Receiving of directly-filed claims | PhilHealth (unofficial RE:GOV concept) · RE:GOV

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GOVPH · Republic of the Philippines

Receiving of directly-filed claims

You get your directly filed benefit claim received for processing when no automatic deduction was made.

At a glance

Office: Local Health Insurance Offices (LHIOs)
Classification: Simple
Who may apply: All PhilHealth Members who were NOT able to avail of the automatic deduction
Total fees: None
Total processing time: 1 hour and 10 minutes

Requirement	Where to get it
Properly filled-out Acknowledgement Receipt Form (1 original copy)	Public Assistance and Complaint Desk PhilHealth Website (www.philhealth.gov.ph/downloads) or in any PhilHealth Local Health Insurance Office (LHIO)
Properly filled-out PhilHealth Claim Form 1, 2, 3, & 4 and Claims Signature Form (CF1, CF2, CF3, CF4, CSF), as applicable (1 original copy)	Public Assistance and Complaint Desk PhilHealth Website () or in any PhilHealth Local Health Insurance Office (LHIO)

What you do	What the office does	Fee	Time
Get queuing number at the PACD and wait for the number to be called	Issue queuing number and advise client to proceed to designated counter when the number is called (PACD Officer)	None	1 hour ***
Submit duly accomplished acknowledgement receipt form and PhilHealth Claims form with supporting documents	Receive and screen claims documents as to completeness of documentary requirements (non-medical) If documents have deficiency/ies, Return the same and advise the client accordingly If documents are complete; Stamp “received” in the acknowledgement receipt form and give the client a receiving copy (Frontline Officer/Claims Receiving Officer Designate)	–	6 minutes
Receive acknowledgement receipt or claim with deficiency	Log the Claims received in the logbook and let the member or representative signed for acknowledgement (Frontline Officer/Claims Receiving Officer Designate)	–	1 minute
	Advise client to receive Benefit Payment Notice (BPN) within 60 days (Frontline Officer/Claims Receiving Officer Designate)	–	1 minute