primary care benefit 1 - Philippine Health Insurance Corporation

community, volunteer or barangay health workers, women’s health teams and community
health teams.
Non‐hypertensive – individual with systolic BP of < 140 mmHg and diastolic BP < 90 mmHg in
the absence of intake of antihypertensive medications.
Obligated service – refers to a service that must be rendered to target clients because it is
medically necessary and for the purpose of determining outcome performance as basis for
payment.
Organized group – any organization of the informal sector registered with an authorized
government regulatory body with the aim of providing social protection or social health
insurance to its members. These organizations may include microfinance institutions,
cooperatives, non‐government organizations, transport operators and drivers associations, and
credit unions, among others. The eligibility of these organizations to avail of PCB1 will be
determined by the applicable policies concerning the organized group.
Pap smear ‐ A procedure in which cells are scraped from the cervix for examination under a
microscope. It is used to detect cancer and changes that may lead to cancer and may be used
as alternative for Visual Inspection with Acetic Acid. A Pap smear can also show conditions,
such as infection or inflammation,that are not cancer. It is also called Pap test and Papanicolaou
test.
PCB Provider – refers to any health facility providing services under the Primary Care Benefit
package. It is also referred as Provider in this Manual.
PCB 1 Package – stands for primary care benefits 1 package which includes the following 3 main
provisions:
a. primary preventive services
b. diagnostic examinations
c. drugs and medicines for certain diseases
Periodic clinical breast examination – is an examination of the patient’s bilateral breasts by a
physician or a nurse, which includes inspection and palpation. This should be performed at
regular intervals as specified in the circular among the targeted individuals even in the absence
of symptoms or signs related to the breasts.
Philippine Health Insurance Corporation – a government owned and controlled corporation duly
organized and existing by virtue of Republic Act No. 7875 (as amended by Republic Act No.
9241), otherwise known as the National Health Insurance Act of 1995. It may be referred to as
PHIC, PhilHealth or the Corporation in this Manual.
Profiling – refers to the act of doing/updating the individual or client health profile of entitled
member and dependents.
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