January 15, 2005
Mr. Jazon Quintero
Wakas St.
Pilar, Bataan
Dear Mr. Quintero,
This is to inform you of the amount of Medicare Benefits reimbursed by PhilHealth to the member/hospital/doctor for the aforementioned hospitalization. In case medicare benefits were not deducted from your bill, please present this form together with official receipt/s to the hospital/doctor for refund. For inquiries, please contact our Claims Processing Division at telephone nos. 451-2481, 425-578
Very truly yours,
Melanie Castillo