Eligibility and Claim Requirements
- OFW or dependent must present a certification from the hospital and attending physician.
- Certification must confirm that medicare benefits were not deducted from hospital bills and full payment was made by the claimant.
- All other documentary requirements relevant to the claim must be submitted.
Processing of Claims
- Medical Care Assistance Unit is responsible for processing submitted claims.
- Upon proper documentation, the unit shall issue payment checks in favor of the OFW claimant.
Time Limit for Filing Claims
- Claims related to confinement while at the job site must be filed within six (6) months from the discharge date.
- Claims filed after this six-month prescription period shall be automatically denied.
Documentation and Evaluation Requirements
- A medical evaluation report shall substitute for PHIC Form 2 to facilitate faster evaluation and claim processing.
- Claims will follow standard processing procedures despite documentation change.
Certification Alternatives
- If the duly authenticated Medical Examination Certificate (MEC) is unavailable, a certification from the Management Information System Division (MISD) will be accepted.
- If MEC is presented, the processing office must authenticate the xerox copy of the MEC to expedite procedures.
Intended Effect and Compliance
- Provisions aim to expedite the processing of medicare claims for active OFW members.
- The memorandum was adopted on October 4, 1996, undersigned by Administrator Wilhelm D. Soriano.