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GUIDELINES ON FILING OF CLAIMS

 

Claims for reimbursement will be governed by the following guidelines:

 

VALIDITY PERIOD:    

  1.  A claim for reimbursement must be filed and received by I-Care within sixty (60) days from the date of   availment for out-patient benefits and sixty (60) days from the date of discharge in case of in-patient benefits.

  2.  Processing period shall be thirty (30) days from the date of receipt by I-Care of the said claim provided that the member has submitted (together with the claim) all the necessary documents required.  In case an additional requirement is needed, the 30-day period shall be reckoned against the date when said additional requirement is submitted

REQUIREMENTS:

All claims for reimbursement must be submitted together with the original copy of the following documents:

 

v         OUT PATIENT

q          Medical Certificate from the attending physician

q          Official Receipts of payments to physician &/or hospital

q          Charge slips with breakdown of charges

 

v         IN PATIENT

q          Medical Certificate from the attending physician

q          Official Receipts of payments to physician &/or hospital

q          Statement of Account

q          Charge Slips with breakdown of charges

q          Operative Record/Surgical Procedure including histopathological report when applicable

q          Police Report &/or Subrogation Report if Medico-legal case

 

v         PRESCRIPTION BENEFIT/DENTAL BENEFIT

q          Medical Certificate from the attending physician / dentist

q          Prescription

q          Official Receipts indicating medicines purchased

 

It is understood that other requirements may be imposed as deemed necessary.                           

For inquiries and follow-up, you may call the Medical Claims Section at 813-0131 to 36 loc. 8301-8302, 813-7835

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Download Claim for Reimbursement Form here!

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