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What is the Claims Online with e-Card XP Debit card?

• Solution subscribed by Generali Pilipinas from MediLink to be able to offer electronic hospitalization program to its corporate clients

• First membership and payment system in the healthcare industry

• Offers “real-time” processing and settlement of claims

• Members are treated as private patients (own choice of doctors)

• Utilizes the Multi-purpose application of Equitable Card Network’s e-Card XP VISA Debit card

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GENERALI PILIPINAS

e-Card XP VISA Debit Card

Front

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Jane De La Cruz

Back

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Equitable Card Hotline: to report lost / damaged cards

Existing Availment vs Claims Online with e-Card XP

NESTLENESTLE• Manual Issuance of Letter

of Guarantee (LOG) • Claims settlement after

confinement.– Hospital sends bill to

NESTLE– Excess determination

largely up to accredited hospital.

• Accepted in 76 Service Providers nationwide

Claims Online with e-Card XPClaims Online with e-Card XP• Swipe technology• Electronic Eligibility

verification prior to Admission• Plus claims settlement during

confinement– Electronic claims settlement – Excess to be identified and

paid prior to discharge.• Accepted in 94 key

Designated Hospitals nationwide (to become 160++ by mid year)

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BENEFITS TO NESTLE EMPLOYEES

• Cash-less hospitalization plan in more hospitals• Members are treated in hospitals as “private” patients.

– Member can choose his own doctor/s• Automatic reconciliation of hospital bills.

– Members informed of updated benefits on the day of Admission at e-Card XP designated hospitals.

– Electronic loading of benefits on the day of discharge.• No need to secure Letter of Guarantee prior to admission• Employee and Dependents will be given individual

Medilink e-Card XP Debit Cards (except those below 13 years old)

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STEP 1: CARD ACTIVATION

WHEN Admission

EMPLOYEE or Qualified Dependent

Presents card for swiping at the MediLink’s POS Terminal. If eligible: Signs the electronic Notice of Activation (NOA) generated by the terminal

DESIGNATED HOSPITAL

Swipes card to signify admission. Performs normal admission process.

IN-PATIENT (IP) AVAILMENT

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Sample Notice of Activation (NOA) Slip

SAN JUAN DE DIOS HOSPITALROXAS BLVD., PASAY CITY

61000295 80000000009238

MEDILINK4559689100003333* CARD VER 000001 MAY 25, 05 09:45 499222750145 782808 TRANSPOS47 TOTAL PHP0.00

GENERALI PILIPINAS –INPATIENT 29P NOA# 782808 25DEC2006HUMILDE, MARILYNN11111-2-00NESTLE PHILS.CARD# 4559689100003333RNB: Php550/DAYPHILHEALTH REQUIRED SLIP MEANS CARD HAS BEEN ACTIVATED. PLEASE SWIPE DURING DISCHARGE FOR LOADING OF BENEFIT. MEMBER AUTHORIZE HOSPITAL TO PROVIDE ALL RECORDS TO GENERALI PILIPINAS.

Marilyn Humilde

Line 1: Generali Pilipinas ; Coverage; Age

Line 2: Activation Number ; Date of

Transaction

Line 3: Name of Member

Line 4: Policy Number

Line 5: Corporation Name

Line 6: Card Number

Line 7: Room and Board

Line 8: With PHILHEALTH/NONE

Line 9: Disclaimer

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• Note: Pls. Ask your HR for a copy of the signed PHILHEALTH FORM

STEP 2: VERIFICATION OF COVERABILITY

GENERALI Authorizes admission (w/n 24 hours). Calls the Patient confined in the MediLink Designated Hospital

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IN-PATIENT (IP) AVAILMENT

STEP 3: LOAD PROCESSING

WHEN Discharge

EMPLOYEE or Qualified Dependent

Presents card for swiping at the MediLink POS Terminal to signify discharge. Signs the Notice of Load processing slip.

HOSPITAL Swipes Member’s card Faxes Final Statement of Account (SOA) upon request of the member.

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IN-PATIENT (IP) AVAILMENT

SAN JUAN DE DIOS HOSPITAL ROXAS BLVD., PASAY CITY

61000295 880000000009238 MEDILINK4559689100003333* AUTHORIZE 000001 MAY 30, 05 09:45 499222750145145 782145 TRANSPOS47 TOTAL PHP0.01

GENERALI PILIPINAS –INPATIENT 29P NLP# 782145 30DEC2006 HUMILDE, MARILYN

KINDLY FAX SOA: 8865238BENEFITS WILL BE LOADED TO CARD:4559689100003333I WILL USE AMOUNT LOADED TO SETTLE HOSPITAL BILL. I AUTHORIZE HOSPITAL TO PROVIDE GENERALI ALL DOCS OF MY CONFINEMENT.

Sample Notice of Load Processing (NLP) Slip

Marilyn Humilde

Line 1: Generali Pilipinas ; Coverage; Age

Line 2: Load Processing Number ; Date of Transaction

Line 3: Instructions

Authorization

Disclaimer

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STEP 4: COMPUTATION OF BENEFITS (FAX

LOA) AND MEMBER ALERT

WHEN Discharge

GENERALI Received Final SOA from the HospitalProcesses claim and loads Member’s card based on approved benefits. Alerts/Informs the Member of approved amount (via SMS Notification)

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IN-PATIENT (IP) AVAILMENT

Total Hospital Bill P30,300.00.GENERALI has loaded P30,300.00 inclusive of PF of DR. ABELARDO MENDEZ

Options Back

(PHP12,000.00), DR.INOCENTE PEREZ (PHP 6,000.00). Pls proceed to cashier to settle bill.Thank you.

Options Back

Sample Member’s Text Notification

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STEP 5: PAYMENT

WHEN Discharge

EMPLOYEE or Qualified Dependent

Presents card at the Cashier. Signs Credit Card Receipt

HOSPITAL Swipes the card in the Credit Card Terminal and enters amount given by the Member. Accepts payment

MEMBER Submits original hospitalization documents to NESTLE Site Nurse within five (5) working days (from date of Employee’s return to work)     

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IN-PATIENT (IP) AVAILMENT

SAN JUAN DE DIOS HOSPITALROXAS BLVD.PASAY CITY

TERM# 60000005 MER#720500007CARD TYPE VISA4559689100003333MARILYN HUMILDEAUTHORIZE EXPY DATE 05/06BATCH NO.000001 TRACE NO. 597201DATE/TIME MAY 30, 05 13:25REF.NO.000040597143 APPR.CODE015424

TOTAL PHP 30,300.00

Marilyn Humilde

Sample Credit Card Receipt

REMINDERS• Present your e-Card XP Debit Card on the day of your admission (Card

Activation) and on the day of discharge (Load Processing and Payment). • Qualified Dependent is defined as a NESTLE Principal Member’s Dependent

who is 13 years old and above and qualified to be given an e-Card XP VISA Debit card

• For Dependents of Principal Member less than 13 years of age, it will be the Principal’s e-Card XP which be loaded on the day of discharge. Only the Principal Member is allowed to sign on behalf of the Dependent

• Be familiar and read your customized e-Card XP Member Guide. • In cases where the Professional Fee of your Attending Doctor is not part of

the Hospital Final Statement of Account (SOA), the Employee/Patient will have to advance the payment. However, as an alternative, you can ask for Generali’s help by calling the 24/7 hotline. Generali will try to convince your doctor to include his PF in the hospital Statement of Account. But of course, final decision rests on the doctor and you should still be ready to advance payment if ever they don’t agree to include it in the Hospital bill

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REMINDERS• Special Arrangement hospitals

– These are hospitals that accept VISA payments, but has no Medillink POS facility for card activation upon admission

– For these hospitals, please contact Generali to notify them of your admission and discharge via these numbers:

• (02) 894-1135 (Mon-Friday: 7 am to 10 pm;Sat-Sun: 8 am – 5 pm)

• 0917 – 8941135 up to 36 (24 by 7 hotline)

– Or send a Text Message given the format below • NOA <Card number> <Hospital Code*> IP then send to 0917

8942901• NLP <Card number> <Hospital Code*> IP then send to 0917

8942901

* Refer to Member Guide

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REMINDERS• Take care of your E-Card XP:

– Report any damage / loss immediately (see back of card or call Generali) and advise Nestle HR

– Replacement cards will have the ff charges:• Lost Cards: Php150.00• Damaged Cards: Php100.00

• Notify HR of personal changes immediately:– Especially NEW dependents or change in Marital

Status– Nestle HR should report these changes to

Generali within 30 days from the effectivity date.

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IN-PATIENT (IP) AVAILMENT

Thank You!