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OPD Coordinator

The document outlines the role and responsibilities of an OPD Coordinator in facilitating medical services through an HMO. The coordinator verifies patient coverage, secures necessary referral forms and approvals for consultations, diagnostics, and elective surgeries. They assist clients through the process with courtesy and ensure all requirements are met before medical procedures.

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medocare lo
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945 views12 pages

OPD Coordinator

The document outlines the role and responsibilities of an OPD Coordinator in facilitating medical services through an HMO. The coordinator verifies patient coverage, secures necessary referral forms and approvals for consultations, diagnostics, and elective surgeries. They assist clients through the process with courtesy and ensure all requirements are met before medical procedures.

Uploaded by

medocare lo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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OPD Coordinator

ROLE
• a person whose job is to organize the process
of availing medical services.
• Key person in an area. (for special hospital
concerns)
• Widely knowledgeable in HMO processes and
skilled in troubleshooting any problems that
may arise.
• Assist each client with courtesy and respect.
OUT PATIENT CONSULTATION
ACCREDITED HOSPITAL OR CLINICS
Present MedOCare Card.
Getting referral forms for
consultation from the HMO
office / Coordinators office.

The OPD Coordinator/ HMO


will verify with the 24/7
MedOCare Call Center the
coverage of the patient.
If diagnostics are requested secure
Proceed to accredited doctors OPPA Forms from Medical
and present referral forms Coordinator or HMO office. All
procedures are subject for approvals
Present the OPPA form at the respective department for diagnostic test.
FOR ELECTIVE SURGICAL
PROCEDURES ACCREDITED
HOSPITAL OR CLINICS
For an elective (non – emergency) in or
out-patient surgical procedure, seek
approval from Medocare Call Center
through the Designated Medical
Coordinator or HMO office of Accomplish all pre-surgery requirements
Accredited Hospital and Clinics prior to such as Cardiopulmonary Clearance,
the surgery. Philhealth documents, and Admitting
Orders before the surgery / scheduled
admission.
Proceed to Admitti ng Offi ce (if for confinement)
or the Operating Room ( for out-patient surgical
procedures) on the scheduled day of admission.

The Admitting Office will call/inform


Medocare Medical Department the
confinement within 24 hours from the
time of admission.
Upon discharge Billing Office representative will call/inform
Medocare Call Center and apply Philhealth Benefits and collect
non covered charges.
RECEIVING OF
CLAIMS

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