Purple cow 2011 (admin)

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  • 1.
    • (InpatientorOutpatient)
  • You will only need to file for reimbursementif 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 callSheila(888-0001 ext. 846).
  • 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.

Reimbursement 2.

  • Submit accomplishedOut-Patient Claim Form
    • To be accomplished & signed by the Employee AND the attending physician
    • To be submitted to HR
  • ORIGINALof 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

OutpatientClaim Checklist 3.

  • Submit accomplishedHospitalization Claim Form
    • Part 1 - by the insured
    • Part 2 - by the authorized HR officer
    • Part 3 - by the ATTENDING physician
  • ORIGINALof 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

InpatientClaim Checklist 4. 5.