WELCOMES YOU AS OUR

AFFILIATED PROVIDER

Group Medical Services

Call 866-6358 or 866-6337
www.sunlifegrepa.com
 WHAT AND WHO IS
SUNLIFE GREPA FINANCIAL,
INC.?

Established in 1954

One of the Philippine’s

TOP insurance companies

A member of the YGC

Conglomerate
 SYNERGY

YUCHENGCO GROUP OF COMPANIES

 SYNERGY

YUCHENGCO GROUP OF COMPANIES

 SYNERGY

YUCHENGCO GROUP OF COMPANIES

 WHAT AND WHO IS
SUN LIFE FINANCIAL?

The
#1 Life Insurer
Per 2016 Insurance Commission Ranking
BUSINESS PORTFOLIO
Group Clients
COMPANY ADVANTAGE

WE ARE KNOWN FOR:

• Comprehensive benefits
Benefits • Life, Accident , Disability, and
Medical

• Vast network of providers

Access • Nationwide access

• Reasonable
Rates • With real value on your
money
AVAILMENT PROCESS
 OUTPATIENT AVAILMENT PROCESS
Step 1
Member shall proceed to SLGFI accredited
clinic/hospital in the area.
a. Clinic Setting- Member shall present SunLife
GREPA card to reception/HMO officer.
b. Hospital Setting – Member shall present SunLife
GREPA card to to the assigned Plan
Coordinator or HMO/Industrial Section of the
hospital.
Step 2
HMO Officer or Assigned Coordinator
shall swipe Sunlife Grepa card to POS
Terminal to validate if member is
ACTIVE.
If ACTIVE, HMO Officer or Assigned
Coordinator shall issue Consultation Form
and refer member to Sunlife grepa
Affiliated physician.
If INACTIVE, HMO Officer or Assigned
Coordinator shall call Sunlife Grepa Call
Center for approval code.
Sun Life GREPA Financial
Health Care Card
Outpatient Consultation
Form

• Three (3) days validity

• Need to complete form
• Signature
• Affiliated Physician only
 July 1, 2018

12456789 JUAN DELA CRUZ 01/01/1979 39 M ABC Corp.

July 3, 2018 PHILIPPINE GENERAL HOSPITAL DR. PEDRO REYES

Fever

weakness (+) t/c UTI Urinalysis

Dr. Pedro Reyes

Juan Dela Cruz7/3/2018
OUTPATIENT AVAILMENT PROCESS
Step 3
• After consultation, if there are
diagnostic procedures requested by the
Sunlife Grepa affiliated Physician,
Sunlife Grepa member shall proceed to
HMO Officer or Assigned Coordinator
for the Laboratory/Diagnostic Form
• Should the member be referred to
another affiliated physician, member
shall return to HMO Office or
Coordinator for the consultation form.
Step 4
• HMO Officer or Assigned Coordinator
shall swipe Sunlife Grepa card to POS
Terminal.
• If ACTIVE and Diagnostic Procedure
is amounting to Php 999 below, HMO
Officer or Assigned Coordinator shall
issue Diagnostic Form.
• If INACTIVE or Diagnostic Procedure
is amounting to Php 1000 and above,
HMO Officer or Assigned Coordinator
shall call Sunlife Grepa Call Center for
approval code.
Laboratory and Diagnostic
Form

• Three (3) days validity

• Need to complete form
• Signature
• Diagnostic Procedures
amounting to Php 1000 and
above must have an
Approval code
 July 1, 2018
987654321 c/o ferdie
3

123456789 JUAN DELA CRUZ 1/1/1979 38 MALE ABC Corp.

July 3, 2018 PHILIPPINE GENERAL HOSPITAL Dr. Pedro Reyes

T/C UTI URINALYSIS

Marie Santos / H.M.O.

Juan Dela Cruz7/3/2018
CALL CENTER HOTLINE

When do you need to call for

approval?
1. Inactive Cards
2. All Diagnostic Procedures
amounting to Php 1000 and
above
3. Outpatient Surgical
Procedures
 EMERGENCY CASE

EMERGENCY CARE connotes that:

Treatment must be obtained within 24 hours from the time

the accidental injury was sustained, or within 12 hours from the
onset of symptoms for serious illness.
EMERGENCY AVAILMENT PROCESS

STEP
Step 22
Step 11
STEP
ER personnel will render proper
Proceed to Emergency Room of accredited hospital treatment
and present members card

Step 3 Step 3

FOR ADMISSION
FOR NON-ADMISSION Follow in-patient
UPON DISCHARGE from ER procedures.
 Sign necessary documents
 Check Hospital Charge Slips
 Settle charges not covered by
SunLife GREPA (if any)
 INPATIENT AVAILMENT PROCESS
Step 1
Member goes to SunLife GREPA Accredited
Hospital and give admitting orders
Step 4
UPON DISCHARGE
• Member must file PhilHealth
• Check Hospital Charge Slips
• Settle charges not covered by (if any)
Step 2
Accredited Hospital swipes SLGFI card
and calls SunLife GREPA to report
admission
Step 3
Liaison Officer shall monitor admission
and issues LOA once final diagnosis is
available.
Inpatient LOA

• Issued once Final Diagnosis

is available
• Sent via Facsimile (Fax)
 July 3, 2018
987654321

123456789 JUAN DELA CRUZ 1/1/1979 39 M ABC Corp.

1/1/2018 12/31/2018 PHILIPPINE GENERAL HOSPITAL 7/1/2018 Private 1200

Dr. Pedro Reyes General Surgeon

Appendicitis

Appendectomy

Member to file PHIC.

Admission Kit not covered

James Cruz Ferdinand Estabillo July 3, 2018

Juan Dela Cruz7/3/2018
 BILLING
All Original Copy of SLGFI Forms (LOA) accompanied by supporting documents
(charge slips, OR techs, etc.) should be billed to Sunlife Grepa within 30 days.

Sunlife Grepa shall pay the provider within 30 days from

the receipt of bills.
 BILLING

Hard copies:

Sun Life Grepa Claims Department

Group Allied Services
5th Floor Grepalife Bldg.,
221 Sen. Gil Puyat Ave., Makati City, 1203

Soft copies:

to: slgfi-groupclaims-processingteam@sunlifegrepa.com
cc: margelica.yago.juliano@grepa.sunlife.com
CLARIFICATIONS &
QUERIES

Got any questions? 

Glad to be of service:

RICHARD L. TAN
Network Relation and Head Outpatient Services
Group Sales and Servicing Department

(+632) 8866-6810
09167046815
Richard.Tan@sunlifegrepa.com

Securing your future is our PASSION FOR

LIFE!
Margelica Juliano
Network Coordinator
Group Sales and Servicing Department
+632 8866 6850
0999 226 2963
margelica.yago.juliano@grepa.sunlife.com
James Paul Cruz
Network Coordinator
Group Sales and Servicing Department
+632 8866 6850
0999 226 2963
JamesPaul.Cruz@sunlifegrepa.com