Health Maintenance Organizations (HMO)
Out Patient
-
HMO members will present their card and valid ID to hospital-authorized representatives.
-
Hospital representatives will verify if the card is still active by calling the HMO hotlines or HMO agents, or through email, or online app.
-
Once verified as active, HMO members can now proceed to the clinic of accredited doctors for consultation.
-
For emergency cases, they can proceed to the Emergency Room for immediate treatment.
-
After consultation, HMO members will return the consultation form to the HMO office. If, with a diagnostic procedure, the Hospital Representative will call HMO hotlines for approval.
-
Once the procedure is approved, the Hospital representative will issue an approval slip.
In Patient
-
If the member is for admission, the Hospital representative will report the admitting details of the member to the liaison officer.
-
Daily updates of the temporary bill of the member.
-
Answer telephone calls and inquiries of liaison officers.
FOR DISCHARGE
-
Report the patient/ member for discharge to their HMO.
-
Scanned the SOA and detailed bill of the patient, then sent to the email of their designated HMO.
-
The Hospital Representative will wait for the LOA (Letter of Authority).
-
If with LOA, the hospital representative will forward to the Billing Section for final deduction of HMO.