Job Overview: A PHIC (Philippine Health Insurance Corporation) accredited doctor in the Philippines is responsible for diagnosing, treating, and managing patients' health conditions in accordance with the policies and benefits of the Philippine Health Insurance Corporation (PhilHealth). The doctor ensures that services provided to patients comply with PHIC's guidelines and that patients are able to maximize their PhilHealth benefits. They are also involved in health promotion, disease prevention, and the overall healthcare management of individuals and communities.
Key Responsibilities:
Patient Care and Treatment:
Conduct comprehensive medical evaluations of patients, including taking medical histories and performing physical examinations.
Diagnose medical conditions and illnesses, ordering and interpreting diagnostic tests, and developing treatment plans.
Prescribe medications, therapies, and other medical interventions in line with the patient's condition and PhilHealth coverage.
Administer procedures, minor surgeries, or medical interventions as necessary based on the medical needs of the patient.
Monitor and assess patient progress and make adjustments to treatment plans as needed.
PHIC Compliance and Documentation:
Ensure the proper documentation of all medical procedures, treatments, and diagnoses as required by PhilHealth for reimbursement and claims.
Familiarize oneself with and adhere to PhilHealth guidelines regarding covered services, billing codes, and required documentation.
Assist in the completion of PhilHealth claims forms and ensure accurate and timely submission of claims to facilitate patient coverage.
Explain the scope of PhilHealth benefits to patients and ensure they are informed about their entitlements under the insurance program.
Support patients in accessing PhilHealth benefits, including hospitalization, outpatient services, and other insured services.
Health Promotion and Disease Prevention:
Provide guidance and counseling to patients regarding health maintenance, disease prevention, and lifestyle modifications.
Promote public health programs aimed at preventing common diseases and health risks in the community.
Educate patients on the importance of preventive care, including vaccinations, regular health screenings, and managing chronic conditions (e.g., diabetes, hypertension).
Collaborative Care:
Work closely with nurses, allied healthcare professionals, and other doctors to develop and implement patient care plans.
Participate in medical rounds and case discussions to determine the most appropriate course of treatment for patients.
Provide referrals to specialists, as needed, for complex cases or for services outside the coverage of PhilHealth.
Emergency and Critical Care:
Provide emergency medical care to patients, stabilizing them and ensuring proper treatment is administered in critical situations.
Participate in emergency response efforts during medical emergencies, disaster response, or mass casualty situations.
Patient Education and Counseling:
Educate patients about their diagnoses, treatment options, and the expected course of their illness or condition.
Counsel patients on coping strategies for dealing with chronic illness, mental health challenges, and end-of-life care.
Provide patients with clear instructions on follow-up care, medication usage, and any lifestyle changes required for health improvement.
Ethical and Legal Responsibilities:
Adhere to ethical guidelines and medical standards as set by the Philippine Medical Association (PMA) and other relevant professional organizations.
Maintain patient confidentiality and ensure compliance with all legal and ethical standards in the medical practice.
Follow the protocols for obtaining informed consent from patients for procedures or treatments.
Professional Development:
Participate in continuous medical education (CME) to stay current with medical advances, treatment modalities, and new PhilHealth policies.
Attend seminars, conferences, or workshops related to medical practice, healthcare management, and public health.
Required Qualifications:
Education:
Doctor of Medicine (MD) degree from an accredited medical school in the Philippines or abroad.
Completion of the required internship and other clinical training programs.
Must have passed the Philippine Medical Licensure Examination and hold an active PRC (Professional Regulation Commission) license.
Accredited by the Philippine Health Insurance Corporation (PHIC) as a provider of healthcare services.
Skills and Competencies:
Strong clinical knowledge and expertise in diagnosing and treating a wide range of medical conditions.
In-depth knowledge of PhilHealth policies, benefits, and documentation requirements.
Ability to communicate effectively with patients, families, and the healthcare team.
Strong interpersonal skills with an ability to provide empathetic care to patients.
Analytical and critical thinking skills for problem-solving and decision-making.
Knowledge of healthcare systems and regulations in the Philippines.
Experience:
Previous experience in a clinical setting such as a hospital, clinic, or private practice.
Experience with PhilHealth claims submission and healthcare reimbursements is an advantage.
Specialization or experience in certain areas of medicine (e.g., internal medicine, pediatrics, surgery, etc.) is beneficial.
Job Types: Full-time, Part-time
Expected hours: 7 per week
Benefits:
Flexible schedule
Schedule:
Day shift
Flextime
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