[ PHIC PHILHEALTH CIRCULAR NO. 07, S. 2005, February 16, 2005 ]

IMPLEMENTING GUIDELINES ON CLAIM APPLICATIONS AND REIMBURSEMENTS UNDER THE OVERSEAS WORKERS PROGRAM (OWP) OF PHILHEALTH



Pursuant to Executive Order No. 182 as amended, the Medicare Program for Overseas Workers formerly managed by the Overseas Workers Welfare Administration (OWWA) shall now be administered by the Philippine Health Insurance Corporation (PhilHealth).

Effective 01 March 2005, PhilHealth shall commence receiving and processing claim applications of overseas workers. All pending claims (claims received and transferred to PhilHealth that were not paid prior to March 1, 2005 which includes claims that were previously returned to claimants for completion/reconsideration) and those received at the close of business hours of February 28, 2005 shall be processed and reimbursed by PhilHealth.

Therefore, all overseas workers concerned as well as accredited health care providers are now advised to file their claim applications with PhilHealth starting March 1, 2005 through its regional and service offices nationwide. For further information of the location of our regional offices and service offices, please refer to our website at www.philhealth.gov.ph or call telephone number 6379999 local 1122 & 1124 for the address of a particular regional office. For the convenience of the overseas workers and their family members, PhilHealth shall maintain service desks in all OWWA offices that will receive claim applications. These will then be forwarded to the PhilHealth Head Office at Citystate Centre, 709 Shaw Boulevard, Pasig City for processing and payment.

The prescribed claim forms to be used by overseas workers shall remain the same as provided for in PhilHealth Circulars 11 and 24 series of 2000. These are the PhilHealth Claim Form 1 to be accomplished by the overseas worker-member; and PhilHealth Claim Forms 2 and 3 for accredited health care providers. Documentary requirements as provided for in OWWA Memorandum of Instruction No. 002 series of 2001 shall remain in full force and effect.

Furthermore, please be informed that all claims for confinement within the Philippines must be filed within 60 calendar days after discharge. Confinement abroad, however, can be filed within 180 days from discharge.

For your information and guidance.

Adopted: 16 Feb. 2005

(SGD.) FRANCISCO T. DUQUE III
Secretary
President and CEO