Advisory on the Processing of EC Medical Reimbursement with Previous Philhealth and/or HMO Benefits

July 30, 2014ECC CIRCULAR NO. 07-018ADVISORY ON THE PROCESSING OF EC MEDICAL REIMBURSEMENT WITH PREVIOUS PHILHEALTH AND/OR HMO BENEFITSThe following advisory is hereby issued in relation to the implementation of Board Resolution No. 12-05-15 ("Admissibility of Certified True Copies of Official Receipts in the Filing of Claims for Medical Reimbursement") and due to numerous queries on whether the amount covered by PhilHealth and/or HMO benefits may be reimbursed from the Systems: 1. After the allowable HMO and/or PhilHealth benefits, if any, have been completely exhausted for a particular confinement or consultation, only the out-of-pocket expenses of the employee with work-related sickness or injury shall be the subject of claim for EC medical reimbursement;2. The amount of reimbursement should not be higher than the actual amount paid by the said employee and the prevailing rates prescribed by the Commission;3. Claim for EC medical reimbursement from the employer may only be allowed in case the employer has paid the hospitalization expenses of the employee with work-related sickness or injury.For guidance of all concerned. EDSAacDone in the City...