星空体育

Intellicare听continually updates its list of affiliated doctors, thus it is advisable for you to check the list of听Intellicare-affiliated听doctors, their schedule, and their contact details in the PROVIDERS page of the听Intellicare website. You may also speak with one of our Customer Service Specialists through telephone numbers听(02) 789-4000听辞谤听(02) 902-3400.

Consultation, treatment, and referral for diagnostic procedures and/or confinement coming from a non-affiliated doctor are non-reimbursable. For you to enjoy the benefits of your health plan, you must avail of your benefits in an Intellicare-accredited hospital or clinic and have your case managed by an Intellicare-affiliated doctor, except during emergency cases.

You may write a request for affiliation to听滨苍迟别濒濒颈肠补谤别鈥檚 Medical Relations Department听or coordinate with your听HR Representative听to facilitate your request. The doctor/dentist will be asked to submit necessary requirements to听Intellicare听and will be evaluated by听the company鈥檚 Medical Relations Department (MRD)听if they are qualified to be part of听滨苍迟别濒濒颈肠补谤别鈥檚 network. The doctor may only be affiliated if he/she passes听滨苍迟别濒濒颈肠补谤别鈥檚 evaluation and if he/she agrees to the payment terms and conditions of the contract.

Yes, you may occupy a room category higher than what is entitled to you. However, during voluntary upgrading (when you choose to occupy a higher room category even if your allowed room is available), you will pay all incremental charges. Due to socialized pricing in hospitals, the higher the room occupied, the higher the cost of services. This includes room rate, professional fees, medicines, medical supplies, hospital procedures, and the like. The same charges may also apply if you are admitted in a hospital that does not provide or does not allow confinement of non-private patients in the room category corresponding to your plan. The听Intellicare Patient Relations Officer (PRO) shall explain and remind you to pay these charges prior to hospital discharge.

Any and all illnesses proven to be related to or is a complication of a certain illness shall share the same听Maximum Benefit Limit (MBL).

It is the member鈥檚 responsibility to file the听Philhealth forms. If you fail to file upon hospital discharge, you will pay the amount corresponding to your听Philhealth听benefit and apply for reimbursement directly from the听Philhealth Office听afterwards. You may coordinate with your company鈥檚 HR Representative during your confinement period to secure a signed听Philhealth Claim Form 1,听Philhealth contributions听and听Member鈥檚 Data Record (MDR)听as well as a听Philhealth Claim Form 2听to be signed by your attending physician prior to hospital discharge.听Intellicare Patient Relation Officers (PROs)听will provide assistance in reminding you to submit the said forms. They, however, will not be directly responsible for the actual filing. In the case of a听non-Philhealth member, member must pay the听Philhealth portion of the hospital bill prior to hospital discharge.

Submission of the duly accomplished Intellicare Reimbursement Form and required attachments is within听30 days听from the date of hospital discharge or treatment.听Intellicare听will process the request within听30 days upon receipt of the complete documents.

You may pay for the cost of the procedure first then file for reimbursement later on. Reimbursement shall be based on the Relative Value Scale (RVS) or pre-agreed rates for laboratory and diagnostic examinations (e.g. CT scan, MRI). If you do not wish to pay for the amount being asked for, you may transfer to another Intellicare-accredited facility that does not have a 鈥渃ash basis only鈥� policy. You may also call 滨苍迟别濒濒颈肠补谤别鈥檚 Customer Service for assistance at听(02) 789-4000听辞谤听(02) 902-3400.

The professional fees of Neurologists at the moment are on a 鈥渃ash basis鈥� policy for all HMO members. This policy is in accordance with the guidelines set by the Philippine Neurological Association. You may pay for the cost of professional fees first then file for reimbursement based on 滨苍迟别濒濒颈肠补谤别鈥檚 Relative Value Scale (RVS). For any recommended procedures, Intellicare will cover the member immediately according to the plan benefit.

Intellicare will exert all its effort to negotiate for the Intellicare rate to be charged once the member is referred to a non-affiliated specialist. If the physician does not agree to the rate, you will be asked to pay the cost of their professional fee first then file for reimbursement based on the Intellicare Relative Value Scale (RVS).

In this case, you need to submit a police report and other pertinent documents for any injuries sustained in vehicular accidents and other medico-legal cases (e.g. shooting, stabbing, mauling) subject for evaluation. Intellicare will not cover injuries resulting from causes under the general exclusions and limitations.

The member鈥檚 星空体育 benefit is co-terminus with their stay with the company. You should surrender your card prior to resignation as this is a requirement of the clearance process. Use of the card after separation from the company is an illegal transaction and the member will be billed for any medical availment incurred after resignation/separation from the company.

You should notify your HR Representative and call 滨苍迟别濒濒颈肠补谤别鈥檚 Customer Service at听(02) 789-4000听辞谤听(02) 902-3400 within 24 hours upon discovery of the loss. You need to submit an Affidavit of Loss to Intellicare and will be charged Php 100 for the replacement of the card. If you need medical care while your new card is being processed, you may contact 滨苍迟别濒濒颈肠补谤别鈥檚 Customer Service for endorsement to the medical facility where the procedure or consultation/treatment will be conducted.