purple cow 2012 (admin button)
TRANSCRIPT
(Inpatient or Outpatient)
★ You will only need to file for reimbursement if you seek treatment as a Private Patient and pay up front, versus seek treatment as an HMO Patient and not pay at all, because:
★ 1) you want to be treated by a non-accredited doctor; and/or★ 2) you want to be treated in a non-accredited hospital/clinic.
★ To get reimbursed, fill out the proper claim form, complete all the requirements, and submit all the documents.
★ For pick-up of your claims documents in Manila, please call Lala (888-0001 ext. 835).
★ Outside Manila, please send via LBC to:
GRA (attention: Purple Cow) 15/F Chatham House, Salcedo Village,
Makati City
★ The standard wait period for reimbursement of claims is fifteen (15) working days.
ReimbursementReimbursement
Submit accomplished ‘Out-Patient Claim Form’
To be accomplished & signed by the Employee AND the attending physician
To be submitted to HR
ORIGINAL of the following should be submitted:
Official Receipt(s);
Prescription for the diagnostic test(s);
Medical Certificate in the absence of Out-Patient Claim Form but insured still has to accomplish the Out-Patient Claim Form
OutpatientOutpatient Claim Checklist Claim Checklist
★ Submit accomplished ‘Hospitalization Claim Form’✔ Part 1 - by the insured
✔ Part 2 - by the authorized HR officer
✔ Part 3 - by the ATTENDING physician
★ ORIGINAL of the following should also be submitted:✔ Official Receipt(s) bearing ‘BIR Permit
Number’ ✔ Hospital bills, ✔ Professional Fee(s)✔ Medicines bought outside the hospital but were
consumed during confinement
✔ Statement of Account (SOA)✔ Itemized list of expense, Charge Slips
✔ Police Report, when necessary
InpatientInpatient Claim Checklist Claim Checklist