provider directory: chile - aetna internationalprovider directory: chile below you will find the 4...
TRANSCRIPT
Non-Emergency Care
813-775-0426
GMMI [email protected] 813-775-0426 888-219-5950
Non-Emergency Care
813-775-0451
Aetna [email protected] 813-775-0451 888-219-0477
813-775-0426
888-219-5950 [email protected]
[email protected] 813-775-0426 888-219-5950
3. Clinics/Hospitals associated with Mutual De Seguridad: A Mutual de Seguridad Medical Ambulatory Clinic should be used first, and if a higher level of care is needed to treat the
missionary, the mission will need to reach out to GMMI and request an LOA for the providers that indicate 'Associated to
Mutual de Seguridad'.
Mission will request the LOA from GMMI - Request LOA by phone or by email with the missionary’s name and Aetna ID#, plus
the provider name and address.The missionary will take the completed LOA to their appointment, along with the GMMI ID
card and a form of identification. If medical expenses for missionary's medical treatment are over $5,000 US Dollars please
contact Aetna.
Provider Directory: Chile
Below you will find the 4 options your mission has access to provide medical coverage for young missionaries. Please pay close attention to the following
instructions and the notes next to each provider listed in here. Should you have any questions please don't hesitate to contact your assigned Aetna
representative Emmanuel de la Rosa [email protected]
1. REQUEST LOA FOR GMMI PROVIDERS:
Mission will request the LOA from GMMI - Request LOA by phone or by email with the missionary’s name and Aetna ID#, plus
the provider name and address.The missionary will take the completed LOA to their appointment, along with the GMMI ID
card and a form of identification. If medical expenses for missionary's medical treatment are over $5,000 US Dollars please
contact Aetna.
2. USE AETNA PROVIDERS:Mission will reach out to Aetna and provide them with the missionary’s name and Aetna ID#, plus the provider's name and
address. Once the LOA is received, missionary will then take the completed LOA to their appointment, along with their Aetna
ID card and a form of identification.
Page 1
Pay with Mission fundsComplete a Reimbursement
Form
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Ancud
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(65) 2623028
(65) 92436796Baquedano N° 267
Ambulatory Walk-in Clinic
M-F 09:00 - 19:00 hrs.
AngolGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(45) 2711861 Manuel Jarpa Nº082Ambulatory Walk-in Clinic
M-F 08:30 - 20:00 hrs.
Sat. 09:00 - 14:00 hrs.
Antofagasta
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA from
GMMI
Nelson Antonio Moya Muñoz
(56) 552590502
(56) 9044 2300
Coquimbo 712 Oficina
802. AntofagastaMedical Surgeon - Urologist
Antofagasta
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Clínica Bupa Antofagasta (55) 228 1050
Manuel Antonio
Matta 1945
2° piso Edificio Pukará
Clinic / Hospital
Antofagasta
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
from GMMI
http://www.clinicaportada.cl
Clínica La Portada
Associated to Mutual de
Seguridad
(55) 269 4300
(55) 269 4342Av. Balmaceda 2468
Clinic / Hospital
Medical Center
M-F 8-8 pm
Saturday 9 am to 2 pm
Urgent Care & Hospitalization
24/7
Antofagasta
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=10Megasalud Antofagasta (55) 2410 590 Sucre N° 251 Medical Center
4. PAY/CLAIM PROVIDERS:
Be prepared to pay the provider with Mission funds and obtain an itemized receipt with name of missionary, services
provided and amount paid. Give receipt to Mission office and they will send a claim form with the receipt to Aetna for
reimbursement to the Church. You will find the reimbursement form under Supporting Documents ,
http://www.aetnainternational.com/sites/lds/cl/index.html
Page 2
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Antofagasta
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Lilian Varas o Patricia Cortes
[email protected] o [email protected]
(55) 265 1300 o (55) 265 1353
(55) 265 1300Antonino Toro N° 709,
Antofagasta
Ambulatory Walk-in Clinic
M-F 08:00 - 20:00 hrs.
Sat. 9:00 - 14:00 hrs.
Arica
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA from
GMMIClínica Arica (58) 224 1300 Av. Argentina 2249 Clinic / Hospital
Arica
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA from
GMMIMegasalud Arica San Marcos N° 121 Medical Center
Arica
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Karen Jimenez
(58) 206 729
(58) 220 6700Av. Argentina N°
2247, Arica
Ambulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
Bio-Bio PAY/CLAIM PAY/CLAIM Centro de Diagnostico San Martin (56) 4 1262 9700
Calle San Martin 940,
VIII Bio Bio
Concepcion, Chile
Medical Center
Bio-Bio PAY/CLAIM Make Appointment / request LOA Hospital Clínico del Sur SPA (56) 4 1212 8000Cardenio Avello 36,
Región del Bio BioClinic / Hospital
Bio-Bio PAY/CLAIM PAY/CLAIM Integramedica Bio-Bio(02) 2 636 6666
(600) 636 6666
Los Carrera 301, Mall
Plaza Mirador Bio-
Bio)
Medical Center
Calama
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual De Seguridad Clinic
Priscila Espinosa
Uberlinda Galleguillos o Alejandra
Bautista
(55) 265 8827 o (55) 265 8800
(55) 265 8800
Av. Central Sur N°
1813, Villa Ayquina,
Calama
Ambulatory Walk-in Clinic
Medical Center
24 hrs.
Calama PAY/CLAIM PAY/CLAIM Clínica El Loa (55) 242 4801Av. Granaderos N°
2935
Calama PAY/CLAIMSchedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=6 Megasalud Calama
(55) 231 1755
(55) 231 2073
Av. Granaderos N°
1474Medical Center
CalbucoGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(65) 2461450
(65) 2461599
Galvarino Riveros N°
426
Ambulatory Walk-in Clinic
M-F 09:00 - 18:00 hrs.
Caldera
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMIClínica Mutual de Seguridad Caldera (69) 838 55985
Calle Enrique Gigoux
92
Ambulatory Walk-in Clinic
Clinic / Hospital
Page 3
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
CalderaGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(52) 2315954Enrique Gigoux N°
921, Caldera
Ambulatory Walk-in Clinic
M-F 09:00 - 13:00 hrs. ; 15:30 - 19:00
hrs.
Sat. 09:00 - 12:45 hrs.
CasablancaGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(32) 2571080 Leiva Amor N° 251Ambulatory Walk-in Clinic
M-F 08:30 - 17:30 hrs.
Castro
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Alvaro Ricarde Calisto
(65) 224 94621
(65) 263 2784
(65) 249 4621
O`Higgins N° 735,
Castro
Ambulatory Walk-in Clinic
M-F 08:30 - 21:00 hrs.
CauquenesGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(73) 2512387
(73) 513648
Claudina Urrutia
N°701, Cauquenes
Ambulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
Cerrillos PAY/CLAIM PAY/CLAIM Integramedica Mall Plaza Oeste(02) 2 636 6666
(600) 636 6666
Av. Américo Vespucio
1501, Mall Plaza
Oeste
Medical Center
Chicureo PAY/CLAIMMake Appointment / request LOA
http://www.clinicalascondes.cl/QUIEN
ES-SOMOS/Chicureo.aspx
Clínica Las Condes - Piedra Roja
(56) 2 2210 4000 Principal
(56) 2 2610 8000 Citas
(56) 2 2610 7777 Rescate
Av. Chicureo, sector
de Piedra Roja,
comuna de Colina
Health Center
Chillan
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
Hospital Clinico Herminda Martin
Associated to Mutual de Seguridad
Priscila Espinosa
56422 208 148Av. Francisco
Ramírez Nº 10Hospital / Clinic
Chillán
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Pamela Palma
(42) 258 8900
(42) 258 8900
(42) 258 8920
Av. Argentina N° 742,
Chillán
Ambulatory Walk-in Clinic
M-F 08:00 - 20:00 hrs.
Chillán PAY/CLAIMReferral from Mutual de Seguridad
Medical Center neededClínica Chillán (042) 208 148
Pedro Aguirre Cerda
35Clinic / Hospital
Chillán PAY/CLAIMSchedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=26 Megasalud Chillán
(42) 221 7186
(42) 221 5585Libertad N° 431 Medical Center
Page 4
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
ColtaucoGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(72) 2462278Carretera H-30, El
Molino s/n
Ambulatory Walk-in Clinic
Temporada Alta: Oct. - Junio
M-F 08:00 - 19:00 hrs.
Sáb. 09:00 - 14:00 hrs.
Temp. Baja: Julio - Sept.
M-F 08:00 - 17:30 hrs.
Sáb. 09:00 - 13.00 hrs.
Concepcion PAY/CLAIM Make Appointment / request LOA
Clinica Nobel Salud
Dr. Gomez
9-9888-4990, 41-2913-915 Baros Arana 457 Hospital / Clinic
Concepcion PAY/CLAIM Make Appointment / request LOA
Dra. Macarena Oliver Burgos
parentalconcepcion@gmailcom
011-4202300240, 56- 41-230-0393, 56-
41-99-7354058
Part 199 oficina 707
A, ConcepcionHospital / Clinic
Concepción
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
Hospital Clinico del Sur
Associated to Mutual de Seguridad
Priscila Espinosa
(41 ) 212 8000 Cardenio Avello 36
Clinic / Hospital
Medical Center
M-F 8-8 pm
Saturday 9 am to 2 pm
Urgent Care & Hospitalization
24/7
Concepción
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Erika Heredia
(41) 272 7317
(41) 272 7300
Admisión Concepción
Autopista Concepción
Talcahuano N°8720,
Hualpen
Ambulatory Walk-in Clinic
M-F 08:00 - 20:00 hrs.
Concepción PAY/CLAIM PAY/CLAIM Asoc Chilena de Seguridad Cardenio Avello #36 Clinic / Hospital
Concepción
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Centro de Especialidades Medicas(56)(41) 212 8171
Cardenio Avello N
70 Concepcion
Medical Center
Concepción PAY/CLAIM PAY/CLAIM Corporación Sanatorio Alemán (41) 279 6000Pedro de Valdivia N°
801Clinic / Hospital
Concepción
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
Flandez, Enzo
Psicólogo
Oficina: (56) 41 224 0655
Cel: 9308-1320
Pasaje Alfreco Casa
2516
Villa Produccion y
Comercio
Santa Sabina
Mental Health Professional
Concepción PAY/CLAIM PAY/CLAIMGómez , Paulina Turner
General Practitioner(41) 291 3975
Calle Cuatro #116
Casa 8
Lomas San Sebastian
General Practitioner
Concepción
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA IMAGENOLOGIA HCS SPA (56) 4 1212 8013Cardenio Avello 36
ConcepciónRadiology
Page 5
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Concepción PAY/CLAIM PAY/CLAIM MEDIMAS (41) 252 0240
O'Higgins 630 off.
409, Chile
www.medimas.cl
Physical Therapy
Concepción
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=27 Megasalud Concepción
(41) 292 5040
(41) 292 5050Freire N° 1445 Medical Center
Constitución
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Carla Barra
(71) 220 4702
(71) 220 4700
(71) 220 4720
Mac Iver N° 580,
Constitución
Ambulatory Walk-in Clinic
M-F 10:00 - 18:00 hrs.
Copiapó
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Clínica Atacama (52) 200 510 Infante 861
Clinic / Hospital
Medical Center
M-F 8-8 pm
Saturday 9 am to 2 pm
Urgent Care & Hospitalization
24/7
Copiapó
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Karen Galleguillos o Carolina East
(52) 220 7543 o (52) 220 7595
(52) 220 7543
(52) 220 7400
Avda. Copayapu N°
877, Copiapó
Ambulatory Walk-in Clinic
M-F 08:00 - 20:00 hrs.
Sat. 9:00 - 14:00 hrs.
Coquimbo
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Dra. Miriam Madrid Rojas (56) 95 651-8835
Centro Medico Mesik
Avenida El Sauce
#1232 Sidempart,
Coquimbo
Podiatrist
CoronelGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(41) 2711472Lautaro Nº401,
Coronel
Ambulatory Walk-in Clinic
M-F 08:00 - 20:00 Hrs.
Coyhaique PAY/CLAIM PAY/CLAIMHospital Regional de
Coyhaique(67) 226 2001
(67) 226 2002
Dr. Jorge Ibar #068, XI
Region de AysenClinic / Hospital
Coyhaique
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Leodan Mellado
(67) 226 8600
(67) 226 8600Eusebio Lillo N° 20,
Coyhaique
Ambulatory Walk-in Clinic
M-F 09:00 - 18:00 hrs.
Page 6
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Curico
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Marisel Guzman
(75) 220 4522
(75) 220 4522Av. España N° 1191,
Curicó
Ambulatory Walk-in Clinic
M-F 09:00 - 19:30 hrs.
Curico
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
Clinica Imageonológica San
Patricio
Alexis Avendano
961619613
752324683
752324864
752324768 Ave B. O'Higgins 32
Clinic
El Bosque - SantiagoGMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOABarbara Brisalia Gonzalez Luna
[email protected]+56 9 6108 8301
Av. Lo Esperjo #490,
Depto. B33Kinesiologist
El SalvadorGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(52) 2475383Avda. El Tofo N°546
, El Salvador
Ambulatory Walk-in Clinic
M-F 09:00 - 13:00 hrs.; 15:30 - 19:00
hrs.
Sáb. 09:00 - 12:45 hrs.
Enea
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(02) 278 79780
(02) 278 79781
Av Américo Vespucio
Oriente 1309 Local
110 A, Pudahuel
Ambulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
Estación Central PAY/CLAIM PAY/CLAIM Integramedica Estacion Central(02) 2 636 6666
(600) 636 6666
Av. Libertador
Bernardo O'Higgins
3466
Medical Center
Huechuraba PAY/CLAIM PAY/CLAIM Integramedica Mall Plaza Norte(02) 2 636 6666
(600) 636 6666
Av. Américo Vespucio
1537, Mall Plaza
Norte
Medical Center
Iquique
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
https://www.megasalud.cl/nuestra-
red/iquique/Megasalud Iquique (57) 2510 540 Ramírez N° 1162 Dental Care ONLY
Iquique
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA from
GMMI
Clínica Iquique
Associated to Mutual de Seguridad
Priscila Espinosa
(57) 239 3200 O´Higgins 103 Clinic / Hospital
Iquique
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Nelly Terraza o Pamela Gonzalez
(57) 240 8740 o (57) 240 8745
(57) 240 8700 Orella N° 769, IquiqueAmbulatory Walk-in Clinic
M-F 08:00 - 20:00 hrs.
Page 7
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Isla PascuaGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(42) 745093 Calle Hotu MutuaAmbulatory Walk-in Clinic
M-F de 08:30 - 18:00 hrs.
La CaleraGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(33) 2228292Almirante Latorre N°
53
Ambulatory Walk-in Clinic
M-F 08:30 - 17:30 hrs.
La Parva
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://www.clinicalascondes.cl/QUIEN
ES-SOMOS/Conozca-CLC/Sedes/La-
Parva.aspx
Clínica Las Condes - La Parva
(56) 2 2210 4000 Principal
(56) 2 2610 8000 Citas
(56) 2 2610 7777 Rescate
Centro de Ski La Parva Trauma Center
La Serena
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA from
GMMI
Clínica Red Salud Elqui (contact
Jorge Barraza Alcayaga - 0512 2563
039 or 0512 2563 033 or
(051) 332 300 Av. El Santo 1475 Clinic / Hospital
La Serena PAY/CLAIM PAY/CLAIM Integramedica Mall Plaza La Serena(02) 2 636 6666
(600) 636 6666
Alberto Solari 1400,
Mall Plaza La SerenaMedical Center
La Serena
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=11 Megasalud La Serena
(51) 233 7405
(51) 233 7447Huanhualí N° 186 Dental Care ONLY
La Serena
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Elena Molina o Horacio Ibarra
[email protected] o [email protected]
(51) 242 1626 o (51) 242 1629
(51) 242 1600
Huanhualí N° 186,
edificio Megasalud, La
Serena
Ambulatory Walk-in Clinic
M-F 08:00 - 20:00 hrs.
Sat. 09:00 - 14:00 hrs.
La UnionGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(64) 2425514 Arturo Prat N° 455Ambulatory Walk-in Clinic
M-F 08:30-18:30 hrs.
Las CabrasGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(72) 2501120Av. Carlos Fresno N°
147
Ambulatory Walk-in Clinic
M-F 08:30 - 17:30 hrs.
Las Tranqueras
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Claudia Nunez o Mario Sazo
(02) 222 08305
(02) 2-578 8300
(02) 2-578 8330
Admisión Las Tranqueras
Av. Las Tranqueras
N°1327, Vitacura
Ambulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
Page 8
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Linares
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Alicia Quiroz
(73) 256 3826
(73) 256 3826 Freire N° 663, LinaresAmbulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
LituecheGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(99) 8857471
(99) 4502242
Cardenal Caro N°
793
Ambulatory Walk-in Clinic
M-F 08:30 - 17:30 hrs.
LlanquihueGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(51) 2242025
Errazuric esquina
Baquedano s/n,
Llanquihue
Ambulatory Walk-in Clinic
M-F 09:00 - 13:00 - 14:00 a 18:00 hrs.
LoncocheGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
5645-2471197 Barros Arana N° 558Ambulatory Walk-in Clinic
M-F 08:30 - 13:00 - 14:30 - 18:15 hrs.
Los Andes
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(34) 242 8146 Las Heras N° 245Medical Center
M-F 08:30 - 19:00 hrs.
Los Ángeles
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Clínica Los Andes (43) 210 200 Av. Genaro Reyes 581
Clinic / Hospital
Medical Center
M-F 8-8 pm
Saturday 9 am to 2 pm
Urgent Care & Hospitalization
24/7
Los Ángeles
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=28 Megasalud Los Ángeles (43) 231 1338 Lautaro N° 615 Medical Center
Los Ángeles
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Victor Acuña
(43) 240 7426
(43) 240 7400
(43) 234 1919
Mendoza N° 350, Los
Ángeles
Ambulatory Walk-in Clinic
M-F 08:00 - 18:00 hrs.
Los Espejos
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Felipe Santander
(02) 232 78200
(02) 2-327 8200
Admisión Los Espejos
Av. Lo Sierra N°
03200, San Bernardo
Ambulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
Page 9
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
MejillonesGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(55) 2651256Almirante Goñi N°
99Ambulatory Walk-in Clinic
Monday a Domingo 24 hrs.G96
Melipilla PAY/CLAIM PAY/CLAIM Hospital San Jose de Melipilia (02) 574 5555 O' Higgins # 551 Clinic / Hospital
Melipilla
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(02) 2-270 4100
Admisión Melipilla
San Agustín N° 270,
Melipilla
Ambulatory Walk-in Clinic
M-F 08:30 - 19:00 hrs.
Osorno
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOAClínica Alemana Osorno
Associated to Mutual de Seguridad(64) 245 4000
Av. Zenteno 1530,
ChileClinic / Hospital
Osorno
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=31 Megasalud Osorno
(64) 226 9543
(64) 226 9504
Bernardo O'Higgins N°
791Medical Center
Osorno
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Jose Miguel Grau o Edson Montenegro
(53) 233 4023 o (64) 233 4029
(64) 233 4000
(64) 233 4020
(64) 233 4023 hasta 233 4029
Guillermo Bühler N°
1756, Osorno
Ambulatory Walk-in Clinic
M-F 8:30 - 18:30 hrs.
Ovalle
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Grina Aguirre
(53) 262 6300
(53) 262 0024
Los Peñones 386,
camino a Sotaqui,
Ovalle
Ambulatory Walk-in Clinic
M-F 08:00 - 20:00 hrs.
Sat. 09:00 - 14:00 hrs.
Paine
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Manuel Reyes o Ana Roman
[email protected] o [email protected]
(02) 282 41157 o (02) 282 41157
(02) 2-824 1157
Admisión Paine
General Baquedano
N° 610-620, Paine
Ambulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
PeumoGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(72) 2561430Walker Martinez N°
315
Ambulatory Walk-in Clinic
M-F 08:30 - 17:50 hrs
Sáb. 09:00 - 13:00 hrs.
Plaza Barón
GMMI - Mission
Requests LOA
from GMMI
Call to schedule appointment Megasalud Plaza Barón(32) 225 5621
(32) 221 6069 Av. Argentina N° 1 Medical Center
Page 10
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
PorvenirGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(61) 2581735 Sampaio N° 300Ambulatory Walk-in Clinic
M-F 09:00 - 13:00 & 14:30 - 19:30hrs.
Puerto ChacabucoGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(67) 2351129Av. L. B. O'Higgins
N° 270
Ambulatory Walk-in Clinic
M-F 08:00 - 22:00 hrs.
Puerto Montt
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Centro Medico los Andes de Puerto Montt (065) 220 9116
Avda. Bella Vista 123
Puerto Montt, Chile Medical Center
Puerto Montt
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Clinica Universitaria de Puerto Montt (56) 6 5220 9175Avda. Bella Vist 1240
Puerto Montt, ChileClinic / Hospital
Puerto Montt
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Clínica Puerto Montt (065) 484 800 Panamericana Sur 400
Clinic / Hospital
Medical Center
M-F 8-8 pm
Saturday 9 am to 2 pm
Urgent Care & Hospitalization
24/7
Puerto Montt
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=32 Megasalud Puerto Montt (65) 228 6143 Rengifo N° 412 Medical Center
Puerto Montt
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Pedro Soto 0 Cristina Antilef
[email protected] o [email protected]
(65) 232 8023 o (65) 232 8050
(65) 232 8000Urmeneta N° 895,
Puerto Montt
Ambulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
Puerto Natales
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(61) 2414188Blanco Encalada N°
362
Ambulatory Walk-in Clinic
M-F 08:30 - 12:30 & 14:00 - 19:00 hrs.
Puerto Varas Aetna LOA Request LOA from Aetna Clínica Alemana Puerto Varas 065 258 2100 Av. Dr. Bader 810 Clinic / Hospital
Punta Arenas
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOAClínica Magallanes
Associated to Mutual de Seguridad
Oficina: (061) 220 7300
Fax: (061) 221 4700
0-1448 Av. Bulnes,
ChileClinic / Hospital
Page 11
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Punta Arenas
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=33 Megasalud Punta Arenas
(61) 224 1110
(61) 224 7986Pedro Montt N° 890 Medical Center
Punta Arenas
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Pamela Ruiz o Carola Vargas
[email protected] o [email protected]
(61) 220 7823 o (61) 220 7822
(61) 220 7800Av. España N° 01890,
Punta Arenas
Ambulatory Walk-in Clinic
M-F 08:30 - 17:00 hrs.
PurranqueGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(64) 2351708Tomás Burgos N°
326
Ambulatory Walk-in Clinic
M-F 09:00 - 13:00 & 13:45 - 18:00 hrs.
QuellonGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(65) 2681376
(65) 2683088
Ramon Freire N°
354
Ambulatory Walk-in Clinic
L-V: 08:30 - 19:00 hrs.
Quilicura
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
562-28765600Panamericana Norte
N° 7500, Quilicura
Quillota
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(33) 231 2095
(33) 231 7095
(33) 231 0958
La Concepción 371BAmbulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
Quilpue
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=13 Megasalud Quilpe
(32) 292 7946
(32) 292 5070Anibal Pinto N° 843 Medical Center
QuinteroGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
56322571090Calle Luis Orione
380
Rancagua
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOAClínica de Salud Integral
Associated to Mutual de Seguridad(072) 950 000
Av. Alameda
634/Cáceres 645Clinic / Hospital
Rancagua
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
Clínica Isamédica
Claudia Caceres
305 6300
(072) 200 0140
(009) 741 3329
Carretera El Cobre
884Clinic / Hospital
Rancagua
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://www.meds.cl/sucursales/rancag
ua
Clínica Meds Rancagua(56) 2 2499 6400 Principal
(56) 2 2 499 6500 Citas
Einstein 290
Centro Comercial
Plaza America
Medical Center
Page 12
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Rancagua PAY/CLAIM PAY/CLAIM Hospital Clínico FUSATOficina: (72) 20 4350
Fax: (72) 20 5353
Email: [email protected]
Carretera El Cobre Clinic / Hospital
Rancagua
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=23 Megasalud Rancagua
(72) 222 8987
(72) 223 1437
(600) 425 6000
Germán Riesco N° 206 Medical Center
Rancagua
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(72) 233 1900Av. República de Chile
N° 390, Rancagua
Ambulatory Walk-in Clinic
M-F 08:00 - 20:00
Sat. 09:00 - 14:00 hrs.
Reñaca PAY/CLAIM PAY/CLAIM Clínica ReñacaOficina: (032) 265 8000
Email: [email protected]
Anabaena 336,
Valparaíso, ChileClinic / Hospital
RengoGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(72) 2511442 Guanguali N° 38Ambulatory Walk-in Clinic
M-F 08:30 - 17:50 hrs.
Sat. 09:00 - 13:00 hrs.
SalamancaGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(53) 2553321 Av. Infante N° 860Ambulatory Walk-in Clinic
M-Th. 8:00 - 17:15 hrs.
Fri. 8:00 - 16:00 hrs.
San Antonio PAY/CLAIM PAY/CLAIM Clínica San AntonioOficina: 3 535-7000
Email: clinicasanantonio.cl/directorio.phpAntonio Palmieri 250
Gálvez Moya, Juan
General Practitioner
San Antonio
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(35) 228 0403Arzobispo Casanova
N° 239, Llolleo
Ambulatory Walk-in Clinic
M-F 09:00 - 18:00 hrs.
San Felipe
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(34) 251 1586Portus N° 111 . Of.
106
Ambulatory Walk-in Clinic
M-F 09:00 - 18:00 hrs.
San FernandoGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(72) 2712700
(72) 2717405
Cardenal Caro N°
634
Ambulatory Walk-in Clinic
M-F 08:30 - 19:00 hrs.
Sáb. 09:00 - 13:00 hrs.
San Miguel PAY/CLAIM PAY/CLAIM Integramedica San Miguel(02) 2 636 6666
(600) 636 6666
El Llano Subercaseaux
3965Medical Center
Santa CruzGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(72) 2822326
(72) 2822671Diaz Besoain N° 248
Ambulatory Walk-in Clinic
M-F 08:00 - 20:00 hrs.
Sáb. 09:00-14:00 hrs.
Page 13
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Santiago
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
Hospital Clínico
Associated to Mutual de Seguridad
Fernanda Carrasco (Enfermera Jefe
Admisión)
Cecilia Torres [email protected]
Eva Bustos [email protected]
Slvia Pino (Enfermera Jefe Admisión)
(600) 301 2222
(02) 267 75336 Admisión de urgencia
(02) 267 75128 Torres
(02) 267 75127 Bustos
(02) 267 75536 Pino
Admisión Hospital Clínico
Av. L. B. O'Higgins N°
4848, Est. Central
Hospital / Clinic
24 hrs.
SantiagoGMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOADra. Maria Rosario Soto Vidal
(2) 2575 4000 // cellular: 56 9 9542
6088
Av. Salvador 364,
Providencia, Región
Metropolitana
Physician
Santiago
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Castillo, Dr. Gonzalo (56) 9 8925 6907Pasaje C 9137,
PeñalolénKinesiologist
Santiago
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Clinica Alemana La Dehesa (45) 229 107 000
Av. Jose Alcalde
Delano 12205, Lo
Barnechea, Region
Metropolitana
Clinic / Hospital
Santiago
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://portal.alemana.cl/wps/wcm/conn
ect/internet/home Clínica Alemana Santiago (45) 220 1201
Avenida Vitacura
5951, Region
Metropolitana
Clinic / Hospital
Santiago
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
www.clinicaloscoihues.cl
Clínica los Coihues
Associated to Mutual de Seguridad(02) 2465 7900
Laguna Sur 6561
Estación Central
Santiago
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://www.meds.cl/sucursales/calera-
de-tango Clínica Meds Calera de Tango
(56) 2 2499 6400 Principal
(56) 2 2499 6500 Citas
Camino Malloco
esquina Santa Teresa
Calera de Tango
Medical Center
Santiago
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://www.meds.cl/sucursales/fleming Clínica Meds Fleming
(56) 2 2499 6400 Principal
(56) 2 2499 6500 Citas
Av. Padre Hurtado Sur
No. 1621
locales comerciales 9
y 10A, Las Condes
Medical Center
Santiago
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://www.meds.cl/sucursales/isabel-
la-catolica Clínica Meds Isabel La Catolica
(56) 2 2499 6400 Principal
(56) 2 2499 6500 Citas
(56) 2 2499 6458 Directo
Isabel La Catolica
3740, Las CondesMedical Center
Santiago
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://www.meds.cl/sucursales/maipu Clínica Meds Maipu
(56) 2 2499 6400 Principal
(56) 2 2499 6500 Citas
Av. Pajaritos 1968
Local No. 104
Maipu
Medical Center
Santiago
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://www.meds.cl/sucursales/las-
brujas-principe-de-gales
Clínica Meds Principe de Gales,
Las Brujas(56) 2 2499 6400 Principal
(56) 2 2499 6500 Citas
Av. Carlos Silva
Vildosola 9073,
local 16, La Reina
Medical Center
Page 14
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Santiago Aetna LOA
USE AETNA LOA only For Hospitalizations
or Major Critical Issues - non-urgent
needs should be directed to a nearby
Medical Center
Hospital Clinico
(un Hospital Pontificia Universidad Catolica)
Tel: 2235 43000
Fax: 2222 20843Marcoleta 367 Clinic / Hospital
Santiago PAY/CLAIM PAY/CLAIM Integramedica Alameda(02) 2 636 6666
(600) 636 6666
Av. Libertador
Bernardo O'Higgins
654
Medical Center
Santiago PAY/CLAIM PAY/CLAIM Integramedica Bandera(02) 2 636 6666
(600) 636 6666Bandera 168 Medical Center
Santiago PAY/CLAIM PAY/CLAIM Integramedica Centro(02) 2 636 6666
(600) 636 6666
Huerfanos 1147,
Galeria PacificoMedical Center
Santiago
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Clínica Universidad de Los Andes (56) 22 618 3594
Av. Plaza 2501, Las
Condes, Region
Metropolitana
Clinic / Hospital
Santiago - Agustinas
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Carola Matus o Claudia Munoz Belaguero
(02) 287 65705
(02) 2876 5730Agustinas Nº 1365,
Santiago Centro
Ambulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
Santiago - Alameda
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=7
Megasalud Alameda (22) 425 7000
(22) 425 7214
(600) 425 6000
San Martín N° 30 Medical Center
Santiago - Conchali
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=16 Megasalud Conchali
(22) 460 9317
(22) 444 7501
(600) 425 6000
Av. Fermín Vivaceta
N° 3161Medical Center
Santiago - Gran Avenida
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=17 Megasalud Gran Avenida
(22) 425 7500
(22) 425 7513
(600) 425 6000
Av. J. Miguel Carrera
N° 5728Medical Center
Santiago - Kennedy
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosdenta
lweb.aspx?id=18 Megasalud Kennedy
(22) 431 7700
(22) 431 7741
(600) 425 6000
Av. Kennedy N° 5735,
Piso 3.Medical Center
Santiago - La Florida PAY/CLAIM PAY/CLAIM Integramedica La Florida(02) 2 636 6666
(600) 636 6666
Av. Vicuña Mackenne
Oriente 6969Medical Center
Santiago - La Florida PAY/CLAIM PAY/CLAIM Integramedica Mall Plaza Vespucio(02) 2 636 6666
(600) 636 6666
Av. Vicuña Mackenna
7110, Blvd Plaza
Vespucio
Medical Center
Santiago - La Florida
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=19 Megasalud La Florida
(22) 4257300
(22) 4257390
(600) 425 6000
Av. Vicuña Mackenna
N° 7747Medical Center
Page 15
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Santiago - La Florida
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA Vergara, Dr. Eduardo (56) 9 8889 5694
San Jorge 930 depto
L504, Condominio San
Jorge
Kinesiologist
Santiago - La Florida
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Cecilia Rucal [email protected]
Marta Rubio [email protected]
Silvia Mundy [email protected]
(02) 235 55800
(02) 235 55830 Rucal
(02) 235 55829 Rubio
(02) 235 55826 Mundy
Admisión La Florida
Av. Vicuña Mackenna
Oriente N° 6381, La
Florida
Ambulatory Walk-in Clinic
M-F 08:30 - 21:00 hrs.
Sat. 09:00 - 14:00 hrs.
Santiago - Las Condes
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://www.clinicalascondes.cl/QUIEN
ES-SOMOS/Conozca-
CLC/Sedes/CLC.aspx
Clínica Las Condes - Sede
Central
(56) 2 2210 4000 Principal
(56) 2 2610 8000 Citas
(56) 2 2610 7777 Rescate
Estoril 450 (South
entrance)
o
La Fontecilla 441
(North entrance)
Las Condes
Clinical and Specialty Centers
Santiago - Las Condes
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://www.meds.cl/sucursales/las-
condes-mall-sport Clínica Meds Las Condes
(56) 2 2499 6400 Principal
(56) 2 2499 6500 Citas
(56) 2 2499 6538 Directo
Las Condes 13.451
Mail Sport
Las Condes
Medical Center
Santiago - Las Condes Aetna LOA
USE AETNA LOA only For Hospitalizations
or Major Critical Issues - non-urgent
needs should be directed to a nearby
Medical Center
Clínica San Carlos de Apoquindo
(Hospital de la Pontificia Universidad
Catolica)
Tel: 22754 8700
Fax: 22754 8800Camino El Alba 12351 Clinic / Hospital
Santiago - Las Condes PAY/CLAIM PAY/CLAIM Integramédica Alto Las Condes(02) 2 636 6666
(600) 636 6666
Av. Kennedy 9001,
Mall Alto Las Condes,
4° nivel
Medical Center
Santiago - Las Condes PAY/CLAIM PAY/CLAIM Integramédica Manquehue(02) 2 636 6666
(600) 636 6666
Av. Manquehue Sur
329Medical Center
Santiago - Maipú PAY/CLAIM PAY/CLAIM Hospital Carmen (56) 2 2612 0401
Dr. Luis Valentin
Ferrada
Camino a Rinconada
1201
Clinic / Hospital
Santiago - Maipú PAY/CLAIM PAY/CLAIM Integramedica Maipu(02) 2 636 6666
(600) 636 6666
Pajaritos 1790, Mall
Espacio UrbanoMedical Center
Santiago - Maipú
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=20 Megasalud Maipú
(22) 4257400
(600) 425 6000Alberto Llona N° 1770 Medical Center
Santiago - Maipú
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Yasna Norambuena
(02) 232 78205
(02) 278 79880
Avda. Pajaritos 999
interior centro de
diagnóstico Pajaritos -
Maipú
Ambulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
Page 16
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Santiago - Nuñoa
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=9 Megasalud Nuñoa
(22) 3790233
(22) 3790970
(600) 425 6000
Av. Irarrázaval N°
2305Medical Center
Santiago - Padre Hurtado
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosdenta
lweb.aspx?id=34 Megasalud Padre Hurtado
(22) 9799016
(22) 9799013
(600) 425 6000
Av. Padre Hurtado Sur
Nº 1621Medical Center
Santiago - Padre Hurtado
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOAClínica Padre Hurtado
Associated to Mutual de Seguridad
(02) 278 79610
(02) 278 79611
Padre Hurtado Sur N°
1621 esquina Fleming
Medical Center
M-F 08:30 - 17:30 hrs.
Santiago - Providencia
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMIClínica Indisa
Oficina: Para Marcar consultas 02 362
5400
Fax: 02 274 0228
Avd. Santa Maria
1810, Region
Metropolitana, Chile
Ambulatory Walk-in Clinic
Clinic / Hospital
Santiago - Providencia PAY/CLAIM PAY/CLAIM Clínica Santa Maria (56) 2 2913 3043
Santa Maria 500,
Providencia, Region
Metropolitana
Clinic / Hospital
Santiago - Providencia PAY/CLAIM PAY/CLAIM Integramedica Barcelona(02) 2 636 6666
(600) 636 6666Barcelona 2116 Medical Center
Santiago - Providencia
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=8 Megasalud Providencia
(22) 4317288
(22) 4317290
(600) 425 6000
Av. 11 de Septiembre
N° 1920Medical Center
Santiago - Providencia
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Rut Marcela Fonseca o Carmen Gloria
Robles
(02) 287 65721 o (02) 287 65722
(02) 287 65721
(02) 287 65722
Av. Salvador N° 100
Piso 6 Interior Clínica
Avansalud,
Providencia
Ambulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
Santiago - Puente Alto
GMMI - Mission
Requests LOA
from GMMI
Dr. Monica Jara Venegas(56) 2 2315 7331
(56) 9 6517 2527
Jorge Ross Ossa 292,
Puente Alto Santiago
Chile 8166930
General Practitioner
Santiago - Puente Alto PAY/CLAIM PAY/CLAIM Integramedica Mall Plaza Tobalaba(02) 2 636 6666
(600) 636 6666
Av. Camilo Henríquez
3296, Mall Plaza
Tobalaba
Medical Center
Santiago - Puente Alto PAY/CLAIM PAY/CLAIM Integramedica Puente Alto(02) 2 636 6666
(600) 636 6666Concha y Toro 26 Medical Center
Santiago - Puente Alto
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=21 Megasalud Puente Alto
(22) 4202021
(22) 4202104
(600) 425 6000
Av. Concha y Toro N°
3779Medical Center
Page 17
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Santiago - Puente Alto
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Enriqueta Gomez o Luis Henriquez
(02) 235 55856 o (02) 235 55850
(02) 235 55856
Admisión Puente Also
Teniente Bello N° 66,
Puente Alto
Ambulatory Walk-in Clinic
M-F 08:30 - 19:00 hrs.
Santiago - Quilicura
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=42 Megasalud Quilicura
(22) 5707900
(600) 425 6000
Av. O’Higgins N° 581,
of. 67. Mall Arauco
Quilicura.
Medical Center
Santiago - Quilicura
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(02) 287 65600
(02) 287 65625 Cabezas
(02) 287 65624 Crumilla
(02) 287 65629 Soto
Admisión Quilicura
Panamericana Norte
N° 7500, Quilicura
Ambulatory Walk-in Clinic
M-F 08:00 - 24:00 hrs.
Sat. 09:00 - 14:00 hrs.
Santiago - Salvador
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosdenta
lweb.aspx?id=38 Megasalud Salvador
(22) 3695100
(600) 4256000
Av. Salvador N° 100.
Piso 7Medical Center
Santiago - San Bernardo PAY/CLAIM PAY/CLAIM Integramedica Mall Plaza Sur(02) 2 636 6666
(600) 636 6666
Av. Jorge Alessandri
20.040, Mall Plaza SurMedical Center
Santiago - San Bernardo PAY/CLAIM PAY/CLAIM Integramedica Santa Lucia(02) 2 636 6666
(600) 636 6666Victoria 421 Medical Center
Santiago - San Bernardo
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=22 Megasalud San Bernardo
(22) 425 7800
(22) 425 7844
(600) 425 6000
Av. América N° 654 Medical Center
Santiago - San Bernardo
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Jessica Toledo o Maria Luz Alegria
[email protected] o [email protected]
(02) 287 65938 o (02) 876 5930
(02) 287 65900
Atendimiento después de las 17:00 hrs.
llamar al (02) 287 65902
Admisión San Bernardo
Freire N° 339, San
Bernardo
Ambulatory Walk-in Clinic
M-F 08:30 - 20:00 hrs.
Talagante PAY/CLAIM PAY/CLAIM Hospital Talagante 2574 4252 Balmaceda 1458 Clinic / Hospital
Talagante
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Cristina Carreno [email protected]
Gustavo Morales [email protected]
Marcos Grinel (fin semana)
(02) 281 55108
(02) 281 53283 Carreno
Admisión Talagante
Enrique Alcalde N°
993, Talagante
Ambulatory Walk-in Clinic
M-F 8:30 - 19:00 hrs.
Sat. 9:00 - 13:00 hrs.
Page 18
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Talca
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOAClínica Lircay
Associated to Mutual de Seguridad071 209 900 2 poniente 1372
Clinic / Hospital
Medical Center
M-F 8-8 pm
Saturday 9 am to 2 pm
Urgent Care & Hospitalization
24/7
Talca PAY/CLAIM PAY/CLAIM Integramedica Talca(02) 2 636 6666
(600) 636 6666
1 Sur 1557, Mall
Portal CentroMedical Center
Talca
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
https://www.megasalud.cl/nuestra-
red/talca/Megasalud Talca (71) 2228099
(600) 425 6000
1 Poniente N° 1369 Medical Center
Talca
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Ivonne Villavicencio
(71) 220 6125
(71) 220 1252
(71) 206 1233
Dos Poniente N° 1380,
Piso 6, Talca
Ambulatory Walk-in Clinic
M-F 08:30 - 18:00 hrs.
TalcahuanoGMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
Clinica Bio Bio
Edith Ochoa Gonzalez
Dominique Arriagada Valenzuela
Barbara Sanchez Osorio
+56 41 273 4200
Av. Pdte. Jorge
Alessandri
Rodriguez 3515,
Talcahuano, Octava
Región del Bio Bio,
Chile
Hospital / Clinic
Talcahuano PAY/CLAIM PAY/CLAIM Integramedica Mall Plaza El Trebol(02) 2 636 6666
(600) 636 6666
Jorge Alessadri 3177,
Mall Plaza del TrebolMedical Center
Temuco
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://portal.alemana.cl/wps/wcm/conn
ect/temuco/home///
Clínica Alemana Temuco
Associated to Mutual de Seguridad
(45) 220 1201 Senador Estébanez
645Clinic / Hospital
Temuco
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=29 Megasalud Temuco
(45) 264 3494
(45) 264 3482Manuel Bulnes N° 846 Medical Center
Temuco
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Margarita Carrasco
(45) 206 024
(45) 220 6000Av.Holandesa N°
0615, Temuco
Ambulatory Walk-in Clinic
M-F 10:00 - 18:30 hrs.
Page 19
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Tocopilla
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Carla Jimenez o Maritza Valdovinos
(55) 281 6605 o (55) 281 6602
(55) 281 1140 21 de Mayo N°120Ambulatory Walk-in Clinic
M-F 08:00 - 20:00 hrs.
TraiguenGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(45) 2861979 Calle Riveros 891 AAmbulatory Walk-in Clinic
M-F 08:30 - 13:00 & 14:30 - 18:15 hrs.
Valdivia
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOAClínica Alemana Valdivia
Associated to Mutual de Seguridad
(63) 224 6200Av. Beuchef 765, Chile Clinic / Hospital
Valdivia
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=30 Megasalud Valdivia (63) 220 0743 Av. Alemania N° 475 Medical Center
Valdivia
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Viviana Benitez o Angela Fernandez
(61) 226 8116 o (61) 226 8130
(63) 226 8100Av. Prat N° 1005,
Valdivia
Ambulatory Walk-in Clinic
M-F 08:30 - 18:30 hrs.
Vallenar
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(51) 261 7844
(51) 261 4583Serrano N° 471
Ambulatory Walk-in Clinic
M-F 08:00 - 20:45 hrs.
Sat. 08:00 - 15:45 hrs
Sun. 08:00 - 16:15 hrs.
ValparaisoGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(32) 2571032Av. Argentina N° 1
Piso 1
Ambulatory Walk-in Clinic
M-F 09:00 - 18:00 hrs.
Valparaíso
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
Clínica Valparaiso
Associated to Mutual de Seguridad
Priscila Espinosa
(032) 2268 100 Av. Brasil 2350 Clinic / Hospital
Valparaíso Aetna LOA Request LOA from Aetna Clínica Cuidad del Mar SA (56) 32 245 1000 13 Norte 635 Clinic / Hospital
Page 20
CITY
Letter of
Authorization
Template (LOA)
INSTRUCTIONS PROVIDERS PHONE NUMBER ADDRESSTYPE OF PROVIDER & HOURS OF
SERVICE
Valparaíso
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=14 Megasalud Valparaíso
(56) 2 2887 9844
(56) 3 2251 3000
Av. Argentina 1,
segundo piso,
Estacionamientos
Medical Center
VictoriaGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(45) 2843004 Lagos N° 251Ambulatory Walk-in Clinic
M-F 08:30 - 13:00 & 14:30 - 18:15 hrs.
VicuñaGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(51) 2411386Av. Las Delicias N°
479-A
Ambulatory Walk-in Clinic
M-F 09:00 - 12:30 & 13:15 - 18:00 hrs.
VillarricaGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(45) 2411262 Pedro Montt N° 701Ambulatory Walk-in Clinic
M-F 08:30 - 20: 00 hrs.
Sat. 09:00 - 14:00 hrs.
VillavicencioGMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
(56) 3202724011 Cl 33 36-50
Viña del Mar PAY/CLAIM PAY/CLAIM Integramedica Viña del Mar(02) 2 636 6666
(600) 636 6666
13 Norte 853, 4° y 5°
piso, Boulevard
Marina Arauco
Medical Center
Viña del Mar
GMMI - Mission
Requests LOA
from GMMI
Schedule appointment online at:
http://www.megasalud.cl/centrosamed
icoweb.aspx?id=15 Megasalud Viña del Mar
(32) 232 1403
(32) 232 14153 Norte N° 464 Medical Center
Viña del Mar
GMMI - Mission
Requests LOA
from GMMI
No appts needed - request LOA from
GMMI
Mutual de Seguridad Ambulatory
Priscila Espinosa
Roxana Rivera
Maribel Villa
Ricardo Aguilera
Dania Guzman (15:00 a 23:00 hrs)
Maria Loreto Contreras (15:00 a 23:00)
(32) 257 1000
(32) 257 1055 [email protected]
(32) 257 1033 [email protected]
(32) 257 1032 [email protected]
(32) 257 1055 [email protected]
(32) 257 1055 [email protected]
Calle Limache N°
1300, Viña del Mar
Ambulatory Walk-in Clinic
Monday - Sat. 08:30 - 23:00 hrs. Sun.
& Holidays: 14:00 - 23:00 hrs.
Vitacura
GMMI - Mission
Requests LOA
from GMMI
Make Appointment / request LOA
http://www.clc.cl/QUIENES-
SOMOS/Conozca-CLC/Sedes/Valle-
Nevado.aspx
Clínica Las Condes - Valle Nevado
(56) 2 2210 4000 Principal
(56) 2 2610 8000 Citas
(56) 2 2610 7777 Rescate
Hotel Valle Nevado Medical & Trauma Center
Page 21