Claims / Reimbursement Procedures

1. Secure Reimbursement Claim Form (RCF) from PhilCare
2. Accomplish the Reimbursement Claim Form

•      - Member fills out Part I of the RCF
•      - Attending Physician fills out Part II of the RCF
•      - Client Company fills out Part III of the RCF

3. Submit the following documents to PhilCare (within 30 days from date of discharge)

•      - Accomplished Reimbursement Claim Form
•      - Original copies of the Official receipt for Professional Fee and Hospital Bill
•      - Hospital Statement of Account
•      - Charge Slips/Itemized breakdown of charges
•      - Admitting History/Emergency Report/Clinical Abstract
•      - Operative Report (if surgical)
•      - Police Report (if accident)
•      - Computation of benefits by other HMO (if the first layer of benefit was shouldered by another HMO)