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    Ape Endorsement Letter

    Uploaded by

    Princess Gemayma Edd Reyes
    This letter serves as confirmation that AFNI Philippines employees are entitled to avail an Annual Check-Up (ACU) package with Maxicare. The routine ACU package includes a basic physical exam, chest X-ray, CBC, urinalysis, fecalysis, and optional ECG or pap smear. The letter provides instructions for scheduling an appointment, health protocols during the exam, specimen collection preparation, and procedures during the check-up. Members must present their Maxicare card, ID, and this endorsement letter and sign below to confirm their availment of the ACU within the letter's validity period from April 2022 to March 2023.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Ape Endorsement Letter

    Uploaded by

    Princess Gemayma Edd Reyes
    2K views2 pages
    This letter serves as confirmation that AFNI Philippines employees are entitled to avail an Annual Check-Up (ACU) package with Maxicare. The routine ACU package includes a basic physical exam, chest X-ray, CBC, urinalysis, fecalysis, and optional ECG or pap smear. The letter provides instructions for scheduling an appointment, health protocols during the exam, specimen collection preparation, and procedures during the check-up. Members must present their Maxicare card, ID, and this endorsement letter and sign below to confirm their availment of the ACU within the letter's validity period from April 2022 to March 2023.

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    ape

    Original Title

    APE ENDORSEMENT LETTER

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    This letter serves as confirmation that AFNI Philippines employees are entitled to avail an Annual Check-Up (ACU) package with Maxicare. The routine ACU package includes a basic physical exam, chest X-ray, CBC, urinalysis, fecalysis, and optional ECG or pap smear. The letter provides instructions for scheduling an appointment, health protocols during the exam, specimen collection preparation, and procedures during the check-up. Members must present their Maxicare card, ID, and this endorsement letter and sign below to confirm their availment of the ACU within the letter's validity period from April 2022 to March 2023.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2K views2 pages

    Ape Endorsement Letter

    Uploaded by

    Princess Gemayma Edd Reyes
    This letter serves as confirmation that AFNI Philippines employees are entitled to avail an Annual Check-Up (ACU) package with Maxicare. The routine ACU package includes a basic physical exam, chest X-ray, CBC, urinalysis, fecalysis, and optional ECG or pap smear. The letter provides instructions for scheduling an appointment, health protocols during the exam, specimen collection preparation, and procedures during the check-up. Members must present their Maxicare card, ID, and this endorsement letter and sign below to confirm their availment of the ACU within the letter's validity period from April 2022 to March 2023.

    Copyright:

    © All Rights Reserved
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    MAXICARE HEALTHCARE CORPORATION

    Endorsement Letter with Negative List

    DATE ISSUED: : APRIL 19, 2022


    TO : AFNI Philippines, Inc. (PRINCIPAL & DEPENDENT MEMBERS)
    PROVIDER : ALL MAXICARE ACU AFFILIATED PROVIDERS
    Endorsement Letter for the Annual Check-Up (ACU).
    RE : Validity period from April 20, 2022 until March 31, 2023.

    Greetings!

    This letter serves as confirmation of your entitlement to avail Annual Check-Up (ACU) as a Maxicare member.

    Please refer to the list of procedures included in your ACU package.

    ROUTINE ACU PACKAGE


    Basic 5 Package
    Complete Physical Examination
    Chest X-ray
    Complete Blood Count (CBC)
    Urinalysis
    Fecalysis
    Additional Test/s
    12 Lead ECG (Optional For members 35 years
    old and above)
    Pap Smear (females only) (Optional to
    members 35 years old and above)

    Important things to remember for your ACU:

    a. Strictly by appointment basis. Please call your designated clinic for the necessary arrangements.
    b. Observe the minimum health standards while inside the clinic. Wear your face mask and face shield and observe physical distancing
    of 1 meter while inside the clinic.
    c. Complete the health declaration form and initial assessment provided by the clinic prior entering the facility.
    d. Results are for member's pick-up. An authorized representative may claim the results on your behalf with the following
    requirements:
    - Authorization letter from the member
    - Photocopy of one (1) valid ID of the member & of the authorized representative
    e. You can coordinate directly with the clinic any other arrangement for the release of your ACU result if available.

    Page | 1
    Preparation prior to availment:
    a. Fasting is required to packages that includes and does not limited to any of the following: FBS, Lipid Profile, Triglycerides, etc.
    Fasting in not required for Basic 5 Package.
    b. Stool samples shall be collected not more than 1 hour prior to the submission to the laboratory. You can place your specimen
    in any clean receptacle or you can get one from your designated clinic.
    c. Urine samples shall be collected not more than 15 minutes prior to the submission to the laboratory. You can place your
    specimen in any clean receptacle or you can get one from your designated clinic.
    d. Properly label your specimen bottles with your complete name, birthday, and date of specimen collection.
    e. Female members who opt to avail Pap smear should avoid sexual contact at least 48 hours before the procedure.

    Procedure during ACU availment:


    a. You should provide your Maxicare card or card number, one (1) valid ID, and a printed copy of this endorsement letter to your
    designated clinic.
    b. You should affix your signature below as proof of your availment.
    c. You are entitled within the validity period indicated in this endorsement letter.
    d. You should complete all the tests in the same provider within 14 days from the availment.

    Thank you.

    MARIA CLARINDA G. LAO


    Clinic Annual Check-Up Unit
    Maxicare Healthcare Corporation

    To our Valued Maxicare Member,

    By signing this document, I hereby attest to


    the following:
    - I have read and understood the instructions
    pertaining to my ACU availment.
    - I have availed my ACU on the designated clinic and schedule.

    ________________
    Member’s Signature over printed name Date

    Page | 2

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