PhilCare Survey Form 2017

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DE LA SALLE ARANETA UNIVERSITYHUMAN RESOURCES MANAGEMENT OFFICE SURVEY ON PHILCARE

Greetings in St. La Salle!

The Human Resources Development and Management Office is conducting this survey to get feedback from all Lasallian partners who are enrolled in PhilCare. Please answer all questions which you deem applicable. Your feedback will be greatly appreciated, as we are in the process of evaluating the performance of our HMO provider whose contract is expiring on July 31.

Once accomplished, please return this form to the HRDM Office on or before June 30, 2017.

Thank you very much!

RONALD YAGO IBARLIN
HRDM Director

Name:

Position:

Department:

Date:

PhilCare provided me with my membership card and booklet.

yes

Clear selection

PhilCare conducted an orientation of the benefits and services they offer.

yes

Clear selection

PhilCare benefits and services suit my medical/health needs.

yes

Clear selection

I am satisfied with PhilCare’s services and benefits.

yes

Clear selection

I will renew my HMO membership with PhilCare.

yes

Clear selection

Did you take advantage of PhilCare benefits for School Year 2016-2017?

Yes

Clear selection

Wellness Fair

Yes

Zumba

Yes

Annual Physical Examination

Yes

Inpatient Care/Hospitalization (If yes, please specify)

Outpatient Care/Hospitalization (If yes, please specify)

Emergency Benefits (If yes, please specify)

Ambulance Services (If yes, please specify)

Dental Benefits (If yes, please specify)

No. I did not take advantage of the benefits because

Did you undergo any inpatient/hospitalization services in a non-accredited PhilCare hospital/clinic? (Please specify the name of the clinic/hospital)

Are you able to process the reimbursement in a timely manner?

yes

Clear selection

Did you undergo any outpatient/hospitalization services in a non-accredited PhilCare hospital/clinic? (Please specifythe name of the clinic/hospital)

Are you able to process the reimbursement in a timely manner?

yes

Clear selection

9. Did you avail of ambulances services in non-accredited PhilCare hospitals? (Please specify the name of the hospital)

Are you able to process the reimbursement in a timely manner?

yes

Clear selection

Did you undergo any emergency service in a non-accredited PhilCare hospital? (Please specify the name of the clinic/hospital)

Are you able to process the reimbursement in a timely manner?

yes

Clear selection

Wellness Fair

Please check the rating scale if you strongly agree or disagree

The booths provided the necessary information about certain diseases

Strongly Agree

Strongly Disagree

Clear selection

There was enough time provided for the audience to consult with the booth handlers.

Strongly Agree

Strongly Disagree

Clear selection

There was enough time provided for questions/comments/feedback.

Strongly Agree

Strongly Disagree

Clear selection

The venue is appropriate for the booth.

Strongly Agree

Strongly Disagree

Clear selection

The booth handler is an expert on the topics discussed.

Strongly Agree

Strongly Disagree

Clear selection

The booth handler showed mastery of the topic discussed.

Strongly Agree

Strongly Disagree

Clear selection

The booth handler used educational audiovisual presentations/displays/etc.

Strongly Agree

Strongly Disagree

Clear selection

The booth handler invited participation from the audience.

Strongly Agree

Strongly Disagree

Clear selection

The booth handler dressed professionally.

Strongly Agree

Strongly Disagree

Clear selection

The booth handler’s voice quality is appropriate for the seminar.

Please specify other strengths of the booth/booth handler

ZUMBA

Please check the rating scale if you strongly agree or disagree

The sessions were scheduled on days and times that the community is available to attend them.

Strongly Agree

Strongly Disagree

Clear selection

The venue is appropriate for the sessions.

Strongly Agree

Strongly Disagree

Clear selection

The dance instructor is an expert of Zumba.

Strongly Agree

Strongly Disagree

Clear selection

The dance instructor invites feedback from the participants.

Strongly Agree

Strongly Disagree

Clear selection

The dance instructor dressed appropriately.

Strongly Agree

Strongly Disagree

Clear selection

Please specify other strengths of the dance instructor

Annual Physical Examination (APE)

Please check the rating scale if you strongly agree or disagree

The attending physicians, nurses, radiology technicians and medical technologists were polite and courteous.

Strongly Agree

Strongly Disagree

Clear selection

The attending physicians, nurses, radiology technicians and medical technologists were professionally and appropriately dressed.

Strongly Agree

Strongly Disagree

Clear selection

The APE process was systematic and orderly.

Strongly Agree

Strongly Disagree

Clear selection

My APE was completed in a timely manner.

Strongly Agree

Strongly Disagree

Clear selection

I was informed and educated of the coverage of my HMO.

Strongly Agree

Strongly Disagree

Clear selection

The following examinations were made available to me

Physical Examination

Chest X-Ray

Urinalysis

Fecalysis

Complete Blood Count

ECG for members 35 years old and above

Pap smear for females 35 years old and above

Fasting Blood Sugar, Lipid Profile, SGPT, Blood Creatinine and Blood Uric Acid

Blood Creatinine and Blood Uric Acid

Other:

Clear selection

Please specify other positive feedback, if any

Inpatient Care/Hospitalization

Please check the rating scale if you strongly agree or disagree

The call center agent/personnel-in-charge in the hospital was polite and courteous.

Strongly Agree

Strongly Disagree

Clear selection

I was informed and educated of the coverage of my HMO.

Strongly Agree

Strongly Disagree

Clear selection

The process of PhilCare is systematic and orderly from admission to check out

Strongly Agree

Strongly Disagree

Clear selection

My request for hospital admission was processed in a timely manner.

Strongly Agree

Strongly Disagree

Clear selection

The following services were made available to me:

Professional fees of Attending Doctor/s:

Anesthesia and Oxygen and its administration:

Use of the Intensive Care Unit (ICU) :

Use of operating and recovery rooms:

Drugs & medicines for use in the hospital:

Standard nursing services:

Standard admission kit including wee bag:

Other:

Clear selection

Please specify other positive feedback, if any

Outpatient Care

Please check the rating scale if you strongly agree or disagree

The call center agent/personnel-in-charge in the hospital was polite and courteous.

Strongly Agree

Strongly Disagree

Clear selection

I was informed and educated of the coverage of my HMO.

Strongly Agree

Strongly Disagree

Clear selection

The outpatient care process of PhilCare is systematic and orderly.

Strongly Agree

Strongly Disagree

Clear selection

My request for outpatient care was processed in a timely manner.

Strongly Agree

Strongly Disagree

Clear selection

The following services were made available to me:

Pre & post natal consultations

Medically necessary consultations

Eye, ear, nose and throat (EENT) treatment

Treatment of minor injuries

Tuberculin Test

Sclerotherapy of varicose veins

Warts removal

Eye laser therapy

Speech therapy

Physical therapy

Other:

Clear selection

Please specify other positive feedback, if any

Emergency Services

Please check the rating scale if you strongly agree or disagree

The call center agent/personnel-in-charge in the hospital was polite and courteous.

Strongly Agree

Strongly Disagree

Clear selection

I was informed and educated of the coverage of my HMO

Strongly Agree

Strongly Disagree

Clear selection

The emergency services process of PhilCare is systematic and orderly.

Strongly Agree

Strongly Disagree

Clear selection

My request for emergency services was processed in a timely manner

Strongly Agree

Strongly Disagree

Clear selection

The following services were made available to me:

Doctors services:

Medicines used for immediate

relief during treatment:

Emergency room fees:

Dressings, cast and sutures:

X-ray, laboratory, and diagnostic exams:

Waiving of Room Upgrade:

Coverage of tetanus vaccines:

Other:

Clear selection

Please specify other positive feedback, if any

Ambulance Services

Please check the rating scale if you strongly agree or disagree

The call center agent/personnel-in-charge in the hospital was polite and courteous.

Strongly Agree

Strongly Disagree

Clear selection

I was informed and educated of the coverage of my HMO.

Strongly Agree

Strongly Disagree

Clear selection

The ambulance services process of PhilCare is systematic and orderly.

Strongly Agree

Strongly Disagree

Clear selection

My request for ambulance services was processed in a timely manner

Strongly Agree

Strongly Disagree

Clear selection

Please specify other positive feedbacks if there are any

Dental Benefits

Please check the rating scale if you strongly agree or disagree

The call center agent/personnel-in-charge in the hospital was polite and courteous.

Strongly Agree

Strongly Disagree

Clear selection

I was informed and educated of the coverage of my HMO.

Strongly Agree

Strongly Disagree

Clear selection

The dental benefits process of PhilCare is systematic and orderly.

Strongly Agree

Strongly Disagree

Clear selection

My request for dental benefits was processed in a timely manner

Strongly Agree

Strongly Disagree

Clear selection

The following services were made available to me:

Consultations and oral examination:

Permanent Light cure filling:

Oral prophylaxis:

Simple tooth extractions:

Temporary fillings:

Desensitization of hypersensitive teeth:

Simple adjustment of dentures:

Restorative and Prosthondontic treatment planning:

Temporo Manibular Joint Consultation:

Dental Health Education:

Other:

Clear selection

Please specify other positive feedback, if any

12. Did you take advantage of any of the following additional benefits from PhilCare? Please check which apply

Unprovoked Assault, including domestic violence, whether initiated by the Member or by a known third party covered up to limit.

Motor Vehicular Accidents

Congenital Hernia is covered up to congenital limit but subject to PEC coverage Acquire Hernia Covered

Scoliosis (whether pre-existing, congenital or acquired) including necessary procedures, except physical therapy sessions

Congenital Disease

Work Related Conditions based on conditions covered by (ECC) Slipped disc/Spondylosis/Spinal Stenosis

Referral slip issued by Philcare company physician for outpatient consultations and laboratory and diagnostic procedures limited to Complete Blood Count (CBC), routine urinalysis, routine fecalysis, and chest X-ray

Travel Insurance thru Assist America

Group Life with AD & Death benefits

Other:

Clear selection

Other Comments and Suggestions

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