rd - calapan · 5.gold card database/system 6.gold card id w/ beneficiary record(br) how to avail...

New Government Center, Guinobatan, Calapan

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TABLE OF CONTENTS

1. Procedures and Requirements

2. Gold Card Benefits

3. Accredited Hospitals

4. Membership and Distribution of ID’s


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5.Gold Card DataBase/System

6.Gold Card ID w/ Beneficiary Record(BR)

HOW TO AVAIL THE SERVICES:

Step What will the client do? What will service provider do? Requirements

For Evaluation:

Certificate of indigency from the

Barangay Captain.

1 Ask for assistance? Go to the Barangay Hall or designated area

Interview and assist client if qualified to avail

benefits


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Fill-up membership form(2 copies).

Barangay certification that she/he is

resident of the barangay with resident

certificate.

18 years old and above

Registered voter of Calapan City

CSWDD and Gold Card Office identify

and validate the qualified and

legitimate residents as beneficiaries of

the program

For Membership of Gold Card

Photocopy of the following:

Marriage contract(if married)

Birth certificate( If not married/or

single)

Birth certificate for the children of aged

21 below.

Senior Citizen ID

Latest Community Tax Certificate.

If membership form have been completed,

approval of the City Health Card Program

Manager.

Printing of Gold card ID’s

Distribution of Gold Card ID’s in every

Barangay.

End of Transaction


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HOW TO AVAIL THE HOSPITALIZATION SERVICES:


For Gold Card

Gold Card ID

Beneficiary Record (BR)

For Hospital

Clearance Form

Claim Form 1

Claim Form 2 (Health Care Providers

Certification)

Drug and Medicine Fsorm( X-Ray,

Laboratories and other)

Copy of statement of account (SOA)

Note: Please submit all supporting documents

within seven (7) days from the date of

1

Present hospital

clearance form,

photocopy of Gold

Card ID Beneficiary

Record (BR) and

statement of

account to the Gold

Card Office.

Register and encode the statement of

account to the system.

Sign and release the clearance form to the

patient/client

2

Submit Hospital Bill

and other

supporting

documents in

Health Care

Providers.

Receive, compute and check the patient

covered benefits from the Gold Card that are

confined in the hospital.

Prepare necessary official documents of

hospital billing for payment obligation.

The concerned department process the

official documents for payment obligation.


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availment.

End of Transaction

HOW TO AVAIL THE DIAGNOSTIC SERVICES SUCH AS LABORATORY AND OTHER MEDICAL PROCEDURE:


For availment of diagnostic services such as

laboratory and other medical procedure

services including ultrasound, CT scan, 2D echo

and MRI with or without confinement or

admission to the hospital.

1

Present the

necessary

documents

together with their

Gold Card ID and

Beneficiary Record

Physician request letter for the medical

procedure.

Guarantee letter issued with the affixed

signature of the Program Manager to the

partner hospital that cover obligation of a

specific amount.


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(BR) for validation

of request and

membership.

Release the clearance form B to the

patient/client

Out Patient/ In Patient

For Gold Card

Guarantee Letter issued by the Program

Manager

Claim Form B

For Hospital

Physician request for medical

examination

Statement of account issued by the

Health Provider(SOA)

Result of laboratory examination with

diagnosis

Photocopy of Gold Card ID

Beneficiary Record (BR)

Note: Please submit all supporting papers

within seven (7) days from the date of

availment.

Prepare the necessary official documents of

diagnostic services for payment of benefits

under the program.

The concern department process the official

documents for payment obligation.


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End of Transaction

HOW TO AVAIL OF THE CONSULTATION SERVICES TO OTHER HEALTH PROVIDERS:


For Gold Card

Referral letter from the City Health

Physician

Guarantee letter

Claim Form A

1

Present the Gold

Card ID and

Beneficiary

Record(BR) for

validation of

membership.

Referral letter from

the City Health

physician and

guarantee letter

Encoded official document to the system.

Release the clearance form A and guarantee

letter to the patient/ client

Referral letter from the Health Physician.


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from City Socialized

Medical Health

Care Office

Program Manager

For Hospital

Medical Certificate

Note: Please submit all supporting documents

to the Doctor/Specialist when the patient

undergo the consultation.

Prepare the necessary documents for

medical consultation.

The concern department process the official

documents for payment obligation.

End of Transaction


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HOW TO AVAIL OF THE MAINTENANCE MEDICINE SERVICES FOR SENIOR CITIZEN

AND PATIENT W/ NEUROLOGIC PROBLEMS:


For Elderly and Mental Patient

Gold Card ID

Medical Certificate

Purchase Booklet

Physician Prescription

1

Present the Gold card

ID and Beneficiary

Record(BR) for

validation of

membership together

with their purchase

booklet.

Present the medical

certificate and

prescription of

medicine to Gold Card

Office

Loof for purchase booklet, encode to the

system.

Refer to Botika ng Lungsod availment of

prescribe medicine

Prepare the necessary official documents

of maintenance medicine for payment

obligation.

The concerned department process the

official document for payment obligation.


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End of Transaction

GOLD CARD BENEFITS


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1.CT-SCAN


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2. 2D – ECHO


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3. ULTRASOUND


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4. MRI(Magnetic Resonance Imaging)


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5. CHEMOTHERAPY


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6. HEMODIALYSIS


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FOR SENIOR CITIZENS


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HYPERTENSION

DIABETES

MEDICINE PURCHASE

BOOKLET


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FOR PATIENT W/ NEUROLOGIC PROBLEMS


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MEDICINE PURCHASE

BOOKLET


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1. ORIENTAL MINDORO PROVINCIAL HOSPITAL(OMPH)


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Sta. Isabel, Calapan City

2. MEDICAL MISSION GROUP HOSPITAL(MMG)


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Tawiran, Calapan City

3. MARIA ESTRELLA GENERAL HOSPITAL INC.(MEGH)


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Tawiran, Calapan City

4. LUNA GOCO MEDICAL CENTER(LGMC)


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Lalud, Calapan City

5. STA. MARIA VILLAGE CLINIC(SMVC)


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Sta. Maria Village, Calapan City

6. HOSPITAL OF THE HOLYCROSS


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Ilaya, Calapan City

7. CHILDREN’S MEDICAL HOSPITAL


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Salong, Calapan City


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rd - calapan · 5.gold card database/system 6.gold card id w/ beneficiary record(br) how to avail...

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