FAQs
Internal Inquiries
REQUEST OF CHANGE OF DOCTOR IN LOA
No need to change LOA, inform hospital to note the correct physician in the LOA.
If the patient/corp is the one who requested thru email/fb/viber you just manually edit the LOA using this link.
REQUEST OF ADDITIONAL PROCEDURE
Generate new LOA for the additional procedure.
REQUEST OF CHANGE OF CPT
Request TL/dev team for change of CPT or if they are not available create new LOA for the procedure.
REQUEST ADDITIONAL CHARGE IN EMERGENCY LOA
Cancel the old LOA make sure that no additional charges and generate new LOA for the whole ER case.
REQUEST ADDITIONAL/REVISION REMARKS
No need as long as indicated in tracker.
If the LOA needs to be sent though email, you may edit remarks using the this link.
Make sure to send LOA in pdf format.
REQUEST SENDING OF LOA EVEN IF YOU ALREADY VERBALLY RELAYED THE LOA
Inform the provider that you will send an amaphil blank form instead, so they can reprint it until they will receive amaphil forms.
REQUEST OF REMOVE CPT/PROCEDURE
No need, claims will only process the charges based on the submitted billing from the provider.
If requested an updated LOA instruct the caller to disregard/cross out the procedure/s not included.
If there are procedures that are not yet done but included in LOA that was previously used, generate new LOA for it.
REQUEST OF REDATE
Request TL/dev team for redate or if they are not available, cancel old LOA and create new LOA.
(Note: We do not redate an advanced date, redate will be dated the same day of request.)
REQUEST OF CHANGE AMOUNT
Check remaining limit first if the requested adjustment is within the member's limit, no need to generate new LOA.
Just inform the caller we will adjust the amount in the system (request the TL/dev to change amount but no need to wait for it to be changed).
*Don't forget to note it in the tracker.
REQUEST CHANGE PROVIDER
Request TL/dev team for change provider or if they are not available, cancel old LOA and create new LOA.
REQUEST BACKEND
Request TL/dev team.
PROVIDER REQUESTS ACCOUNT IN PROVIDER ACCESS
Request for the following details and email
Name of Caller/Dept:
Provider Name:
Email Address:
Subject: REQUEST FOR PROVIDER ACCESS ACCOUNT
to: pmo@amaphil.com.ph
cc: mo@amaphil.com.ph / dev@amaphil.com.ph
REPORT ISSUES IN ALLACCESS
https://docs.google.com/forms/d/e/1FAIpQLSfB-40gMg6kaWGe4D6QI48E3m87tiuMcUPJV6QAD9XB28h21w/viewform
ALLACCESS SYSTEM REQUEST FORM
https://docs.google.com/forms/d/e/1FAIpQLScR3P2VAhkqUVJB7-4zwiSJVYqB4ArpsobEqu5EfrOomMgQ2Q/viewform
MEMBER STATUS IS TERMINATED/CANCELLED OR INACTIVE
Go to view Icon of the member, check status:
If with movement done by enrollment team, inform the member that his/her account was requested for deactivation by their corp, and coordinate with their HR.
If no movement done by enrollment team, this may be a system issue, coordinate with the dev team.
MEMBER STATUS IS EXPIRED
Go check the member's expiration date in the system:
If the date is not yet for expiration, this may be a system issue, coordinate with the dev team.
If the date is really expired, kindly check email or verify with enrollment team if no renewal received. If no renewal, for LAWINA members, verify first with them if no renewal for the member. Other corp, we may immediately decline the availment of the member.
DURING LOA CREATION, PROMPT MESSAGE OF "INSUFFICIENT FUND"
Go to CORPORATE, search name of the member's corporate, then add fund, see below video:
After that try to generate LOA again, if the same message prompts, view corporate information, check the THRESHOLD FUND vs REMAINING FUND, the remaining fund should be higher than the threshold fund, if not, you need to add fund again.
If no movement in amount even after adding fund in the remaining fund, this may be a system issue, coordinate with the dev team.
REQUESTED PROCEDURE IS NOT FOUND IN THE SYSTEM
Enroll the procedure in CPT:
PROVIDER PAYMENT FOLLOW UP
Get the following details:
Name of Caller:
Name of Provider:
Contact Number:
Email Address:
Inform them that we will relay their concern to the finance dept or that may also directly email finance@amaphil.com.ph.
INQUIRY OF NON ACCEPTING PROVIDER BUT TAGGED AS ACCREDITED IN ALLCCESS
Get the following details of the member:
Complete Name:
Company Name:
Contact Number:
Inform them that we will escalate/verify this with our accrediting team (Account executive/Provider management officer) and will get back to them as soon as we receive a response from them.
PROVIDER REQUESTING AMAPHIL FORMS
Get the following details:
Name of Caller/Department:
Name of Provider:
Contact Number:
Email Address:
Inform the caller that we will request this to our admin.
*After call, email:
TO: pmo@amaphil.com.ph
CC: mo@amaphil.com.ph
Email Subject: REQUEST AMAPHIL FORMS | (PROVIDER'S NAME)
Provide in the email the details given by the provider.
WHAT ARE THE AMAPHIL MAJOR HOSPITAL?
The Medical City - Main
Makati Medical Center
St. Lukes Medical Center (QC)
St. Lukes Medical Center (BGC)
Cardinal Santos Medical Center
Asian Hospital
Davao Doctors Hospital
Cebu Doctors University Hospital
Chong Hua Hospital Mandaue
Chong Hua Hospital Fuente
IF YOU RECEIVE A CALL NOT RELATED TO BENEFIT INQUIRIES/ACCREDITED PARTNERS/APPROVALS
Name of Caller:
Company Name/Provider Name:
Contact Number/Email:
Issue/Concern:
"We will forward your issue to the appropriate department. Please await their response."
REQUEST OF DISCHARGE PATIENT OR FOLLOW UP LOA OF PATIENT FOR DISCHARGE
REQUEST OF CHANGE OF DOCTOR IN LOA
No need to change LOA, inform hospital to note the correct physician in the LOA.
If the patient/corp is the one who requested thru email/fb/viber you just manually edit the LOA using this link.
REQUEST OF ADDITIONAL PROCEDURE
Generate new LOA for the additional procedure.
REQUEST OF CHANGE OF CPT
Request TL/dev team for change of CPT or if they are not available create new LOA for the procedure.
REQUEST ADDITIONAL CHARGE IN EMERGENCY LOA
Cancel the old LOA make sure that no additional charges and generate new LOA for the whole ER case.
REQUEST ADDITIONAL/REVISION REMARKS
No need as long as indicated in tracker.
If the LOA needs to be sent though email, you may edit remarks using the this link.
Make sure to send LOA in pdf format.
REQUEST SENDING OF LOA EVEN IF YOU ALREADY VERBALLY RELAYED THE LOA
Inform the provider that you will send an amaphil blank form instead, so they can reprint it until they will receive amaphil forms.
REQUEST OF REMOVE CPT/PROCEDURE
No need, claims will only process the charges based on the submitted billing from the provider.
If requested an updated LOA instruct the caller to disregard/cross out the procedure/s not included.
If there are procedures that are not yet done but included in LOA that was previously used, generate new LOA for it.
REQUEST OF REDATE
Request TL/dev team for redate or if they are not available, cancel old LOA and create new LOA.
(Note: We do not redate an advanced date, redate will be dated the same day of request.)
REQUEST OF CHANGE AMOUNT
Check remaining limit first if the requested adjustment is within the member's limit, no need to generate new LOA.
Just inform the caller we will adjust the amount in the system (request the TL/dev to change amount but no need to wait for it to be changed).
*Don't forget to note it in the tracker.
REQUEST CHANGE PROVIDER
Request TL/dev team for change provider or if they are not available, cancel old LOA and create new LOA.
REQUEST BACKEND
Request TL/dev team.
PROVIDER REQUESTS ACCOUNT IN PROVIDER ACCESS
Request for the following details and email
Name of Caller/Dept:
Provider Name:
Email Address:
Subject: REQUEST FOR PROVIDER ACCESS ACCOUNT
to: pmo@amaphil.com.ph
cc: mo@amaphil.com.ph / dev@amaphil.com.ph
REPORT ISSUES IN ALLACCESS
https://docs.google.com/forms/d/e/1FAIpQLSfB-40gMg6kaWGe4D6QI48E3m87tiuMcUPJV6QAD9XB28h21w/viewform
ALLACCESS SYSTEM REQUEST FORM
https://docs.google.com/forms/d/e/1FAIpQLScR3P2VAhkqUVJB7-4zwiSJVYqB4ArpsobEqu5EfrOomMgQ2Q/viewform
MEMBER STATUS IS TERMINATED/CANCELLED OR INACTIVE
Go to view Icon of the member, check status:
If with movement done by enrollment team, inform the member that his/her account was requested for deactivation by their corp, and coordinate with their HR.
If no movement done by enrollment team, this may be a system issue, coordinate with the dev team.
MEMBER STATUS IS EXPIRED
Go check the member's expiration date in the system:
If the date is not yet for expiration, this may be a system issue, coordinate with the dev team.
If the date is really expired, kindly check email or verify with enrollment team if no renewal received. If no renewal, for LAWINA members, verify first with them if no renewal for the member. Other corp, we may immediately decline the availment of the member.
DURING LOA CREATION, PROMPT MESSAGE OF "INSUFFICIENT FUND"
Go to CORPORATE, search name of the member's corporate, then add fund, see below video:
After that try to generate LOA again, if the same message prompts, view corporate information, check the THRESHOLD FUND vs REMAINING FUND, the remaining fund should be higher than the threshold fund, if not, you need to add fund again.
If no movement in amount even after adding fund in the remaining fund, this may be a system issue, coordinate with the dev team.
REQUESTED PROCEDURE IS NOT FOUND IN THE SYSTEM
Enroll the procedure in CPT:
PROVIDER PAYMENT FOLLOW UP
Get the following details:
Name of Caller:
Name of Provider:
Contact Number:
Email Address:
Inform them that we will relay their concern to the finance dept or that may also directly email finance@amaphil.com.ph.
INQUIRY OF NON ACCEPTING PROVIDER BUT TAGGED AS ACCREDITED IN ALLCCESS
Get the following details of the member:
Complete Name:
Company Name:
Contact Number:
Inform them that we will escalate/verify this with our accrediting team (Account executive/Provider management officer) and will get back to them as soon as we receive a response from them.
PROVIDER REQUESTING AMAPHIL FORMS
Get the following details:
Name of Caller/Department:
Name of Provider:
Contact Number:
Email Address:
Inform the caller that we will request this to our admin.
*After call, email:
TO: pmo@amaphil.com.ph
CC: mo@amaphil.com.ph
Email Subject: REQUEST AMAPHIL FORMS | (PROVIDER'S NAME)
Provide in the email the details given by the provider.
WHAT ARE THE AMAPHIL MAJOR HOSPITAL?
The Medical City - Main
Makati Medical Center
St. Lukes Medical Center (QC)
St. Lukes Medical Center (BGC)
Cardinal Santos Medical Center
Asian Hospital
Davao Doctors Hospital
Cebu Doctors University Hospital
Chong Hua Hospital Mandaue
Chong Hua Hospital Fuente
IF YOU RECEIVE A CALL NOT RELATED TO BENEFIT INQUIRIES/ACCREDITED PARTNERS/APPROVALS
Name of Caller:
Company Name/Provider Name:
Contact Number/Email:
Issue/Concern:
"We will forward your issue to the appropriate department. Please await their response."
REQUEST OF DISCHARGE PATIENT OR FOLLOW UP LOA OF PATIENT FOR DISCHARGE
Please confirm the patient's name and the facility first. Then ask the caller if they’ve already sent the required documents (like the SOA, itemized charges, etc.) to our group email: mo@amaphil.com.ph.
- If they have sent them, check if we’ve received them.
- If they have but no found email, ask if they used the correct email address.
- If we still haven’t received the documents, kindly ask them to resend.
Once we receive everything, let the caller know that our discharge team will handle it from there, and they’ll receive the LOA by email.
REQUEST TO ACCREDIT THEIR PREFERRED DOCTOR
Get the following the details:
Name of Caller:
Company Name:
Name of Doctor:
Name of Facility:
Inform the caller that you will escalate the request.
Email: pmo@amaphil.com.ph
REQUEST TO ACCREDIT THEIR PREFERRED PROVIDER
Get the following the details:
Name of Caller:
Company Name:
Name of Facility:
Inform the caller that you will escalate the request.
Email: pmo@amaphil.com.ph
REQUEST TO CANCEL LOA
Get the LOA and reason of cancellation.
General Inquiries
How much is you health card?
Can I get a quotation of of your health card?
AMAPHIL agents and staff do not sell premium-based plans for individuals or families. You can, however, deal directly with our insurance and HMO partners.
Please click the following link to visit their websites:
https://firstlife.com.ph/
https://www.hcd.com.ph/
https://www.libertyinsurance.com.ph/
https://pangpamilya.org/
https://www.paramount.com.ph/
If someone is selling premium-based programs and is claiming to be from AMAPHIL, please exercise caution and disregard their offer.
Can I get a quotation for our company?
Please provide the following details:
Company name:
Number of pax:
Name of coordinator:
Contact number/email:
We will forward your inquiry to our sales team.
What is AMAPHIL’s trunkline number for approval?
You may contact AMAPHIL on the following landline numbers:
(02) 8355-7500
SMART
0939-914-0866
0939-905-8759
GLOBE
0917-650-5933
CANNOT CALL THE TRUCKLINE/HOTLINE (MEMBER)
1. Ask the member to request approval using his/her mobile application or to press the Please Call button for AMAPHIL’s representative to call and cater to your request.
2. You may also send a message to our website or Facebook requesting for approval. Please make sure to leave a number to reach you back.
3. You may also email us at mo@amaphil.com.ph
CANNOT CALL THE TRUCKLINE/HOTLINE (PROVIDER)
1. If provider access is available at the facility, you may request approval through the platform.
2. You can send an email requesting approval to medofficers@amaphil.com.ph and our medical officer will process it for you.
3. If you have the number of the Account Executive-In-Charge of your facility, you may also directly call them for immediate assistance.
4. Verify if you have a viber number, so we can create a GC for LOA approval
How can I request for a letter of Authorization (LOA)? (MEMBER)
You may avail by going to your preferred clinic/hospital and present LOA in the concern dept of your availment.
LOA can be secured by 3 options:
1. proceed to the hmo dept of your preferred clinic/hospital declare that you are under amaphil then present any valid ID
HOTLINE:
(02) 8355-7500
0939-914-0866
0939-905-8759
0917-650-5933
2. you may use the amaphil mobile app to request LOA
Visit our youtube page for tutorials:
https://www.youtube.com/@amaphilsupport8793
3. you may email us at mo@amaphil.com.ph with the following details:
Full Name of Member:
Company:
Hospital/Clinic:
Chief Complaint:
Date of Availment:
Note: Kindly attach the procedure request if the availment is laboratory/imaging test.
***LOA VALIDITY IS 7 DAYS ONLY
What is AMAPHIL outpatient form for and where is it available?
The outpatient form will be used for the eligibility of the transaction. It should bear the name and signature of the patient as well as the physician and its request for laboratory/diagnostic tests. The outpatient form shall support the claim of the facility for payment of the transaction. It is available at the HMO department, business office, or reception area depending on the facility's set-up.
PROVIDER HAS NO AMAPHIL FORM
Get the email address of provider and send copy of amaphil form if the facility has no supplemental form in absence of AMAPHIL form
Where can I check my benefits?
You may ask your HR for your health benefits or call AMAPHIL trunkline to know your benefits. You may also view it from the mobile app.
What should I do if I am asked to pay for medical services which I know are covered?
You may press the call button in your mobile application or call AMAPHIL’s trunkline for assistance.
What will I do if some hospitals have a cash basis policy for my procedure even if it’s recommended and will be performed by an affiliated physician of AMAPHIL?
You may press the call button in your mobile application or call AMAPHIL’s trunkline for assistance. However, there are cases that hospital policy will prevail. If that’s the case, you may opt to continue the procedure and pay in cash then file for reimbursement after.
Why I’m asked to pay for the professional fees of an accredited Neurologist?
Neurologists governed their own rates. They are not subjected to AMAPHIL’s rate hence there are times that they will collect payment in excess of AMAPHIL’s rate.
What if I get into a vehicular accident – will AMAPHIL cover the cost of my medical expenses? Do you have requirements for me to be covered?
Medical expenses are covered if the member is not intoxicated.
Prosthesis/pins/screws for fracture treatment are no covered.
Requirements for MVAs/Vas
IR/POLICE REPORT
PARAMOUNT REQUIREMENTS (If the patient cannot provide the following, he/she needs to sign the waiver):
IR/POLICE REPORT
OR-CR
DRIVER’S LICENSE
Why do I have to pay for uncovered items?
Uncovered items are those that are not covered by your health benefits.
Do I need to set up an appointment for my Annual Physical Exam (APE)?
All Annual Physical Exam shall be coursed through to your HR/Coop coordinator. AMAPHIL does not entertain a request for APE directly from a member.
How do I file my reimbursement?
You may file your reimbursement through AMAPHIL’s mobile application. If your company has no reimbursement feature, you cannot successfully file it in the mobile application. You can also send the reimbursement request to your HR.
You may also email us at mo@amaphil.com.ph
For DBA: reimbursement can only be filed thru their HR
I paid for the portion of the hospital bill that was not covered during confinement; can I file it for reimbursement?
You can’t file for reimbursement due to non-coverage during your confinement. This could be part of the uncovered items or excess in your benefits. However, you may always inquire with your HR or call AMAPHIL for clarification.
Is a hard copy of a reimbursement claim needed to be submitted still?
Generally you are required to
What is the turn-around time for submission and processing of reimbursement?
Turn-around time for the submission is with 30 days upon availment of the member and for processing is 15 working days upon receipt of the hard copies of the documents.
Do I get 100% reimbursement for charges during availment in a non-accredited hospital?
All reimbursement is subject for evaluation upon receipt of documents. No assurance of 100% reimbursement.
How will I follow up or know the status of my reimbursement claim?
You may call AMAPHIL or message us on our website or Facebook page to know the status of your reimbursement. You may also ask your HR.
Can I reimburse for my online consultation?
Yes, you may reimburse your online consultation so long as you have the receipt and medical certificate. The amount to reimburse will be based on AMAPHIL’s consultation rate.
Can I have the medical services reimbursed if I am in an accredited hospital and want to use the services of my personal doctor who is not affiliated?
Yes, you can file for reimbursement of the transaction under your personal doctor if the latter is not accredited with AMAPHIL.
What if there’s no AMAPHIL-affiliated doctor available in any accredited hospital for the field of specialization I need or am referred to?
You may opt to choose the service of any available doctor with the specialization you need and have it filed for reimbursement.
What will I do if the doctor, clinic, or hospital that is affiliated with AMAPHIL will not accept AMAPHIL members?
You may directly report it to AMAPHIL so that we can validate the non-acceptance with the facility and assist you with your transaction.
How do I avail my dental benefits?
You must first verify the dental benefit from your company HR /COOP.
AMAPHIL is partnered with 2 dental network providers. To know their accredited clinics, visit our website (https://amaphil.com.ph/) under downloadables:
Elite Group Dental Network
88367181
0917-315-4926
0925-521-5766
0917-507-9123
(02) 8556-2286
gian.capuyan@gmail.com
gian_capuyan@elitegroup.com.ph
1WWH Dental Network
09178848859
09228986481
(02) 7592402
assist@1-worldwidehealth.com
I lost my dental card, what will I do?
If you’re an Elite member, you may report it to your HR.
If you’re a 1 Worldwide Health member, they don’t provide
Can I reimburse my dental benefit?
Please be informed that dental related availments are not eligible for reimbursement.
I forgot my AMAPHIL app log.in credentials, what should I do?
Please provide your full name, date of birth, company name, mobile number and email address.
Kindly wait for a few minutes and you will receive a sms/email with your mobile app credentials.
In using the mobile app, you may also visit our youtube for tutorials: https://www.youtube.com/@amaphilsupport8793
What is an AMAPHIL virtual card?
AMAPHIL’s virtual card is the one available in your mobile application. You can show it for verification purposes during your transaction in lieu of the physical card.
Can I use AMAPHIL without the AMAPHIL physical card?
Yes, you can use Amaphil without the physical card, just present any valid ID to your preferred provider and declare that you are under Amaphil. If they ask for your amaphil member ID you may refer to your virtual card in the amaphil mobile app.
If I lose my AMAPHIL card, what should I do?
You may report the lost card directly to your HR
What will I do if I want to update my information?
You may directly coordinate with your HR/Coop coordinator for any updates on your information. Your HR/Coop coordinator will endorse the corrections needed to AMAPHIL.
You may also email us at mo@amaphil.com.ph
There's an error of my basic information in the physical card and amaphil mobile app, what should I do?
You may directly coordinate with your HR/Coop coordinator or you may email us regarding this concern and attach any supporting ID/documents for the correction request.
Group email: mo@amaphil.com.ph
There’s a printing error on my AMAPHIL card, what should I do?
You may report the printing error in your AMAPHIL card to your HR/Coop coordinator.
Is there a fee if I will request a card replacement?
Yes, the request for card replacement has an equivalent cost. You may ask directly to your HR for the exact amount.
Can I request for my utilization?
Yes, please provide your email address, and we will sent it to you.
How much is you health card?
Can I get a quotation of of your health card?
AMAPHIL agents and staff do not sell premium-based plans for individuals or families. You can, however, deal directly with our insurance and HMO partners.
Please click the following link to visit their websites:
https://firstlife.com.ph/
https://www.hcd.com.ph/
https://www.libertyinsurance.com.ph/
https://pangpamilya.org/
https://www.paramount.com.ph/
If someone is selling premium-based programs and is claiming to be from AMAPHIL, please exercise caution and disregard their offer.
Can I get a quotation for our company?
Please provide the following details:
Company name:
Number of pax:
Name of coordinator:
Contact number/email:
We will forward your inquiry to our sales team.
What is AMAPHIL’s trunkline number for approval?
You may contact AMAPHIL on the following landline numbers:
(02) 8355-7500
SMART
0939-914-0866
0939-905-8759
GLOBE
0917-650-5933
CANNOT CALL THE TRUCKLINE/HOTLINE (MEMBER)
1. Ask the member to request approval using his/her mobile application or to press the Please Call button for AMAPHIL’s representative to call and cater to your request.
2. You may also send a message to our website or Facebook requesting for approval. Please make sure to leave a number to reach you back.
3. You may also email us at mo@amaphil.com.ph
CANNOT CALL THE TRUCKLINE/HOTLINE (PROVIDER)
1. If provider access is available at the facility, you may request approval through the platform.
2. You can send an email requesting approval to medofficers@amaphil.com.ph and our medical officer will process it for you.
3. If you have the number of the Account Executive-In-Charge of your facility, you may also directly call them for immediate assistance.
4. Verify if you have a viber number, so we can create a GC for LOA approval
How can I request for a letter of Authorization (LOA)? (MEMBER)
You may avail by going to your preferred clinic/hospital and present LOA in the concern dept of your availment.
LOA can be secured by 3 options:
1. proceed to the hmo dept of your preferred clinic/hospital declare that you are under amaphil then present any valid ID
HOTLINE:
(02) 8355-7500
0939-914-0866
0939-905-8759
0917-650-5933
2. you may use the amaphil mobile app to request LOA
Visit our youtube page for tutorials:
https://www.youtube.com/@amaphilsupport8793
3. you may email us at mo@amaphil.com.ph with the following details:
Full Name of Member:
Company:
Hospital/Clinic:
Chief Complaint:
Date of Availment:
Note: Kindly attach the procedure request if the availment is laboratory/imaging test.
***LOA VALIDITY IS 7 DAYS ONLY
What is AMAPHIL outpatient form for and where is it available?
The outpatient form will be used for the eligibility of the transaction. It should bear the name and signature of the patient as well as the physician and its request for laboratory/diagnostic tests. The outpatient form shall support the claim of the facility for payment of the transaction. It is available at the HMO department, business office, or reception area depending on the facility's set-up.
PROVIDER HAS NO AMAPHIL FORM
Get the email address of provider and send copy of amaphil form if the facility has no supplemental form in absence of AMAPHIL form
Where can I check my benefits?
You may ask your HR for your health benefits or call AMAPHIL trunkline to know your benefits. You may also view it from the mobile app.
What should I do if I am asked to pay for medical services which I know are covered?
You may press the call button in your mobile application or call AMAPHIL’s trunkline for assistance.
What will I do if some hospitals have a cash basis policy for my procedure even if it’s recommended and will be performed by an affiliated physician of AMAPHIL?
You may press the call button in your mobile application or call AMAPHIL’s trunkline for assistance. However, there are cases that hospital policy will prevail. If that’s the case, you may opt to continue the procedure and pay in cash then file for reimbursement after.
Why I’m asked to pay for the professional fees of an accredited Neurologist?
Neurologists governed their own rates. They are not subjected to AMAPHIL’s rate hence there are times that they will collect payment in excess of AMAPHIL’s rate.
What if I get into a vehicular accident – will AMAPHIL cover the cost of my medical expenses? Do you have requirements for me to be covered?
Medical expenses are covered if the member is not intoxicated.
Prosthesis/pins/screws for fracture treatment are no covered.
Requirements for MVAs/Vas
IR/POLICE REPORT
PARAMOUNT REQUIREMENTS (If the patient cannot provide the following, he/she needs to sign the waiver):
IR/POLICE REPORT
OR-CR
DRIVER’S LICENSE
Why do I have to pay for uncovered items?
Uncovered items are those that are not covered by your health benefits.
Do I need to set up an appointment for my Annual Physical Exam (APE)?
All Annual Physical Exam shall be coursed through to your HR/Coop coordinator. AMAPHIL does not entertain a request for APE directly from a member.
How do I file my reimbursement?
You may file your reimbursement through AMAPHIL’s mobile application. If your company has no reimbursement feature, you cannot successfully file it in the mobile application. You can also send the reimbursement request to your HR.
You may also email us at mo@amaphil.com.ph
For DBA: reimbursement can only be filed thru their HR
I paid for the portion of the hospital bill that was not covered during confinement; can I file it for reimbursement?
You can’t file for reimbursement due to non-coverage during your confinement. This could be part of the uncovered items or excess in your benefits. However, you may always inquire with your HR or call AMAPHIL for clarification.
Is a hard copy of a reimbursement claim needed to be submitted still?
Generally you are required to
What is the turn-around time for submission and processing of reimbursement?
Turn-around time for the submission is with 30 days upon availment of the member and for processing is 15 working days upon receipt of the hard copies of the documents.
Do I get 100% reimbursement for charges during availment in a non-accredited hospital?
All reimbursement is subject for evaluation upon receipt of documents. No assurance of 100% reimbursement.
How will I follow up or know the status of my reimbursement claim?
You may call AMAPHIL or message us on our website or Facebook page to know the status of your reimbursement. You may also ask your HR.
Can I reimburse for my online consultation?
Yes, you may reimburse your online consultation so long as you have the receipt and medical certificate. The amount to reimburse will be based on AMAPHIL’s consultation rate.
Can I have the medical services reimbursed if I am in an accredited hospital and want to use the services of my personal doctor who is not affiliated?
Yes, you can file for reimbursement of the transaction under your personal doctor if the latter is not accredited with AMAPHIL.
What if there’s no AMAPHIL-affiliated doctor available in any accredited hospital for the field of specialization I need or am referred to?
You may opt to choose the service of any available doctor with the specialization you need and have it filed for reimbursement.
What will I do if the doctor, clinic, or hospital that is affiliated with AMAPHIL will not accept AMAPHIL members?
You may directly report it to AMAPHIL so that we can validate the non-acceptance with the facility and assist you with your transaction.
How do I avail my dental benefits?
You must first verify the dental benefit from your company HR /COOP.
AMAPHIL is partnered with 2 dental network providers. To know their accredited clinics, visit our website (https://amaphil.com.ph/) under downloadables:
Elite Group Dental Network
88367181
0917-315-4926
0925-521-5766
0917-507-9123
(02) 8556-2286
gian.capuyan@gmail.com
gian_capuyan@elitegroup.com.ph
1WWH Dental Network
09178848859
09228986481
(02) 7592402
assist@1-worldwidehealth.com
I lost my dental card, what will I do?
If you’re an Elite member, you may report it to your HR.
If you’re a 1 Worldwide Health member, they don’t provide
Can I reimburse my dental benefit?
Please be informed that dental related availments are not eligible for reimbursement.
I forgot my AMAPHIL app log.in credentials, what should I do?
Please provide your full name, date of birth, company name, mobile number and email address.
Kindly wait for a few minutes and you will receive a sms/email with your mobile app credentials.
In using the mobile app, you may also visit our youtube for tutorials: https://www.youtube.com/@amaphilsupport8793
What is an AMAPHIL virtual card?
AMAPHIL’s virtual card is the one available in your mobile application. You can show it for verification purposes during your transaction in lieu of the physical card.
Can I use AMAPHIL without the AMAPHIL physical card?
Yes, you can use Amaphil without the physical card, just present any valid ID to your preferred provider and declare that you are under Amaphil. If they ask for your amaphil member ID you may refer to your virtual card in the amaphil mobile app.
If I lose my AMAPHIL card, what should I do?
You may report the lost card directly to your HR
What will I do if I want to update my information?
You may directly coordinate with your HR/Coop coordinator for any updates on your information. Your HR/Coop coordinator will endorse the corrections needed to AMAPHIL.
You may also email us at mo@amaphil.com.ph
There's an error of my basic information in the physical card and amaphil mobile app, what should I do?
You may directly coordinate with your HR/Coop coordinator or you may email us regarding this concern and attach any supporting ID/documents for the correction request.
Group email: mo@amaphil.com.ph
There’s a printing error on my AMAPHIL card, what should I do?
You may report the printing error in your AMAPHIL card to your HR/Coop coordinator.
Is there a fee if I will request a card replacement?
Yes, the request for card replacement has an equivalent cost. You may ask directly to your HR for the exact amount.
Can I request for my utilization?
Yes, please provide your email address, and we will sent it to you.