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INSTRUCTIONS

*This Tally Sheet is permanent. No need for the TASK Leader to send a monthly Tally Sheet.
*The Tally Sheet contains Hospital 1,2,3,4,5 which represents week 1,2,3,4,5 respectively
*If a CARES is assigned to a permanent hospital, he or she should only fill-up the HCI 1 all throughout the month,
however, roving CARES should fill-up all the HCI according to weeks deployed

for ROVING
example: Week 1 (HCI 1), CARES hospital assignment is BICOL ACCESS, from Sept 1-5, 2015. You should onl
Week 2 (HCI 2), CARES Hospital assignment is NICC-Doctors Hospital, from Sept 7-12, 2015. You Sh
Week 3 (HCI 3), CARES Hospital assignment is AGO GENERAL HOSPITAL, from Sept 14-19, 2015. Yo
Week 4 (HCI 4), CARES Hospital assignment is ALBAY DOCTORS, from Sept 21-30, 2015. You Shoul
Week 5 is optional, if a month has 5th week you should fill this out.

*It is required to fill-out the Hospital Name and period covered per HCI as your guide. You can only select the hospital located in Region 5
*Please also fill-out the daily discharge if applicable on your hospital.
*Fill-up only the cells in ORANGE. PPFF portion must be fill-up in the CLIENT SERVED TAB
*In CLIENT SERVED MONITORING TOOL, CARES need to fill-out the HOSPITAL NAME opposite to the date covered. You can only sele

DEFINITION OF TER
Total No. of Client Served - Total number of In-patients plus total number of

In-patient Clients (on post) refers to those clients (patient or patients representative)
counted per patient regardless of how many representatives were catered during hospitaliz

Ward Class - refers to those client served during ward classes, health education on wards

Out-patient Clients (on post) refers to those clients (patient or patients representative
counted per patient regardless of how many representatives were catered during hospitaliz

OPD Class - refers to those clients served during Out-Patient Lectures, OPD Health Educat

WALK-IN - refers to those client inquiring on post but not availing benefits. (Not included i

Total No. of Discharges/Day- Number of in-patient discharges plus number of OPD clien

Total No. of Discharges/Month - Total number of in-patient discharges plus total numbe

Total No. of In-Patient Discharges- Total number of discharges reflected in Mandatory M

Total No. of OPD Client Served - Total number of outpatient clients (patients or patient's
OPD lectures.
RUCTIONS

ut the month,

pt 1-5, 2015. You should only fill-up date 1-5


rom Sept 7-12, 2015. You Should only fill-up date 7-12
AL, from Sept 14-19, 2015. You Should only fill-up date 14-19
Sept 21-30, 2015. You Should only fill-up date 21-30

e hospital located in Region 5 in the drop down menu.

SERVED TAB
ate covered. You can only select the hospital located in Region 5 in the drop down menu

ON OF TERMS
umber of Out-patient clients plus Ward Class plus OPD Class per hospital

nts representative) with confined patients served at post; only 1 client is


red during hospitalization. NO DOUBLE ENTRY (1 client served per patient)

education on wards, mother's class, and watcher's class (in-patient) NO DOUBLE ENTRY (1 client

ents representative) served at post; only 1 client is


red during hospitalization.

OPD Health Education

efits. (Not included in client served)

umber of OPD client served on a daily basis

es plus total number of OPD client served per hospital on a monthly basis

cted in Mandatory Monthly Hospital Report (MMHR)

patients or patient's representative) served at post and those served during


LE ENTRY (1 client served per patient)
HOSPITAL ASSIGNMENT: Bicol Medical Center
Feb 1 28 2017
month from to year

IN-PATIENT CLIENTS SERVED


DATE NUMBER OF INPATIENT CLIENTS AT POST
FORMAL INFORMAL LIFETIME INDIGENT SPONSORED NON-MEMBER

1 1 13 3 15 4 2
2 2 15 7 14 2
3
4 2 3 1 7 2
5
6 2 9 0 19 5
7 2 11 6 31 4
8 1 18 7 32 2
9 5 15 7 12 0 3
10 2 4 1 11 4 0
11
12
13 5 12 2 21 5 1
14 1 16 4 14 2 0
15 2 21 7 30 10 0
16 7 9 0 26 7 1
17 8 16 4 38 7 1
18 5 17 2 11 5 1
19
20 6 9 2 26 1 0
21 7 9 11 20 4 0
22 3 7 3 17 2 0
23 4 10 2 24 3 1
24 1 17 5 31 2 0
25
26
27 3 11 3 20 2 1
28 2 8 5 22 1 0
29
30
31
TOTAL 71 250 82 441 70 15

BELOW IS THE SUMMAR


(1 & 2) Bicol Medical Center
NUMBER OF INPATIENT AND OUTPATIENT CLIENTS SERVED AT

FORMAL INFORMAL INDIGENT SPONSORED LIFETIME

71 250 441 70 82

Pay attenti

Total No. of Disc


2883
In-Patient Discharges
Per MMHR
(C/O Task Leader)

Total No. of Discharge/Mon


2883
Total hospitals MMHR Discharges

This is to compu
21
2272 611 MMHR 21
Based from previous month NHIP NON-NHIP SOURCE

VED TOTAL OUT-PATIENT CLIENTS SER


INPATIENT
WARD NUMBER OF OUTPATIENT CLIENTS AT POST
CLIENT
CLASSES/ROOM-
SERVED
TO-ROOM VISITS FORMAL INFORMAL LIFETIME INDIGENT

38
40

15

9 44
19 73
18 78
20 62
23 45

8 54
37
70
50
74
41

11 55
11 62
32
13 57
56

15 55
38
147 1076 0 0 0 0

IS THE SUMMARY THAT WILL BE NEEDED ON THE ONLINE ACCOMPLISHMENT REPORT


(3 & 4) (5) No. of Outpatient Client
Number of Client
Served (Sum of
NTS SERVED AT POST WARD CLASS & Served during IEC &
Outpatient clients served
ROOM-TO-ROOM OPD LECTURES Room-to-room visits at post per category and
NON-MEMBER VISIT (sum of item 3,4,5) item no. 5)

15 147 886 1033 886

Pay attention on the cells in white because these will be needed on the online AR.

Total No. of Discharges/Month % Client Served (Monthly Basis)


886 3769 52.06%
OPD Total OK
Client Served (MMHR+OPD) Percentage per Hospital/Week
Locked Locked Locked

of Discharge/Month (All Hospital if Roving) % Client Served (Monthly Basis)


886 3769 52.06%
Total OPD All Hospitals Percentage per Month (All Hospitals)
Client Served (MMHR+OPD)

This is to compute the total client served of all hospitals if roving.


Days with PPFF in THIS hospital 12 PPFF/Day in THIS Hospital
Days with PPFF in ALL hospital (if ROVING) 12 Overall PPFF/Day for ALL Hospital (IF ROVING)
[ Number of Days covered with PPFF] [ Average PPFF per Day]

CLIENTS SERVED TOTAL WALK - IN


OUTPATIENT GRAND TOTAL (Not Included
CLIENTS AT POST OPD CLIENT Client Served in Client
LECTURES SERVED Served)
SPONSORED NON-MEMBER

34 34 72
27 27 67

15

66 66 110
15 15 88
47 47 125
46 46 108
48 48 93

47 47 101
37 37 74
40 40 110
81 81 131
80 80 154
41

49 49 104
37 37 99
44 44 76
41 41 98
48 48 104

51 51 106
48 48 86
0 0 886 886 1962 0

MENT REPORT
. of Outpatient Client (6)
Served (Sum of
TOTAL INPATIENT
patient clients served
post per category and
TOTAL NO. OF WALK-
IN CLIENTS ASSISTED
DISCHARGES PPFF
item no. 5)

886 0 2297 257

ved (Monthly Basis) 100% [opps! percentage out of ranged, Please input in-patient dis

OK
per Hospital/Week

ed (Monthly Basis)

r Month (All Hospitals)


pital 257
ospital (IF ROVING) 21
PFF per Day]

TOTAL
Total No. of
INPATIENT
DISCHARGES PPFF

124 15
102 10

114 4

113 18
119 13
120 15
108 15
100 14

88 11
118 10
106 14
106 16
137 26
100 7

91 7
129 10
124 15
126 10
82 12

104 8
86 7
2297 257

ease input in-patient discharges MMHR C/O Task Leader]


HOSPITAL ASSIGNMENT: Garchitorena Medicare Community Hospital
PERIOD COVERED: Oct 27 29 2016
month from to year

IN-PATIENT CLIENTS SERVED


DATE NUMBER OF INPATIENT CLIENTS AT POST
FORMAL INFORMAL LIFETIME INDIGENT SPONSORED NON-MEMBER

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
TOTAL 0 0 0 0 0 0

BELOW IS THE SUMMAR


(1 & 2) Garchitorena Medicare Community Hospi
NUMBER OF INPATIENT AND OUTPATIENT CLIENTS SERVED AT

FORMAL INFORMAL INDIGENT SPONSORED LIFETIME

0 0 0 0 0

Pay attenti

Total No. of Disc

In-Patient Discharges
Per MMHR
(C/O Task Leader)

Total No. of Discharge/Mon


2883
Total hospitals MMHR Discharges

This is to compu
pital 0
MMHR 21
Based from previous month NHIP NON-NHIP SOURCE

VED TOTAL OUT-PATIENT CLIENTS SER


INPATIENT
WARD NUMBER OF OUTPATIENT CLIENTS AT POST
CLIENT
CLASSES/ROOM-
SERVED
TO-ROOM VISITS FORMAL INFORMAL LIFETIME INDIGENT
0 0 0 0 0

IS THE SUMMARY THAT WILL BE NEEDED ON THE ONLINE ACCOMPLISHMENT REPORT


ommunity Hospital (3 & 4) (5) No. of Outpatient Client
Number of Client
Served (Sum of
NTS SERVED AT POST WARD CLASS & Served during IEC &
Outpatient clients served
ROOM-TO-ROOM OPD LECTURES Room-to-room visits at post per category and
NON-MEMBER VISIT (sum of item 3,4,5) item no. 5)

0 0 0 0

Pay attention on the cells in white because these will be needed on the online AR.

Total No. of Discharges/Month % Client Served (Monthly Basis)


0 #DIV/0!
OPD Total #DIV/0!
Client Served (MMHR+OPD) Percentage per Hospital/Week
Locked Locked Locked

of Discharge/Month (All Hospital if Roving) % Client Served (Monthly Basis)


886 3769 52.06%
Total OPD All Hospitals Percentage per Month (All Hospitals)
Client Served (MMHR+OPD)

This is to compute the total client served of all hospitals if roving.


Days with PPFF in THIS hospital #DIV/0! PPFF/Day in THIS Hospital
Days with PPFF in ALL hospital (if ROVING) 12 Overall PPFF/Day for ALL Hospital (IF ROVING)
[ Number of Days covered with PPFF] [ Average PPFF per Day]

CLIENTS SERVED TOTAL WALK - IN


OUTPATIENT GRAND TOTAL (Not Included
CLIENTS AT POST OPD CLIENT Client Served in Client
LECTURES SERVED Served)
SPONSORED NON-MEMBER
0 0 0 0

MENT REPORT
. of Outpatient Client (6)
Served (Sum of
TOTAL INPATIENT
patient clients served
post per category and
TOTAL NO. OF WALK-
IN CLIENTS ASSISTED
DISCHARGES PPFF
item no. 5)

0 0 0

ved (Monthly Basis) 100% [opps! percentage out of ranged, Please input in-patient dis

per Hospital/Week

ed (Monthly Basis)

r Month (All Hospitals)


pital 257
ospital (IF ROVING) 21
PFF per Day]

TOTAL
Total No. of
INPATIENT
DISCHARGES PPFF
0 0

ase input in-patient discharges MMHR C/O Task Leader]


HOSPITAL ASSIGNMENT: [Pick from the Drop Down Menu]
PERIOD COVERED: Oct 19 24 2015
month from to year

IN-PATIENT CLIENTS SERVED


DATE NUMBER OF INPATIENT CLIENTS AT POST
FORMAL INFORMAL LIFETIME INDIGENT SPONSORED NON-MEMBER

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
TOTAL 0 0 0 0 0 0

BELOW IS THE SUMMAR


(1 & 2) [Pick from the Drop Down Menu]
NUMBER OF INPATIENT AND OUTPATIENT CLIENTS SERVED AT

FORMAL INFORMAL INDIGENT SPONSORED LIFETIME

0 0 0 0 0

Pay attenti

Total No. of Disc

In-Patient Discharges
Per MMHR
(C/O Task Leader)

Total No. of Discharge/Mon


2883
Total hospitals MMHR Discharges

This is to compu
0
MMHR 21
Based from previous month NHIP NON-NHIP SOURCE

VED TOTAL OUT-PATIENT CLIENTS SER


INPATIENT
WARD NUMBER OF OUTPATIENT CLIENTS AT POST
CLIENT
CLASSES/ROOM-
SERVED
TO-ROOM VISITS FORMAL INFORMAL LIFETIME INDIGENT
0 0 0 0 0

IS THE SUMMARY THAT WILL BE NEEDED ON THE ONLINE ACCOMPLISHMENT REPORT


n Menu] (3 & 4) (5) No. of Outpatient Client
Number of Client
Served (Sum of
NTS SERVED AT POST WARD CLASS & Served during IEC &
Outpatient clients served
ROOM-TO-ROOM OPD LECTURES Room-to-room visits at post per category and
NON-MEMBER VISIT (sum of item 3,4,5) item no. 5)

0 0 0 0

Pay attention on the cells in white because these will be needed on the online AR.

Total No. of Discharges/Month % Client Served (Monthly Basis)


0 #DIV/0!
OPD Total #DIV/0!
Client Served (MMHR+OPD) Percentage per Hospital/Week
Locked Locked Locked

of Discharge/Month (All Hospital if Roving) % Client Served (Monthly Basis)


886 3769 52.06%
Total OPD All Hospitals Percentage per Month (All Hospitals)
Client Served (MMHR+OPD)

This is to compute the total client served of all hospitals if roving.


Days with PPFF in THIS hospital #DIV/0! PPFF/Day in THIS Hospital
Days with PPFF in ALL hospital (if ROVING) 12 Overall PPFF/Day for ALL Hospital (IF ROVING)
[ Number of Days covered with PPFF] [ Average PPFF per Day]

CLIENTS SERVED TOTAL WALK - IN


OUTPATIENT GRAND TOTAL (Not Included
CLIENTS AT POST OPD CLIENT Client Served in Client
LECTURES SERVED Served)
SPONSORED NON-MEMBER
0 0 0 0

MENT REPORT
. of Outpatient Client (6)
Served (Sum of
TOTAL INPATIENT
patient clients served
post per category and
TOTAL NO. OF WALK-
IN CLIENTS ASSISTED
DISCHARGES PPFF
item no. 5)

0 0 0

ved (Monthly Basis) 100% [opps! percentage out of ranged, Please input in-patient dis

per Hospital/Week

ed (Monthly Basis)

r Month (All Hospitals)


pital 257
ospital (IF ROVING) 21
PFF per Day]

TOTAL
Total No. of
INPATIENT
DISCHARGES PPFF
0 0

ease input in-patient discharges MMHR C/O Task Leader]


HOSPITAL ASSIGNMENT: [Pick from the Drop Down Menu]
PERIOD COVERED: Oct 26 31 2015
month from to year

IN-PATIENT CLIENTS SERVED


DATE NUMBER OF INPATIENT CLIENTS AT POST
FORMAL INFORMAL LIFETIME INDIGENT SPONSORED NON-MEMBER

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
TOTAL 0 0 0 0 0 0

BELOW IS THE SUMMAR


(1 & 2) [Pick from the Drop Down Menu]
NUMBER OF INPATIENT AND OUTPATIENT CLIENTS SERVED AT

FORMAL INFORMAL INDIGENT SPONSORED LIFETIME

0 0 0 0 0

Pay attenti

Total No. of Disc

In-Patient Discharges
Per MMHR
(C/O Task Leader)

Total No. of Discharge/Mon


2883
Total hospitals MMHR Discharges

This is to compu
0
MMHR 21
Based from previous month NHIP NON-NHIP SOURCE

VED TOTAL OUT-PATIENT CLIENTS SER


INPATIENT
WARD NUMBER OF OUTPATIENT CLIENTS AT POST
CLIENT
CLASSES/ROOM-
SERVED
TO-ROOM VISITS FORMAL INFORMAL LIFETIME INDIGENT
0 0 0 0 0

IS THE SUMMARY THAT WILL BE NEEDED ON THE ONLINE ACCOMPLISHMENT REPORT


n Menu] (3 & 4) (5) No. of Outpatient Client
Number of Client
Served (Sum of
NTS SERVED AT POST WARD CLASS & Served during IEC &
Outpatient clients served
ROOM-TO-ROOM OPD LECTURES Room-to-room visits at post per category and
NON-MEMBER VISIT (sum of item 3,4,5) item no. 5)

0 0 0 0

Pay attention on the cells in white because these will be needed on the online AR.

Total No. of Discharges/Month % Client Served (Monthly Basis)


0 #DIV/0!
OPD Total #DIV/0!
Client Served (MMHR+OPD) Percentage per Hospital/Week
Locked Locked Locked

of Discharge/Month (All Hospital if Roving) % Client Served (Monthly Basis)


886 3769 52.06%
Total OPD All Hospitals Percentage per Month (All Hospitals)
Client Served (MMHR+OPD)

This is to compute the total client served of all hospitals if roving.


Days with PPFF in THIS hospital #DIV/0! PPFF/Day in THIS Hospital
Days with PPFF in ALL hospital (if ROVING) 12 Overall PPFF/Day for ALL Hospital (IF ROVING)
[ Number of Days covered with PPFF] [ Average PPFF per Day]

CLIENTS SERVED TOTAL WALK - IN


OUTPATIENT GRAND TOTAL (Not Included
CLIENTS AT POST OPD CLIENT Client Served in Client
LECTURES SERVED Served)
SPONSORED NON-MEMBER
0 0 0 0

MENT REPORT
. of Outpatient Client (6)
Served (Sum of
TOTAL INPATIENT
patient clients served
post per category and
TOTAL NO. OF WALK-
IN CLIENTS ASSISTED
DISCHARGES PPFF
item no. 5)

0 0 0

ved (Monthly Basis) 100% [opps! percentage out of ranged, Please input in-patient dis

per Hospital/Week

ed (Monthly Basis)

r Month (All Hospitals)


pital 257
ospital (IF ROVING) 21
PFF per Day]

TOTAL
Total No. of
INPATIENT
DISCHARGES PPFF
0 0

ease input in-patient discharges MMHR C/O Task Leader]


HOSPITAL ASSIGNMENT: Ago General Hospital
PERIOD COVERED: Oct 2015
month from to year

IN-PATIENT CLIENTS SERVED


DATE NUMBER OF INPATIENT CLIENTS AT POST
FORMAL INFORMAL LIFETIME INDIGENT SPONSORED NON-MEMBER

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
TOTAL 0 0 0 0 0 0

BELOW IS THE SUMMAR


(1 & 2) Ago General Hospital
NUMBER OF INPATIENT AND OUTPATIENT CLIENTS SERVED AT

FORMAL INFORMAL INDIGENT SPONSORED LIFETIME

0 0 0 0 0

Pay attent

Total No. of Disc

In-Patient Discharges
Per MMHR
(C/O Task Leader)

Total No. of Discharge/Mon


2883
Total hospitals MMHR Discharges

This is to compu
0
MMHR 21
Based from previous month NHIP NON-NHIP SOURCE

VED TOTAL OUT-PATIENT CLIENTS SER


INPATIENT
WARD NUMBER OF OUTPATIENT CLIENTS AT POST
CLIENT
CLASSES/ROOM-
SERVED
TO-ROOM VISITS FORMAL INFORMAL LIFETIME INDIGENT
0 0 0 0 0

IS THE SUMMARY THAT WILL BE NEEDED ON THE ONLINE ACCOMPLISHMENT REPORT


(3 & 4) (5) No. of Outpatient Client
Number of Client
Served (Sum of
NTS SERVED AT POST WARD CLASS & Served during IEC &
Outpatient clients served
ROOM-TO-ROOM OPD LECTURES Room-to-room visits at post per category and
NON-MEMBER VISIT (sum of item 3,4,5) item no. 5)

0 0 0 0

Pay attention on the cells in white because these will be needed on the online AR.

Total No. of Discharges/Month % Client Served (Monthly Basis)


0 #DIV/0!
OPD Total #DIV/0!
Client Served (MMHR+OPD) Percentage per Hospital/Week
Locked Locked Locked

of Discharge/Month (All Hospital if Roving) % Client Served (Monthly Basis)


886 3769 52.06%
Total OPD All Hospitals Percentage per Month (All Hospitals)
Client Served (MMHR+OPD)

This is to compute the total client served of all hospitals if roving.


Days with PPFF in THIS hospital #DIV/0! PPFF/Day in THIS Hospital
Days with PPFF in ALL hospital (if ROVING) 12 Overall PPFF/Day for ALL Hospital (IF ROVING)
[ Number of Days covered with PPFF] [ Average PPFF per Day]

CLIENTS SERVED TOTAL WALK - IN


OUTPATIENT GRAND TOTAL (Not Included
CLIENTS AT POST OPD CLIENT Client Served in Client
LECTURES SERVED Served)
SPONSORED NON-MEMBER
0 0 0 0

MENT REPORT
. of Outpatient Client (6)
Served (Sum of
TOTAL INPATIENT
patient clients served
post per category and
TOTAL NO. OF WALK-
IN CLIENTS ASSISTED
DISCHARGES PPFF
item no. 5)

0 0 0

ved (Monthly Basis) 100% [opps! percentage out of ranged, Please input in-patient dis

per Hospital/Week

ed (Monthly Basis)

r Month (All Hospitals)


pital 257
ospital (IF ROVING) 21
PFF per Day]

TOTAL
Total No. of
INPATIENT
DISCHARGES PPFF
0 0

ase input in-patient discharges MMHR C/O Task Leader]


Republic of the Philippines
PHILIPPINE HEALTH INSURANCE CORPORATION
PhilHealth Regional Office V
ANST Bldg. III, Alternate Road, Legazpi City
Pro 5 Healthline 052-4815596

PRO V Philhealth CARES Client Served Monitoring Tool

Name of CARES: MARK DARREN Z. PRAXIDES


Period of Hospital Assignment: FEBRUARY 1-28, 2016
Total No. of Discharges/Month
Total No of PPFF Total No. of % Client Served Total No. of In-
Date Name of Hospital Surveyed Client Served Total No. of Daily Basis Patient Discharges
Total No. of OPD
Client Served
Discharges / Day (as per MMHR)
1 Bicol Medical Center 15 72 158 45.57%
2 10 67 129 51.94%
3 #DIV/0!
4 4 15 114 13.16%
5 #DIV/0!
6 18 110 179 61.45%
7 13 88 134 65.67%
8 15 125 167 74.85%
9 15 108 154 70.13%
10 14 93 148 62.84%
11 #DIV/0!
12 #DIV/0!
13 11 101 135 74.81%
14 10 74 155 47.74%
15 14 110 146 75.34%
16 16 131 187 70.05%
17 26 154 217 70.97%
18 7 41 100 41.00%
19 #DIV/0!
20 7 104 140 74.29%
21 10 99 166 59.64%
22 15 76 168 45.24%
23 10 98 167 58.68%
24 12 104 130 80.00%
25 #DIV/0!
26 #DIV/0!
27 8 106 155 68.39%
28 7 86 134 64.18%
29 #DIV/0!
30 #DIV/0!
31 #DIV/0!
GRAND TOTAL 257 1962 3183 61.64% 2883 886
/Month
% Client Served
Remarks
Total Monthly Basis

SICK LEAVE

SUNDAY

SPECIAL PRIVILEGE LEAVE


SUNDAY

SUNDAY

UNDERTIME

SUNDAY

*
*
*
3769 52.06%
Issues and Concerns of PhilHealth CARES
Month of OCTOBER 2016
When
Elevated to
When PRO(if not
Resolved (if resolved by
resolved) by Action Taken by CARES)
Name of Hospital Issues and Concerns
CARES? CARES (What Section
(Date/Time) and to whom
referred,
Date/Time)
[Pick from the Drop Down Menu]
Action Taken by
PRO
(What Section, Status
Date/Time)

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