TamangSagot (TS) - Philippine Health Insurance Corporation

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UMID Card Activation Why must I activate my UMID card with PhilHealth? Activating your UMID card will prepare you for PhilHealth‟s shift to paperless transactions. Your UMID card will eventually enable you to access health care services at accredited facilities without having to submit documentary requirements anymore. Can I choose not to activate my UMID card with PhilHealth? Opting not to activate your UMID card with PhilHealth might render inconvenience for you at point-of-service, i.e., at the hospital billing section if you or your legal dependent is hospitalized. Once PhilHealth goes into paperless transactions, its accredited hospitals only need to swipe the members‟ UMID cards to check on their eligibility to avail themselves of PhilHealth benefits. If your UMID card is not yet PhilHealth-activated, you will be required to submit documentary requirements to support your claim for benefits. What does „card activation‟ mean? Activation of your UMID card with PhilHealth means that your Member Data Record (MDR) will be loaded electronically into your UMID card. The MDR contains your basic information as a PhilHealth member, such as your PhilHealth ID number, date of birth, civil status, address, employer, and your list of legal dependents. Your premium contribution payments for the last two years (2010 and 2011) will also be loaded into your UMID card during card activation. What are the requirements to activate my UMID card with PhilHealth? Do I need to pay any fee for card activation? No, PhilHealth is not charging any transaction fee for card activation. Are there forms I need to fill out before card activation day? None, you will not be required to fill out any forms prior to nor during card activation day. What do I need to bring on card activation day? You only need to bring your UMID card. Are there things I must ensure before I proceed with activating my UMID card? First, make sure that your UMID card is already activated with the GSIS. There are GSIS kiosks in selected local government units where your UMID card may be activated.Second, make sure that your MDR is updated; otherwise, the MDR that is currently posted in our database will be loaded into your UMID card once card activation takes place. Where can I activate my UMID card with PhilHealth? The PhilHealth UMID Mobile Team will be in your office premises on a schedule to be agreed upon with your Human Resource Department. The schedule will be announced by your HRD days before the UMID Mobile Team will set up shop in your office for the card activation. If I missed the schedule of card activation in our office premises, can I proceed to any PhilHealth Branch to have my UMID card activated? You may call the UMID Project Management Office to ask for the next scheduleat your office premises, or if the UMID Mobile Team has a scheduled card activation near your office location so you can activate your card. How long does the card activation process take? The card activation process takes only about five (5) minutes. Since you will only be required to proceed to the card activation venue on your appointed day and time, you need not spend hours at the venue to wait for your turn. Page 32 of 47
Page 33 of 47 Can I update my MDR on the day of card activation through the UMID Mobile Team? The UMID Mobile Team will be busy handling the card activation process and they will not be able to attend to your MDR updating requirements. We advise you to do this at least three (3) days before the schedule of card activation. Your HRD can help you update your PhilHealth records. What are the card activation procedures? The card activation procedure is very simple. Simply follow these steps: 1. Tap your UMID card on card reader 2. Press any of your registered fingers into the fingerprint scanner 3. Validate your Member Data shown onscreen 4. If data are accurate, choose „Overwrite Data on Card‟; otherwise, choose „Cancel‟ 5. Press finger on fingerprint scanner to signify end of procedure 6. Remove card from card reader How will I use my PhilHealth-activated UMID cards? Procurement of kiosks through which the PhilHealth-activated UMID cards can be read is underway. Once these are installed at selected locations nationwide, you can check on your PhilHealth data anytime, anywhere. You can also use the UMID card to track the status of your PhilHealth claim, to verify if a dependent has been declared in your MDR, or verify if your premium contributions have been posted. What are the contact numbers if I have further questions regarding the UMID card activation? Further questions on the UMID card activation may be referred to the UMID Project Management Office at 441- 7444 extension 7671 and 7672. H. BENEFITS AND BENEFITS AVAILMENT What benefits can a member avail himself of under the NHIP? PhilHealth offers a roster of benefits to ensure that members are given true financial risk protection. This section provides a glimpse of these benefits that each member can enjoy. Basic Benefit Package for Hospitalization This package is available to all member-types based on the hospital category and type of illness of the patient. It covers: 1. Allowance for Room and Board 2. Allowance for Drugs and Medicines 3. X-ray, laboratory and others 4. Professional fees 5. Use of the Operating Room complex This package varies according to several factors – hospital level, case type of disease, relative value unit, and doctor‟s qualifications. 1. Case Types (varies according to severity of illness) a. Case Type A – simple illnesses b. Case Type B – moderate cases c. Case Type C – severe cases d. Case Type D – extremely severe illnesses 2. Relative Value Unit (RVU). Benefit allowances for operations vary according to their complexity; this complexity is reflected in the Relative Value Unit or RVU. The more complex the procedure, the higher the RVU and the corresponding benefit allowances.
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