BY: FAYETTE C. RIÑEN
CEBU CITY, August 20 (PIA) --- A new memo circular of the Philippine Health Insurance Corporation (PHIC) released last week now permits members to file direct claims for allowable hospitalization reimbursement from PhilHealth to its office or any of its express lanes in major malls in Central Visayas.
PhilHealth chief of the Benefits Administration section, Dr. Nelda Pe said that unlike before, where hospitals are the only ones that can file reimbursement claims for hospital bill deduction of PhilHealth members from PHIC, the new memo now allows members to directly file hospital reimbursement claims.
“The new memo is retroactive starting January 1, this year,” bared Pe during the weekly forum of the Association of Government Information Officers (AGIO-7) that featured PHIC or PhilHealth’s programs and services.
Pe said the memo is applicable to any hospitalized PhilHealth member who has been discharged on a weekend but has not prepared the needed Philhealth form signed by the member’s employer for the hospital to deduct the PhilHealth contributions.
“In this case, the member will just have to shell out her personal money then file for reimbursement claim from our office,” said Pe. Total processing time for reimbursement claims is 60 days or two months from receipt of required documents.
Pe said the PHIC member who will file direct claim for reimbursement also need to submit to PhilHealth the waiver form signed by the hospital so the latter would no longer file any reimbursement claim.
PhilHealth public relations officer, Atty. Karisma Agraviador however, advised members to have a copy of their Member Data Record (MDR) as this is very important especially during hospital discharge for PhilHealth deduction.
“We never know when we need it so we must keep a copy of our MDR always,” said Agraviador adding that the MDR would suffice in case the member has no PhilHealth form that required the employer’s signature for Philhealth deduction from hospital billing.
Agraviador said any member can visit their office to obtain the MDR or just visit the PhilHealth express lanes in major malls in Cebu like Ayala Center, SM City, Robinsons Fuente, JC Mall and Pacific Mall and ICM City Mall in Tagbilaran City, Bohol and Robinsons Dumaguete in Negros Oriental.
With the MDR, the member can do away with having to pay personal money for reimbursement claim from PhilHealth, said Agraviador as the hospital would now be the one to file for the reimbursement claims. (mbcn/FCR/PIA7)