* AHMOPIgb

ASSOCIATION OF HEALTH MAINTENANCEORGANIZATIONS OF THE PHILIPPINES, INC.

WITNESSETH:

WHEREAS, AHMOPI is the recognized trade organization of Health MaintenanceOrganizations (HMOs) in the Philippines

WHEREAS, AHMOPI is currently composed of several HMOs which are business

entities that arranges for pre-paid health care services for their members by contracting withhospitals, physicians, and other health professionals for their services AHMOPI membersinclude, but are not limited to. the following:

BLUE CROSS HEALTHCARE, INC.800 Makati Avenue corner Burgos StrcclMakati CityTel. No. 899-8001 Fax; 899-5392Website: \wvw bluccross.com.ph

CARITAS HEALTH SHIELD, INC3'k Floor Kalipuiian Building95 E. Rodrigue/ Boulevard. Que/on CityTel. No 7X1-6492 Fax- 732-5251Wcdsiic: ww\\.cantashcajihshild.com.ph

COCOLIFE HEALTH CARES/F Feliza Building. V A, Rufmo StrcclLcgaspi Village. Makati /cityTel. No. SI3-3000 Fax: 812-3363Website; \v\v\h

FORTUNE MEDICARE, INC.3/F CityStalc Centre709 Shaw Boulevard. Pasig CityTel. No. 706-4X47 Fax: 706-4231Website. \vu\\.fortunccare.com.ph

HEALTH MAINTENANCE, INC.To\verGround. Makati Cinema SquareChino Roces Avenue. Makati Cit>Tel. No. 8 1 1 - 1 3 1 3 Fax; 817-1377Website: wwu.hmi com.ph

INSULAR LIFE HEALTH CARE, INC.1-CARH Building. 167 Legaspi StreetLcgaspi Village. 1229 Makati Cit>Tel No 813-013! io36 Fax 813-7856Website, \vw\v.icarccom ph

INTELLICARE7'F Fell/a Building. V A. Rufmo StreetLegaspi Village. Makati CityTel. No 894-2120 Fax: 894-2135Wcdbistc: www.intcilicarc.com.ph

MAXICARE HEALTHCARE CORP.I9/F Medical PI a/a Makati. Amorsolo cordcla Rosa Streets. Lcgaspi Village, Makati Cit>Tel. No. 752-6294 Fax: 813-8713Website: w\\w.niaxicare.com.ph

MEDICAL SERVICES MARKETING &DEVELOPMENT CORPORATIONPenthouse. Seven East Capitol BuildingEast Capitol Drive. Kapitolyo. Pasig CityTel. No. 746-5000 Fax: 632-0651Website: wwvyjnedserve.com.ph

MEDICARD PHILIPPINES, INC.S/F The World Center330 Sen Gil Puyal Avenue, Makati CityTel No. 867-2020 Fax: 810-3855Website w\vw.mcdicardpli11Is coin

MEDOCARE HEALTH SYSTEMS, INC7/F EU State Tower#30 Quc/.on Avenue. Quc/on CityTel. No. 781-9682 Fax: 732-4415Wcdsite: ww\v,cujj,roup net

METROCARE HEALTH SYSTEMS, INC.55 Don Bcnilo Hcniandc/ StreetJalandoui Compound. Pasay CityTel. No 551-7764 (or 67) 'Fax: 551-0911email: admprl'd.mctrocarchealth com

PH1LHEALTH CARE, INC.7/F Philam Life BuildingU.N. Avenue, Malatc. ManilaTel. No. 523-6002 Fax: 528-3651 \: \\-\\^v philamcarc com.ph

PRUDENTIAL HEALTHCARE, INC.3f Floor Prudentialife Building843 Amai/ Avenue. Makati CityTel. No. 816-4976 Fax: 840-0692email brrfl'prudentialife.com ph

STAR HEALTHCARE SYSTEMS, INC.4/F Beneficial Lite Insurance Building166 Salcedo Street. Legaspi Village. Makati Cit>Tel. No 819-0074 Fax: 819-0072email; sales ajslarcarc.com ph

VALUE CARE HEALTH SYSTEMS, INC.Una 607-613 6/F Philippine Slock Exchange CenterExchange Road. Ortigas Centre. 1600 Pasig Cit>Tel. No. (02)702-3388 / (02)687-0219 Fax. 637-9453/56Website wvnv valucare.cQm

WHEREAS, AHMOPI has signed a Memorandum of Agreement (MOA) with thePHILIPPINE COLLEGE OF PHYSICIANS, a private corporation duly registered andexisting in accordance with the laws of the Republic of the Philippines, with office address atUnit 2201-2203, 22nd Floor, One San Miguel Avenue Building, San Miguel Avenue cornerShaw Boulevard, Ortigas Centre, Pasig City, hereinafter referred to as "PCP".

WHEREAS, the PCP-AHMOPI MOA took effect on May 04, 2009 and shall expire onMay 03, 2011, after which both parties may jointly review, revise and/or modify the said MOA,if necessary, prior to its renewal for another two (2)-year term.

WHEREAS, AHMOPI Members are desirous of entering into an arrangement withPCP Members (the Physician) in different localities/communities all over the Philippines for thepurpose of providing medical services to its members.

WHEREAS, the PHYSICIAN is a/an (specialization) .dulylicensed to practice medicine in the Philippines, and is a member of the PCP, and has signed hisconformity to the provisions of the MOA between the PCP and the AHMOPT dated 04 May2009;

NOW THEREFORE, for and in consideration of the foregoing premises the partieshereby mutually agree as follows

I. The Physician agrees to render quality and cost - effective medical services topatients of AHMOPI members In consideration for the above services, thefollowing professional fees (exclusive of Philippine Health Insurance Corporation fees)will be paid:

1 1 Ou t -Pa t i en t Consultation Fees

The out-patient consultation fees of the Physician shall be Php 300.00 regardlessof their place of practice

Other fees are as follows

~r For routine pre-procedure medical evaluation,in- patient and oul-patient - P 600 00

'f For pre-procedure medical evaluation, in-patient andout-patient but with medical indications - 800.00

r Intra-operative monitoring - 1,200 00

In-Patient Daily Visits:

All professional fees (PF) for both attending physicians and co-attendingphysicians shall be based on the following payment schemes:

WardSemi-PrivatePrivateSuiteICU/CCU

Other fees are as follows:

For routine pre-procedure medical evaluation,in- patient and out-patientFor pre-procedure medical evaluation, in-patient^andout-patient but with medical indicationsIntra-operative monitoring

450.005500065000

1,000.001,200.00

- P 600 00

800.001.20000

7

9.

10

The Physician shall not "balance-bill1' AHMOPi patients for coverable health conditionsand availments. However, for non-coverable health conditions and availments, thePhysician may bill AHMOPI patients for PFs based on the PF schedules of the AHMOPI-Member concerned.

All PFs are subject to the prevailing withholding tax rates and such other taxprovisions. The prevailing Value Added Tax (VAT) currently at 12%) shall beshouldered by the AHMOPI-Member provided the Physician submits VAT registrationcertificates to the AHMOPI Member. On the other hand, withholding taxes will bededucted from the Physician's PFs,

For medical procedures listed in the Philippine Health Insurance Corporation(PhilHealth) and Philippine College of Surgeons (PCS) handbook of 2001, as amended in01 April 2009, AHMOPI Members agree to pay professional fees (PF) based on the 2009PHIC Relative Value Scale (RVS) For those procedures not listed, the PCP-AHMOPILiaison Committee, in collaboration with the PCP Subspecialties concerned, shall meetand decide on the most appropriate PF schedules

Discounts for Senior Citizens will not apply to the negotiated rates ( I t e m l ) above.

Similar PFs will apply to all specialists/physicians consulted to co-manage a particularpatient

All bills presented by the Physician with complete documentation shall be fully paid bythe .AHMOPI Member according to the negotiated rates (item 1 above) within forty-five(45) days from receipt of out-patient claims from the Physician, and within sixty (60)day.v from receipt of in-patient claims from the hospital

7 . 1 , A penalty of 3% per month shail be imposed on delays from submission of out-patient and in-patient claims (using the same 45-day and 60-day turn-around timeafter providing services to the patient) to payment of claims

7 2 It is the responsibility of the AHMOPI-Member to remit the payments for PFs j idirectly to the Physician, including the certificate of tax withheld at source (Form \2307), for both in-patient and out-patient services.

All billings pertinent to professional fees of the Physician for out-patient servicesafforded Planholders of AHMOPI Members must be submitted to the individualAHMOPI Member concerned within 60 days from date of service All claimssubmitted for processing beyond this 60-day prescription period shall be consideredvoid and non-payable

The Physician shall extend utmost cooperation and shall coordinate with theAHMOPI Member on all matters pertaining to the effective and efficient deliveryof health care and other support services.

The Physician shall comply with the policies and guidelines governing theservicing of Planholders of AHMOPI Members such as, but not limited to,providing medical records, operative reports, discharge summaries, etc., wheneverthese shall be needed

The Physician is an independent contractor, hence he is not considered anemployee or an agent of the AHMOPI Member As such, the AHMOPI Membershall not assume any statutory employer obligations such as, but not limited to,Social Security, PhilHealth, and Employee's Compensation premiums

The Physician agrees to hold AHMOPI Members and its Planholders free andharmless from any claim or liability to any third party arising out of, or relatedto, any act, omission or negligence of the part of the Physician

13. This Agreement shall be valid and effective on the date of execution hereof andis automatically renewable every year thereafter, unless earlier terminated/revokedby either party by giving a thirty-day prior notice to the other party

14 Any modification/s to this Agreement shall be embodied in an Addendum to beattached herein and considered an integral part hereof

IN WITNESS WHEREOF, the parties have set their hands on this day of

PHYSIC IA IS ASSOCIATION OF HEALTH MAINTENANCEORGANIZATIONS OF THE PHILIPPINES, INC.

Printed Name & SignatureCARLOS D. DA SILVAPresident

AHMOPI MEMBERS:

I Blue Cross HealthCare, Inc

2. Caritas Health Shield, Inc

3 Cocolife Health Care

4 Fortune Medicare, Inc.

5 Health Maintenance, Inc.

6. Insular Life Health Care, Inc

7. IntelliCare

8. Maxicare Healthcare Corp

9 Medical Services Marketing &Development Corporation

10 Medicard Philippines, Inc

I I Medocare Health Systems, Inc

12. Metrocare Health Systems, Inc.

13 Philhealth Care. Inc

14 Prudentialife Healthcare, Inc

15 Star Healthcare Systems, Inc.

16 Value Care Health Systems, Inc

Noel L. Rosas, MD

Geoffrey M. Martinez

Atty Alfredo C. Tumacder, Jr

Dorothea J. Sibal

Pilar A. Adrias, MD

Seralme L Manguni

Mario M Silos

Jose Pastor Z. Puno

Vir?,ilio A. Del ValLe

Nicanor S. Montoya, Jr. , MD

Eugene L. Sagcal, MD.

Jo Eileen Suzanne R Pama, MD

Marites L. Nepomuceno

Benito R. Reverente, Jr., MD

Jaime C Fernandez

Rosemarie U. Yu

' AHMOPl vi

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