PCSO Requirements for Medical Assistance

What are PCSO Requirements for Medical Assistance?
Request for Medicines
  • 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.
Request for Laboratory/Diagnostic Procedures
  • 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.
Request for Payment Hospitalization
  • 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.
Request for Hearing Aid
  • Letter of request addressed to the Hon. Chairman and/or General Manager
  • Original copy of Audiological Evaluation Report duly signed by Audiometrist
  • One or two price quotations from any hearing aid centers
  • Photocopy of identification card with latest picture of the requesting person with his/her signature
Request for Implants/Prosthetic Devices/Wheelchair
  • Letter of request addressed to the Hon. Chairman and/or General Manager
    a. implant/phosthesis request
    – Original or certified true photocopy of medical abstract duly signed by the attending physician. (Note: Include physician’s license number)
    b. wheelchair request
    – Original or certified true photocopy of medical abstract or medical certificate with wheelchair specification signed by the attending physician. (Note: Include physician’s license number)
  • Two (2) official price quotations from two (2) different companies
  • One (1) whole body picture of requesting patient for request for wheelchair and prosthetic devices.
Request for Dialysis
  • 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)
  • Endorsement letter from a Dialysis Center or Hospital where PCSO allots an Endowment Fund
  • Official Price Quotation from the Dialysis Center/Hospital
  • Certification of Acceptance from Dialysis Center/Hospital
  • In cases wherein dialysis solution and/or post-operative medicines is unavailable from the hospital, a Certification on unavailability of the dialysis solution and/or post-operative medicines from the hospital must be submitted to the PCSO.
  • Photocopy of identification card with latest picture of the requesting person with his/her signature indicated at the back.

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