adoption paper
or notarized |
| affidavit
that child is legally adopted |
| -
Step-child |
| *birth
or baptismal certificate with copy of marriage contract
or |
| *affidavit
by the step-mother or step-father |
| PARENT
– affidavit of support (original or Certified
true copy) |
| g.)
OWWA member/dependent – Certified True Copy of
Medicare Eligibility |
| Certificate
(MEC) for undeclared dependents |
| SPOUSE
– authenticated photocopy of Marriage Contract
and Birth |
| Certificate |
| CHILD
– authenticated photocopy of Birth Certificate |
| PARENT
– affidavit of dependency/support and authenticated |
| photocopy
of Birth Certificate |
| *For
patients with operation/procedure performed: attached
photocopy of: |
| a.
Operating Room Record |
| b.
Surgical Technique |
| *Endoscopy
- for procedures done at bedside |
| *Colonoscopy
- photocop of nurse‘s notes or Physician’s
order |
| *For
OB patients - OB History, labor Record, POGS |
| If:
CS, additional requirements: |
| a.
Surgical technique |
| b.
Anesthesia record |
| c.
Operation record |
| Note: |
| 1.) Admission starting
May 1, 2003 , second normal delivery is compensable. |
| 2.) Admission less than
24 hours without procedure is not compensable. |
| 3.) Dependent parents
should be at least 60 years old. |
| 4.) Dependent children
should be below 21 years old. |
| LEGEND:
RF – 1 - Quarterly Remittance form |
| ME
– 5 - Contributions Payment Return form for employed
sector |
| MI
– 5 - Contributions Payment Return form for individually |
| Paying
members |
| M1b
- Membership Data Record form for individually paying |
| E1
- SSS Membership form for new member |
| E4
- SSS Member’s Data Amendment form |
| HOW TO TAKE CARE
OF YOUR BILLS THE FAST AND EASY WAY? |
| Requirements for Patient’s
to charge hospital bills to Health Maintenance |
| Orgranizations
(HMO): |
| 1.
Letter of Authorization – two (2) copies |
| a.
1 original copy |
| b.
1 duplicate/photocopy |
| 2. Insurance Claim Forms
(if required by Insurance Company) |
| 3. Philhealth Forms
1, 2 and 3 (if required by the Insurance Company) |
| ·
Philhealth Form 1 should be duly signed by the member
and employer |
| (if
employed). |
| ·
Philhealth Form 2 should be duly signed by the Attending
Physician only |
| ·
Philhealth Form 3 should be duly signed either by
the Attending Physician, |
| Resident
Doctor. (*These Forms will be given to you in the
Admitting |
| Section
upon admission.) |
| 4. Doctor’s APR
-Attending Physician’s Report (Optional) |
| 5. Clinical Abstract/Discharge
Summary (Optional) |
| 6. Other documents required
by the HMO/Insurance as stated in the Letter of |
| Authority |
| Requirements if Patient
bills is charged to a private company: |
| 1.
Letter of Authorization – two (2) copies |
| a.
1 original copy |
| b.
1 duplicate/photocopy |
| 2.
Philhealth Forms 1, 2 and 3 (if required by the Company) |
| ·
Philhealth Form 1 should be duly signed by the member
and employer |
| ·
Philhealth Form 2 should be duly signed by the Attending
Physician only |
| ·
Philhealth Form 3 should be duly signed either by
the Attending Physician, |
| Resident
Doctor or PGI. |
| (*These
Forms will be given to you in the Admitting Section
upon admission.) |
| PERPETUAL
SUCCOUR HOSPITAL SCHEDULE OF SERVICES: |
| 1. BUSINESS OFFICE DEPARTMENT
– located at the ground floor of the Main |
| Building
adjacent to the Admissions Office |
| a.
Billing Section |
| 7:00
AM to 7:00 PM (Monday to Saturday) |
| 8:00
AM to 7:00 PM (Sundays and Holidays) |
| b.
Medicare Section |
| 8:00
AM to 5:00 PM (Monday to Saturday) |
| 8:00
AM to 12:00 NN (Sundays and Holidays) |
| 1:00
PM to 5:00 PM (Sundays and Holidays) |
| c.
Cashier’s Section |
| (Main
Building) |
| 6:00
AM to 7:00 PM (Monday to Saturday) |
| 8:00
AM to 12:00 NN (Sundays and Holidays) |
| 1:00
PM to 5:00 PM (Sundays and Holidays) |
| (SPC
Medical Specialty Building) |
| 8:00
AM to 12:00 NN (Monday to Friday) |
| 1:00
PM to 5:00 PM (Monday to Friday) |
| *Payments
are accepted at the Information Counter: |
| 7:00
PM to 6:30 AM – Monday to Sunday |
| d.
Admitting/Infomation/Operator Assistance is open 24
hours daily. |
| 2. FOOD CENTERS |
| a.
Canteen – located at the back of the Main Building |
| 6:30
AM to 7:00 PM (Daily) |
| b.
Sister’s Best 1 - situated at the Main Building
across the Admistrator’s |
| Office |
| -
Open from 7:00 AM to 11:00 PM |
| -
(Except on Sundays. It closes at 3:00 PM and opens
the following |
| day
at 7:00 AM) |
| c.
Sister’s Best 2 – to be found at the 2nd
floor, SPC Medical Specialty Center |
| ____________7:00
AM to 7:00 PM – Monday to Saturday |
| 3. MEDICAL IMAGING CENTER
– situated at the ground floor of the Main Building |
|
near the elevator. |
| a.
X-ray |
| -
Service Hours: Opens 24 hours daily |
| -
Procedures: |
| A written request from
your attending physician will be asked from you. You
have |
| the option to pay in
cash or charge (company or HMO). |
| (1)
If payment is in cash: |
| ·
Pertinent information of the patient must be given. |
| ·
A charge ticket will be given to you by the receptionist
for you to present |
| to
the Cashier at the Business Office for payment. |
| ·
Present the Official Receipt to the Receptionist for
her to give you your |
| schedule
for X-ray. |
| (2) If payment is charge
to a company or an HMO |
| ·
You will be asked to proceed to the Out-Patient Department
for registration. |
| ·
Should you have registered already, the Receptionist
will give you an X-ray |
| Request
Form for you to completely fill up. |
| ·
You will then be given your schedule for X-ray. |
| All
films are kept on file in the MIC, should you want
to get the X-ray film, you |
| need to present an authorization
letter from your attending physician. |
| In
preparation, you need to remove all metallic and opaque
objects from the part |
| of the body to be X-rayed
(pins, hairpins, earrings, etc.). |
| b.
Ultrasonography Section |
| -
Service Hours: Mondays to Fridays - 7:00 am - 12nn
and |
| 2:00
pm - 4:00 pm |
| Saturdays
- 7:00 am - 12:00 nn |
| For
Emergency cases – at any day or time |
| -
Procedures : |
| Request forms are sent
immediately to the MIC department completely filled
out |
| with the pertinent information
on the patient. |
| You
will be accompanied to the Ultrasonography Unit by
a Nursing Service |
| personnel together with
your chart. |
| One
copy of the official results is attached to the chart,
while the other copy is |
| retained in the MIC
file. |
| All
procedures are paid in cash except for those who are
subsidized by their |
| respective companies.
Please note that all procedures can only be performed
when |
| the Official Receipt
is presented. |
| 4.
PULMONARY LABORATORY – can be found at the ground
floor of the main |
| building
at the corner going to the Kidney Service |
| -
Open 24 hours a day |
| -
Services are available for both in-patients and out-patients |
| 5.
CLINICAL LABORATORY – is located at the ground
floor of the Cebu Heart |
| Institute |
| -
Requests are logged in the computer or in the reception’s
logbook |
| (for
prescribed patients) |
| -
Extraction of sample then takes place per clinician’s
order |
| -
Medical Technologist goes back to the laboratory with
the specimen |
| obtained
from the patient |
| -
Specimen is delivered to the corresponding section
where the |
| requests
belong |
| -
Ordered laboratory examinations are performed properly
and |
| correspondingly |
| -
Results are released from the section and are then
forwarded to the |
| respective
nurses’ station |
| 6.
MEDICAL RECORDS - is situated at the back of the main
building and is open |
| from
Mondays thru Saturdays from 8:00 a.m. to 5:00 p.m. |
| A.
Release of Medical Records to Authorized Persons |
| -
Release of medical data/information is done by the
Medical Records |
| Clerk
under the supervision/approval of the Administrator.
Other |
| personnel
in the hospital are not authorized to release data
from the |
| patient’s
chart. |
| -
Patient waives claim to privacy when authorization
is received, signed |
| and
witnessed. |
| -
Authorization for minor or legally incompetent persons
may be signed |
| by
patients, guardian or legal representative. |
| -
An authorization for release of information especially
confidential in |
| nature
should be signed by the patient or whoever is the
responsible |
| party
when such information is to be released in the absence
of any |
| specific
law to the contrary. |
| B.
Policies for Release of Information |
| -
All requests should be written and not verbally made. |
| -
Patients who seek information on their own cases should
be referred |
| to
the attending physician. |
| -
Should a patient request for copies of laboratory,
X-ray results, etc., |
| a
written order from the attending physician must be
submitted. |
| -
No Medical staff, Residents, PGI’s are to release
medical data in |
| verbal
or written form, except when discussing the progress
to the |
| patient
with the relatives or interested party. |
| -
Visiting Physicians not affiliated with the hospital
should present |
| authorization
papers signed by the patient to secure any medical |
| record
from the Medical Records Section. |
| -
No information (e.g. lab results, etc.) shall be relayed
by the staff |
| over
the phone per the doctor’s secretary’s request. |
| -
Employers paying for their employees confined in the
hospital should |
| have
written authorization from the patient before medical
data is |
| released. |
| -
Members of the Medical Staff may not give authorization
to Insurance |
| companies
or Lawyers to secure a patient’s record. |
| -
Insurance companies must secure a written request
from the |
| attending
physician and authorization from the patient and company |
| representing
them to secure the medical records of the patient. |
| -
The hospital will not use the medical record to jeopardize
the interest |
| of
the patient except to defend itself in a court of
law. |
| -
Medical Records shall not be taken outside the hospital
except for |
| “Subpoena
Duces Tecum” or specified written authorization
of the |
| Administrator.
Consequently, all records should be kept safe in the |
| Medical
Records Section except when needed in the clinical
areas |
| -
In “Subpoena Duces Tecum” try to have the
court accept photocopy. |
| If
not, have the court issue a receipt for original copies. |
| -
The hospital’s legal representative has access
to the patient’s medical |
| record
without authorization from the patient if the patient
has |
| brought
a lawsuit against the hospital. |
| Contents
of Medical Records to be released: |
| ·
Patient’s history |
| ·
Discharge summary |
| ·
Laboratory results |
| ·
Operative/delivery record |
| ·
Except for subpoenaed charts |
| Certificates
Released by the Medical Records: |
| -
Medical Certificate |
| -
must have a written order by the attending physician; |
| -
only specified requests e.g. Medical Certificate,
Laboratory results, |
| etc.
will be given out. |
| -
Death Certificate – the relatives or the funeral
parlor will be |
| responsible
for the registration |
| -
Fetal Death Certificate |
| -
Babies whose birth weight is 500gms and above will
be given the |
| certificate |
| -
The relatives or the funeral parlor will be responsible
for the |
| registration |
| -
Live Birth Certificate |
| -
For package deal patients or those whose doctors are
holding clinics |
| at
Perpetual Succour Hospital, the certificate will be
released two |
| weeks
after discharge |
| -
For those whose doctors are not holding clinics at
Perpetual Succour |
| Hospital,
the certificate will be released two weeks to a month
after |
| discharge |
| 7.
RELIGIOUS SERVICES |
| A.
Daily Mass Schedule |
| -
Weekdays – 6:30 am |
| -
Wednesdays and Fridays - 12:15 pm |
| -
Wednesdays – 6:00 am |
| -
1st, 4th, and 5th Sundays – 7:00 am |
| -
2nd, and 3rd Sundays – 6:00 am |
| B.
Holy Communion |
| -
Administered right after the morning masses |
| -
Communicants are endorsed by the nurses |
| C.
Daily Prayers |
| -
Angelus – 6:00 am, 12:00 nn, and 6:00 pm |
| -
3 o’ clock prayer |
| D.
Other Services |
| -
An in-house Chaplain is available to perform the Sacrament
of |
| Reconciliation,
celebrate the Holy Eucharist, and administer the |
| Anointing
of the Sick to patients upon arrangement with the
staff on |
| duty
or the Supervisor. |
| -
Daily visitation is being done by the Chaplain, Sisters
and other |
| Lay
Volunteers. |
| -
The Chapel is only opened to celebrate the Holy Eucharist.
However, |
| we
have a Prayer Room that is open 24 hours a day. This
is located |
| at
the 2nd Floor of the main building adjacent to the
ICU. |
| 8.
CARDIOVASCULAR LABORATORY |
| A.
Scheduling |
| I.
In-patients |
| The
nurse on duty at the station will be the one to schedule
the |
| procedure
by calling and sending a request to C.V. Lab. |
| II.
Out-patients |
| The
attending physician's secretary or the patient himself
will |
| call
C.V. Lab for scheduling preferably at least a day
before the |
| desired
schedule. |
| Note:
Patients are exhorted to come to C.V. Lab at least
15 mins. |
| before
his/her schedule. |
| B.
Payment |
| I.
In-patients |
| The
floor nurse should refer to the business office for
clearance |
| of
the patients with C.V. Lab procedures. If patient
is cleared, |
| C.V.
Lab should be informed so as to finalize the schedule.
If |
| patient
is not cleared, they should be advised to prepare
the |
| amount
needed for the procedure then get the charge ticket |
| from
the C.V. Lab and pay it at the cashier. |
| Note:
Final schedule will only be given once patient is
financially |
| cleared. |
| II.
Out-patients |
| -
Payment is either made in cash, credit card or c/o
company/ |
| insurance. |
| -
Those who will pay in cash or credit card should get
a charge |
| ticket
from C.V. Lab then make the payment at the cashier. |
| -
Those who will be charged c/o insurance/company should
bring |
| a
letter of authorization and submit it at the out-patient |
| department
then bring the approved request from OPD to |
| C.V.
Lab. |
| C.
Preparation |
| I.
2D-Echo Doppler - no special preparation |
| II.
Stress Test |
| -
Wear rubber shoes or any comfortable walking shoes |
| -
Wear jogging pants/walking shorts or any comfortable
clothing |
| -
Avoid eating a heavy meal before the procedure (within
an |
| hour) |
| III.
Vascular Studies - no special preparation except for
Renal and |
| Abdominal
Aorta Duplex Scan |
| Note:
Instruction will be given upon scheduling of procedures |
| IV.
Invasive Procedures - preparation instruction will
be given by the |
| attending
physician or cardio-fellow. |
| 9.
Kidney Service |
| A.
In-patients |
| -
Alert the Renal Unit for impending hemodialyis. Secure
doctor's order. |
| -
If with no vascular access, secure consent for operation
and clearance from |
| the
Business Office before operation. |
| -
Secure patient's consent for hemodialysis. |
| -
Refer patient's family and/or significant other/s
to the Renal Unit for the |
| run-down
of hemodialysis charges to be paid at the Business
Office. |
| -
Once payments are made, a clearance slip will be issued
by the cashier. |
| This
must be given to the dialysis nurse on duty before
hemodialysis is |
| started. |
| Particular
to company-sponsored patients: |
| Referral
to the renal unit for the charges won't be necessary
as these will |
| be
forwarded to the Business Office along with the Letter
of Authorization |
| (LOA)
issued by the company. |
| B.O.
clearance for hemodialysis is entirely different from
clearance before |
| surgery
(e.g. shunt insertion), therefore, these should be
facilitated separately. |
| Please
don't leave out proper pre-dialysis endorsement. |
| -
Laboratories to be taken pre & post hemodialysis |
| -
Medicines pre & post hemodialysis |
| -
Blood transfusion - must be properly secured and crossmatched |
| B.
Out-patients |
| All
patients for hemodialysis must be referred officially
to the Director |
| of
the Kidney Service. |
| Dialysis
privileges granted to other physicians will be the
sole discretion |
| of
the Director of the Kidney Service. These are granted
on a case to |
| case
basis. When the privilege is granted, a professional
fee will still be |
| charged
by the Kidney Service. |
| Schedules
for hemodialysis will be posted at least one day prior
to the |
| schedule
of the procedure. |
| The
unit staff should be immediately notified of any cancellation
or |
| delay
of a scheduled procedure. |
| Written
consents should be secured for: |
| -
Each dialysis |
| -
Femoral vein catheterization |
| -
First re-use of dialyzer |
| Note:
The consent should be signed by the patient, parents |
| (if
the patient is a minor), relative or person responsible |
| for
the patient. |
| The
dialysis nurse, technician and aide should prepare
for the |
| procedure
at least one hour prior to schedule. |
| PSH
Kidney Service reserves the right to refuse any patient
for dialysis |
| when
the safety of the dialysis personnel and/or other
patients, or the |
| stability
of the unit is threatened. |
| |
