|
San Carlos City Hospital
I. Functional Statement:
A. Medical Services
1. Medical/Pediatric Service - attends consultation,admits patients and performs minor surgery.
2. Surgical/Orthopedic/Obstetric Services - attends consultation, admits patients, performs major and minor surgery.
3. Anesthesia services - performs preoperative and postoperative evaluation and inducts anesthesia.
B. Nursing Services
Plans, performs, administers nursing care and supervises nursing personnel in the following areas:
1. Stations 1, 2 and 3
2. Emergency Room
3. Delivery Room
4. Operating Room
5. Central Supply Room
6. Recovery Room
7. Dispensary/EKG
8. Out-Patient Section
C. Ancillary Services
1. Laboratory Services - performs, analysis, records and reports laboratory procedures.
2. Pharmaceutical Services - procures, dispenses drugs and surgical supplies.
3. X-Ray Services - performs radiologic services
D. Administrative Division
Performs responsible tasks in relation to hospital management and personnel administration
in the following sections:
1. Personnel
2. Accounting, Budget and Finance
3. Medical Records & PHIC Claims
4. Property & Supply
5. Housekeeping & Laundry
6. Maintenance
7. Security
8. Dietary
9. Social & Other Services
II. SERVICE PLEDGE
“To Prevent, Cure, and Rehabilitate in order to Save Lives”
SERVICE
FEES:
|
1. Consulation
20.00
|
|
|
|
2. Hospitalization
|
SERVICE
FEES:
|
Private Room with Aircon
600.00
750.00
|
SERVICE
FEES:
|
Private Room without Aircon
400.00
550.00
|
SERVICE
FEES:
|
Semi Private
350.00
500.00
|
SERVICE
FEES:
|
Medicare Ward
300.00
450.00 |
SERVICE
FEES:
|
OB Ward
300.00
450.00 |
SERVICE
FEES:
|
(Nursery) NICU
300.00
450.00 |
SERVICE
FEES:
|
Female, Male Pedia Ward
300.00
450.00 |
SERVICE
FEES:
|
Surgical Ward
300.00
450.00 |
SERVICE
FEES:
|
Incubator
300/day
300.00 |
SERVICE
FEES:
|
Bili Light Use
10.00
15.00 |
SERVICE
FEES:
|
Ambulance (within City Proper)
100.00 / call
125.00 |
SERVICE
FEES:
|
Ambulance (Outside City Proper)
+10.00 / Km
|
SERVICE
FEES:
|
Ambulance – San Carlos – Bacolod
2,500.00
3,200.00 |
SERVICE
FEES:
|
Ambulance – San Carlos – Dumaguete
3,000.00
3,800.00 |
SERVICE
FEES:
|
Delivery
300.00
300.00 |
SERVICE
FEES:
|
Operating Room:RUV of:above 10
2,160.00
2,700.00 |
SERVICE
FEES:
|
Operating Room: 5.1 to 10
1,140.00
1,425.00 |
SERVICE
FEES:
|
Operating Room: 5.0 and
670.00
838.00 |
SERVICE
FEES:
|
ER
200.00
250.00 |
SERVICE:
FEES:
|
Labor Room Fee /
25 / hr
30 / hr |
SERVICE:
FEES:
|
Newborn Screening
650.00
650.00 |
SERVICE:
FEES:
|
Medical
30.00
50.00 |
SERVICE:
FEES:
|
Certification of True
20.00
25.00 |
SERVICE:
FEES:
|
Doppler
10.00 / use
15.00 |
SERVICE:
FEES:
|
Removal of Plaster Cast
75.00
100.00 |
SERVICE:
FEES:
|
Oxygen Consumption (subj to change/cost acquisition)
70.00 / hr
90.00 |
SERVICE:
FEES:
|
Wound Dressing Small (0.5 cm or less)
30.00
40.00 |
SERVICE:
FEES:
|
Wound Dressing Medium(0.6 - 4.0 cm)
50.00
60.00 |
SERVICE:
FEES:
|
Wound Dressing Large (more than 4cm)
100.00
125.00 |
SERVICE:
FEES:
|
Excision of Cyst
200.00
250.00 |
SERVICE:
FEES:
|
Incision and Drainage
200.00
250.00 |
SERVICE:
FEES:
|
Circumcision
200.00
250.00 |
SERVICE:
FEES:
|
Injection
15.00
20.00 |
SERVICE:
FEES:
|
Nebulization
20.00
25.00 |
SERVICE:
FEES:
|
EKG – Single Channel
200.00
250.00 |
SERVICE:
FEES:
|
EKG – Three Channel w/ Analysis
300.00
350.00 |
SERVICE:
FEES:
|
Insertion of Urinary Catheter
30.00
40.00 |
SERVICE:
FEES:
|
Suturing
200.00
250.00 |
|
SERVICE FEE PER DAY |
SERVICE:
FEES:
|
General Practitioner
150.00 / day
150.00 |
SERVICE:
FEES:
|
Specialist
250.00 / day
250.00 |
|
Ordinary Cases (PHIC Rate Applies) |
SERVICE:
FEES:
|
General Practitioner
600.00
|
SERVICE:
FEES:
|
Specialist
900.00
|
|
Intensive Care: (PHIC Rate Applies)
|
SERVICE:
FEES:
|
General Practitioner
900.00
|
SERVICE:
FEES:
|
Specialist
1,500.00
|
|
Catastrophic Case: (PHIC Rate Applies)
|
SERVICE:
FEES:
|
General Practitioner
900.00
|
SERVICE:
FEES:
|
Specialist
1,500.00
|
|
Maximum Rate: (PHIC Rate Applies)
|
SERVICE:
FEES:
|
General Practitioner
16,000.00
16,000.00 |
SERVICE:
FEES:
|
Specialist
5,000.00
5,000.00 |
|
|
|
3. Laboratory |
SERVICE:
FEES:
|
CBC
75.00
90.00 |
SERVICE:
FEES:
|
Hct
30.00
40.00 |
SERVICE:
FEES:
|
Hgb
30.00
40.00 |
SERVICE:
FEES:
|
Platelet Count
100.00
110.00 |
SERVICE:
FEES:
|
Blood Typing
45.00
60.00 |
SERVICE:
FEES:
|
Urinalysis
40.00
50.00
|
SERVICE:
FEES:
|
Stool Exam / Fecalysis
30.00
40.00 |
SERVICE:
FEES:
|
Pregnancy Test
200.00
250.00 |
SERVICE:
FEES:
|
HBs Antigen
250.00
300.00 |
SERVICE:
FEES:
|
Donor Screening Fee
450.00
560.00 |
SERVICE:
FEES:
|
Cross matching
75.00
100.00 |
SERVICE:
FEES:
|
FBS
100.00
120.00 |
SERVICE:
FEES:
|
RBS
110.00
120.00 |
SERVICE:
FEES:
|
BUN
110.00
120.00 |
SERVICE:
FEES:
|
Creatinine
110.00
120.00 |
SERVICE:
FEES:
|
Uric Acid
110.00
120.00 |
SERVICE:
FEES:
|
Lipid Profile
450.00
500.00 |
SERVICE:
FEES:
|
Cholesterol
110.00
120.00 |
SERVICE:
FEES:
|
Trylycerides
110.00
120.00 |
SERVICE:
FEES:
|
Electrolytes K,Na, Cl
550.00
600.00 |
SERVICE:
FEES:
|
SGPT/ALT
110.00
120.00 |
SERVICE:
FEES:
|
SGOT/AST
110.00
120.00
|
SERVICE:
FEES:
|
TPAG
260.00
280.00
|
|
|
|
4. X-Ray |
SERVICE:
FEES:
|
Chest PA and Lateral
330.00
400.00
|
SERVICE:
FEES:
|
Abdomen AP (Supine or Upright)
325.00
400.00 |
SERVICE:
FEES:
|
Skull AP and Lateral
490.00
610.00
|
SERVICE:
FEES:
|
Shoulder AP and Lateral
330.00
410.00
|
SERVICE:
FEES:
|
Cervical Spine AP, Lateral, Open-Mouth
400.00
500.00
|
SERVICE:
FEES:
|
Forearm AP & Lateral
420.00
520.00
|
SERVICE:
FEES:
|
Pelvis AP & Left or Right HIP
530.00
660.00
|
SERVICE:
FEES:
|
Knee AP & Lateral
300.00
375.00
|
SERVICE:
FEES:
|
Leg AP & Lateral
420.00
525.00
|
SERVICE:
FEES:
|
Foot AP, Lateral & Oblique
480.00
600.00
|
SERVICE:
FEES:
|
K U B
325.00
400.00
|
** Refer to Ordinance No. 27, Series of 2006
SPECIAL SERVICES
HOSPITALIZATION ASSISTANCE FOR INDIGENTS
I. ELIGIBILITY – To qualify as beneficiary of the Hospitalization Assistance, one must meet the following criteria:
a) He/She should be certified as bonafide resident of San Carlos City for at least six (6) months, by the Barangay Captain, or the Barangay Kagawad, as the case maybe, of the barangay wherein the patient resides. This should be evidenced by a residence certificate. The DSWD shall furnish the City Hospital the list of qualified indigents.
b) He/She should not be gainfully employed, as certified by the Barangay Captain or a Kagawad, as the case maybe;
c) He/She should be a registered voter of the city in the immediately preceding election in addition to # 1, as per official list of Comelec – San Carlos. Exemptions to this are those incapacitated to register due to physical or mental disabilities.
The DSWD shall secure an official list of voters from the COMELEC for the ready reference of the assigned City Hospital Social Worker.
d) He/She should not be a Philhealth member nor a plan holder of any other medical insurance plan, or a beneficiary of such. An undertaking on this matter shall be executed by the patient – applicant, or his/her next of kin.
e) If patient – applicant is minor, his parents/guardians should meet all of the above requirements.
II. COVERAGE:
a) Maximum limit of hospital assistance is Five Thousand Pesos (=P= 5,000.00) per patient per year.
b) Said amount shall be used EXCLUSIVELY for the payment of hospital fees, and MEDICINES BOUGHT ONLY FROM THE CITY HOSPITAL PHARMACY.
c) Patient – applicant shall be handled only by government doctors, or by any private physician but without professional fee.
d) Patient – applicant shall be admitted at the Charity Ward of the City Hospital of San Carlos, Negros Occidental.
REQUIRED DOCUMENTS
Member - SSS - M(Husband/Wife)
- M5
- RF1
- Philhealth ID
SSS – D (Wife)- M5
- RF1
- Marriage Contract
- Philhealth ID
SSS – D (Son/Daughter)
- M5
- RF1
- Birth Certificate
- Philhealth ID
SSS – D (Parents)
- M5
- RF1
- Affidavit of Support
- Philhealth ID
- Birth Certificate of Member
- 60 years old and above
SSS – M (Pensioner)
- Print-out of Contribution Or Non-Paying ID
SSS – D (Wife)
- Print-out of Contribution
- Marriage Contract
- SSS ID (Xerox)
SSS – D (Wife Surviving- Print-out / until 03/05/95 Spouse)
- Marriage Contract
Member
GSIS – M
- Latest Payslip
- Philhealth ID/Policy Contract
GSIS – D (Wife)
- Philhealth ID/Policy Contract
- Marriage Contract
GSIS – D (Son/Daughter)
- Philhealth ID
- Birth Certificate of Patient
- Affidavit of Support if mother is member
GSIS – D (Parents)
- Philhealth ID/Policy Contract
- Affidavit of Support
- Birth Certificate of Member 60 years old and above
GSIS – M (Pensioner)
- Non-Paying ID
- Certification from GSIS
GSIS – D (Wife)
- Non-Paying ID
- Marriage Contract
- Certification from GSIS
Member
MASA
- Philhealth ID
MASA – D (Wife)/Husband
- Philhealth ID
- Marriage Contract
MASA – D (Son/Daughter)
- Philhealth ID
- Birth Certificate of Patient
- Affidavit of Support if the Member is Mother
MASA – D (Parents)
- Philhealth ID
- Affidavit of Support
- Birht Certificate of Member
60 years old and above
Member
Self-Employed (SE)
- M5
- Philhealth ID
D – (Wife/Husband)
- M5
- Marriage Contract
- Philhealth ID
D – (Son/Daughter)
- M5
- Philhealth ID
- Birth Certificate of Patient
- Affidavit of Support if the member is mother
D – (Parents)
- M5
- Philhealth ID
- Affidavit of Support
- Birth Certificate of Member
60 years old and above
FILPED A. MAISOG, MD, FPCS, RN
Chief of Hospital II
** Refer to Ordinance No. 27, Series of 2006
SPECIAL SERVICES
HOSPITALIZATION ASSISTANCE FOR INDIGENTS
I. ELIGIBILITY – To qualify as beneficiary of the Hospitalization Assistance, one must meet the following criteria:
a) He/She should be certified as bonafide resident of San Carlos City for at least six (6) months, by the Barangay Captain, or the Barangay Kagawad, as the case maybe, of the barangay wherein the patient resides. This should be evidenced by a residence certificate. The DSWD shall furnish the City Hospital the list of qualified indigents.
b) He/She should not be gainfully employed, as certified by the Barangay Captain or a Kagawad, as the case maybe;
c) He/She should be a registered voter of the city in the immediately preceding election in addition to # 1, as per official list of Comelec – San Carlos. Exemptions to this are those incapacitated to register due to physical or mental disabilities.
The DSWD shall secure an official list of voters from the COMELEC for the ready reference of the assigned City Hospital Social Worker.
d) He/She should not be a Philhealth member nor a plan holder of any other medical insurance plan, or a beneficiary of such. An undertaking on this matter shall be executed by the patient – applicant, or his/her next of kin.
e) If patient – applicant is minor, his parents/guardians should meet all of the above requirements.
II. COVERAGE:
a) Maximum limit of hospital assistance is Five Thousand Pesos (=P= 5,000.00) per patient per year.
b) Said amount shall be used EXCLUSIVELY for the payment of hospital fees, and MEDICINES BOUGHT ONLY FROM THE CITY HOSPITAL PHARMACY.
c) Patient – applicant shall be handled only by government doctors, or by any private physician but without professional fee.
d) Patient – applicant shall be admitted at the Charity Ward of the City Hospital of San Carlos, Negros Occidental.
REQUIRED DOCUMENTS
Member - SSS - M(Husband/Wife) - M5
- RF1
- Philhealth ID
SSS – D (Wife) - M5
- RF1
- Marriage Contract
- Philhealth ID
SSS – D (Son/Daughter) - M5
- RF1
- Birth Certificate
- Philhealth ID
SSS – D (Parents) - M5
- RF1
- Affidavit of Support
- Philhealth ID
- Birth Certificate of Member
- 60 years old and above
SSS – M (Pensioner) - Print-out of Contribution
Or Non-Paying ID
SSS – D (Wife) - Print-out of Contribution
- Marriage Contract
- SSS ID (Xerox)
SSS – D (Wife Surviving- Print-out / until 03/05/95
Spouse) - Marriage Contract
Member GSIS – M - Latest Payslip
- Philhealth ID/Policy Contract
GSIS – D (Wife) - Philhealth ID/Policy Contract
- Marriage Contract
GSIS – D (Son/Daughter)- Philhealth ID
- Birth Certificate of Patient
- Affidavit of Support if mother is member
GSIS – D (Parents) - Philhealth ID/Policy Contract
- Affidavit of Support
- Birth Certificate of Member
60 years old and above
GSIS – M (Pensioner) - Non-Paying ID
- Certification from GSIS
GSIS – D (Wife) - Non-Paying ID
- Marriage Contract
- Certification from GSIS
Member MASA - Philhealth ID
MASA – D (Wife)/Husband- Philhealth ID
- Marriage Contract
MASA – D (Son/Daughter)- Philhealth ID
- Birth Certificate of Patient
- Affidavit of Support if the Member is Mother
MASA – D (Parents) - Philhealth ID
- Affidavit of Support
- Birht Certificate of Member
60 years old and above
Member Self-Employed (SE) - M5
- Philhealth ID
D – (Wife/Husband) - M5
- Marriage Contract
- Philhealth ID
D – (Son/Daughter) - M5
- Philhealth ID
- Birth Certificate of Patient
- Affidavit of Support if the member is mother
D – (Parents) - M5
- Philhealth ID
- Affidavit of Support
- Birth Certificate of Member
60 years old and above
FILPED A. MAISOG, MD, FPCS, RN
Chief of Hospital II
|
