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CPSA Renewal Guidelines for 2022

Philippine Health Insurance Corporation issued an advisory regarding cataract pre-surgery authorization requests during the 2022 accreditation filing period. The advisory states that health care facilities providing cataract surgery should file for accreditation renewal as soon as possible to ensure continuous access to PhilHealth benefits. It also advises facilities whose requests were previously denied due to their license still being processed to re-submit requests. Finally, the advisory notes that an approved pre-surgery authorization does not guarantee reimbursement claim approval.

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87 views1 page

CPSA Renewal Guidelines for 2022

Philippine Health Insurance Corporation issued an advisory regarding cataract pre-surgery authorization requests during the 2022 accreditation filing period. The advisory states that health care facilities providing cataract surgery should file for accreditation renewal as soon as possible to ensure continuous access to PhilHealth benefits. It also advises facilities whose requests were previously denied due to their license still being processed to re-submit requests. Finally, the advisory notes that an approved pre-surgery authorization does not guarantee reimbursement claim approval.

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Mox Lex
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Philippine Health Insurance Corporation

ADVISORY
No. 2022 - 0044
Phil Health
Your Partner in Health
UNIVERSAL HEALTH CARE
UIU>UQA~ Al ULOMO• , . , . >• C.H.!

Requests for Cataract Pre-Surgery


Authorization (CPSA) During CY 2022
Accreditation Filing Period
To ensure continuous access to PhiiHealth benefits, Health Care
Facilities (HFs) providing services requiring cataract pre-surgery
authorization (CPSA) are advised to file their applications for renewal
of accreditation as soon as possible.

For HFs whose CPSA requests were already disapproved because


their license to operate (LTO) is still on-process with the Department
of Health and date of contemplated surgeries are scheduled between
January 1 and 31 next year, it is advised that concerned HFs to re-
submit another CPSA requests.

The re-submission of CPSA requests shall only apply to HFs that


applied for renewal of accreditation for CY 2023.

It is reiterated that an approved CPSA shall not automatically


guarantee the approval of corresponding claim for reimbursement
as stated in Phil Health Circular No. 59, s-2012 (Requirement of Pre-
Cataract Surgery Authorization).

For your information and guidance.

(Sgd.) ATTY. Ell DINO D. SANTOS


Officer-in-Charge, Office of the President and Chief Executive Officer
Concurrent Executive Vice-President and Chief Operating Officer
Date Signed: December 27, 2022

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