PATIENTS who received emergency department (ED) services from Feb. 14 onward this year, but were unable to avail of Outpatient Emergency Care Benefit (OECB) coverage, may now file for reimbursement directly with the Philippine Health Insurance Corp. (PhilHealth).
This was embodied in PhilHealth Advisory No. 2025-0017, which also outlines updates and clarifications regarding the OECB Package for both patients and healthcare providers.
“The triage classification of a patient seen in the ED shall be left to the discretion of the health care provider,” the PhilHealth advisory read.
To process claims, members must submit Claim Forms 1, 2, and 4, an itemized statement of account, laboratory and imaging results, the Essential Emergency Care List (EECL) Summary Form, and a hospital waiver with an official receipt.