Iligan Medical Center Hospital San Miguel, Pala-0, Iligan City

January 15, 2013 To From Re : IMCH SSK Surgical Physicians : IMCH President : SSK Surgical Cases Packages

Dear Doctor, With the very encouraging progress of our SSK program, we are now planning to expand the benefits available for our SSK patients. Exemplifying with the Packages in the OB-GYN department; NSD & Cesarean Section Packages, we are positive we could do the same with the other specialties. Hence, we are now starting with the Surgery department. We have chosen, as per records yet, namely; Appendectomy. We shall observe this and probably come up with other packages cases when warranted. The scheme is: 1. All these cases shall be only for patients with PhilHealth cards or for SSK patients (non-SSK or your private patients are not included and you can charge with your usual rates); 2. SSK policies shall hold true to all these patients; 3. PhilHealth payments shall go directly to the surgeon & hospital, at PHICs ratio of 60%-40% (60% goes to the hospital & 40% shall cover for the surgeon & anesthesiologist); 4. Computation herein stated shall mean cases that are NOT complicated. Complicated cases shall be charged differently by the surgeon (which of course shall be minimal being SSK patients); 5. Hospital stay shall, as much as possible be kept to the minimum of about 3 to 5 days; 6. Package fee, inclusive is of: a. doctors fees, b. anesthesia (general or epidural) c. room & board fee, d. laboratory/x-ray/others, e. medical/surgical supplies, f. operating room fee g. pharmacy/medicines h. E.R. fee i. miscellaneous fees (ex: biopsy & others) 7. Package Rate for APPENDECTOMY for UN-COMPLICATED Appendicitis shall be pegged at P28,000.00 per case (this is over & on top of the PHIC benefit).

It would mean therefore that for every Appendectomy case performed under the SSK program, the expenses would be: PHIC benefit P24,000.00 (60% to hospital & 40% to all doctors) Excess 28,000.00 (hosp P10,000; doctors P18,000 1. Surgeon P9,000 2. Anes & Asst P4,500 eac Total P52,000.00 almost is shouldered by PHIC. comparative data with OBs Caesarean Section Package: PHIC benefit P19,000.00 Excess 25,000.00 PACKAGE RATE for SSK patients. 8. PHIC payment (40% of total payment P9,600) is for the doctors is further distributed to 70% to Surgeon & 30% to anesthesiologist; hence: Surgeon 70% of the 40% (P6,720.00) Anesthesia 30% of the 40% (P2,880.00) 9. Should you be amenable with the computation of the above distribution of professional fees, the business office shall do the calculation for your convenience. 10. Should there be a need for a 2nd assistant surgeon, the Operator (main surgeon) shall have the free hand to make the distribution of the professional fee for the excess portion. 11. In the event that other specialty may be needed during the operation, such cardiac monitoring during the operation, the case now will fall under the complicated case and therefore the Internist may charge for his own excess PF separate from the Operating Team, keeping in mind of our commitment with the SSK patient. Operation/Procedure Simple Appendectomy Package Fee in excess of PHIC P28,000.00

Incidentally, we are proud to inform you that we have recently acquired an ABG (Arterial Blood Gas) machine. The machine is capable of performing, aside from ABG, various blood examination determinations. We will keep you posted for our demonstration forum about it soon. Thank you very much for your continuous support. Respectfully, Daniel P. U. Rigor M.D. IMCH President Head Surgery Department