HMO : Covid-19 Guidelines and FAQs

HMO : Covid-19 Guidelines and FAQs

A. COVID-19 (Coronavirus) Remote Working Protocol/Communication Guide

Alert
Reminders:
Members must always inform their direct supervisors/leaders regarding their health status, especially members that will test positive for Covid.
Leaders are to send the notification form via ticket to HR and to the following for tracking purposes once a member is confirmed to be a Covid positive case:
Mary Grace Malonzo - marygrace.malonzo@infinit-o.com
Florentin Lenoir - florentin.lenoir@infinit-o.com
Richard Tan - richard.tan@infinit-o.com
Millicent Martinez - millicent.martinez@infinit-o.com

What to do?

A Notification Form (copy at the bottom of the page) should be filled-out and submitted to the internal Health and Safety Committee for any of the following situations. The privacy and confidentiality of the employee must always be maintained.

  1. If an employee calls in sick due to flu-like symptoms: 

  2. Employee to seek medical advice on proper medication and assessment whether necessary or not to undergo testing.
    1. Employee to self-quarantine until results are returned (if tested)
    2. Employee to stay at home for 24 hours after symptoms have subsided (if not tested)
    3. Employee to follow advice of local government and health authorities
    4. Supervisor to maintain regular contact with employee
 

        2. If an employee tests positive:

  1. Health and Safety Committee to contact employee on next steps 
  2. Employee to follow the advice of BHERT (Barangay Health Emergency Response Team) and HMO
  3. Supervisor to maintain regular contact with employee for any support that can be provided
  4. After quarantine (of at least 10 days) and prior or upon return to work, member should secure a fit to work clearance from their attending Physician and/or Barangay Health Emergency Response Team (BHERT) to be presented to their direct supervisor, to be forwarded to HR with the employee’s consent
           

        3. If an employee had CLOSE contact with a confirmed/suspected case:

  1. Employee to notify BHERT about the situation and get in touch with HMO Teleconsult for daily monitoring of condition
  2. Employee to follow advice of local government and health authorities
  3. Supervisor to maintain regular contact with employee
 

        4. If an employee had CASUAL contact with a confirmed case:

  1. Employee to continue working from home as usual
  2. Employee to self-monitor for symptoms
  3. Employee to meek medical advice if symptoms develop (call BHERT and HMO)
  4. Employee to follow advice of local government and health authorities
  5. Employee to notify supervisor if symptoms develop

  1. Employee to continue working from home as usual
  2. Employee to self-monitor for symptoms
  3. Employee to seek medical advice if symptoms develop (call HMO)
  4. Employee to follow advice of local government and health authorities
  5. Employee to notify supervisor if symptoms develop
 
Info
Close contact means that employee had face-to-face contact within one (1) meter or was in a closed space for more than fifteen (15) minutes with an infected person. 
 
In the context of COVID-19, an employee is considered a Casual contact if he/she has been within only two (2) meters of someone infected for less than fifteen (15) minutes. It could also be if said employee has been in the same space as the infected person for longer than fifteen (15) minutes, but more than two (2) meters away. 

B. Covid-19 HMO FAQs


1) If in any case the test is required before a procedure (ex. endoscopy) or admission, will it still be covered?

-Please be advised that the HMO will NOT cover tests for the following purposes:
  1. if it is purely screening in nature
  2. if it's a requirement for returning to work or school
  3. if it's a prerequisite in performing elective surgical procedures
Notes
Note: The standard exclusion conditions still apply, meaning, the test will not be covered if the member did not go through a consultation with an HMO accredited facility and was not provided with a Doctor’s request based on a medical diagnosis requiring the test. 

2) Will the treatment for COVID-19 be covered under our HMO?

-Consultation and treatment, if admitted for in-patient care in a Cocolife accredited medical facility, will be covered by the HMO once the member’s Covid19 swab test result is confirmed to be positive. In case the result came as negative, the cost for the Covid19 swab test will be shouldered by the member but the consultation with the accredited facility will be covered. Please take note that the facility where the member will have the test or will be confined to should be accredited by our HMO. In case the member is tested in a non-accredited facility, the member could file for reimbursement but will be subject to evaluation and for approval by the provider.

3) If a member would apply for the reimbursement for the Covid19 swab test, will the full amount be reimbursed or just the relative amount?

-If the member had the test done with any of our accredited medical facilities, the full amount will be reimbursed for positive Covid19 cases as confirmed by our HMO provider claims team. If it's with a non-accredited medical facility, it will be subject to evaluation and for approval by our provider.

4) If we have a team member who is experiencing Flu-like symptoms and wanted to seek medical attention. Will Rapid Test or Swab Test be covered by our HMO? 

-For rapid test, it's not covered as this is a part of the exclusion from HMO providers

-For swab test, if the member has symptoms upon consultation and was recommended by the Doctor to have a swab test, it will be covered whether it's a positive or negative result

-For asymptomatic cases, meaning the member just wanted to be tested due to possibility of being in contact with someone who is Covid19 positive, they will initially pay for the swab test and can be reimbursed once they are confirmed as a positive case.

***A reminder that the swab testing for Covid19 should be conducted in an accredited medical facility, in cases that it's with a non-accredited facility, member may file for reimbursement but will be subject to evaluation and for approval by the provider


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