Yapster e-Insurance Brokers, Inc. Medical Claim Procedure
There are several classifications of Medical claims depending on the complexity of the medical case:
Consultation or diagnostics with an accredited doctor involves diagnosis of one’s illness.
Laboratory Testing involves examinations rendered as part of the diagnosis of a disease or to determine the overall health status of an individual.
A scheduled confinement is defined as hospital confinement as recommended by an accredited doctor of the employee’s Health Care Provider. Confinement is due to a health condition that needs medical or surgical treatment to be rendered by professional medical practitioners.
An emergency medical condition is herewith defined as a sudden occurrence of illness or injury that can be life threatening, or requires immediate treatment to alleviate severe pain and/or discomfort.
General Instruction for Employees
- Always present your Health Card prior to medical consultation or treatment together with a valid Identification Card.
- For out-patient or scheduled in-patient medical cases, inform your company’s Human Resource (HR) Department to coordinate availment of coverage with Yapster prior to the schedule.
Note: Detailed instructions on your health benefit coverage will be given by Yapster through your HR Department.
- For emergency in-patient cases, a family member or any representative must immediately inform your company’s human resource department regarding your medical status as soon as medical care is rendered or no later than 24 hours after the onset of the illness.
- Make sure to keep any kind of document (doctor’s prescription, medical certificate, official receipts of hospital bills and fees, etc.) related to your medical condition and treatment. (Note: It is also recommended to have these documents photocopied for future reference.)
- Be knowledgeable of the process of filing your Philhealth benefit availment. (Yapster account officers are happy to assist you if you have any question on this matter.)
General Instruction for Companies
- Make sure to endorse the Health Card and booklet to your employee once these are sent to your office.
- Immediately inform Yapster if employees with coverage will be needing medical attention or treatment to speed up the process of health benefit availment.
- Provide the employee with the necessary forms for health benefit availment or medical reimbursement with instructions on accomplishment.
- Submit accomplished forms with all the necessary attachment (the list of required attachments depend on the medical case) immediately to Yapster once these are available for processing.
For medical claim concerns, please see contact persons and contact details below:
Mr. Bong C. Monis
Account Management Officer
Mr. Joseph S. Oseo
Direct line number: (632) 840 8399
Trunkline number: (632) 893 1111 local 2098
e-mail address: moc.l1594438489laeru1594438489sni2@1594438489ofni1594438489