What Are the Requirements for Medical Assistance

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What are the Requirements for Medical Assistance? Request for Medicines

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Letter of request addressed to the Hon. Chairman and/or General Manager Original/or certified true photocopy of medical abstract duly signed by the attending physician. (Note: Include physician's license number) Prescription duly signed by the attending physician with costing from the hospital pharmacy included:

In cases wherein medicines are unavailable from the Hospital Pharmacy, a Certification on unavailability of medicines from the Hospital Pharmacy must be submitted to PCSO.



Photocopy of identification card with latest picture of the requesting person with his/her signature indicated at the back.

<< Back Request for Laboratory/Diagnostic Procedures

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Letter of request addressed to the Hon. Chairman and/or General Manager Original/or certified true photocopy of medical abstract duly signed by the attending physician. (Note: Include physician's license number) Request from the attending physician duly signed (Note: Include physician's license number) Official Price Quotation from the Laboratory Section/Department of the Hospital

In cases wherein Laboratory/Diagnostic Procedure is unavailable from the hospital, a Certification on unavailability of the procedure from the hospital must be submitted to PCSO.



Photocopy of identification card with latest picture of the requesting person with his/her signature indicated at the back.

<< Back Request for Payment Hospitalization

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Letter of request addressed to the Hon. Chairman and/or General Manager Original/or certified true photocopy of medical abstract duly signed by the attending physician. (Note: Include physician's license number) Statement of Account/Hospital Bill certified by the billing Officer/Credit Supervisor. Endorsement letter from the hospital's Social Service if there is any, or from the Credit and Collection Officer for Pay patients.

<< Back Francis Manalad Chief Lottery Ops. Officer Diego Apartment Bayanihan Nueva Ecija Tel. No: (044)9762906 Fax No: (044)4866066 0918-607-8708

INDIVIDUAL MEDICAL ASSISTANCE PROGRAM (IMAP)

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nder this program, medical assistance is given to individual patients through the issuance of guarantee letters

to hospitals where the patients are confined. A guarantee letter is a certification issued to hospitals for a particular charity patient under the PCSO medical assistance program where the agency assumes the obligation of settling the cost of hospitalization, including the medicines, medical, surgical or blood supplies, and diagnostic procedures.

OBJECTIVES
General : Restoration of social functioning (Physical recovery) through medical assistance Specific : Provide assistance for hospitalization expenses, laboratory procedures and purchase of medicines, chemo drugs, dialysis solutions, antibiotics, implants, devices and other medical needs.

DOCUMENTATION REQUIREMENTS
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Letter Request to Chairman/General Manager Medical Abstract Bill/Quotation/Costing from Hospital Pharmacy/Supplies Laboratory Request/Medicine Prescription Endorsement/Acceptance letter from Hospital Social Services/Credit Collection Office

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