Question & AnswerQ&A (PHILHEALTH CIRCULAR NO. 002-2012)
The objective is to strengthen PhilHealth's partnership with accredited Institutional Health Care Providers (IHCPs) through access to a web-based portal for online verification of membership status of Sponsored Program (SP) Members under the National Household Targeting System for Poverty Reduction (NHTS-PR) during benefits availment.
The portal allows verification of PhilHealth Identification Number (PIN), member's name and date of birth, and the list of declared dependents.
All qualified accredited Institutional Health Care Providers (IHCPs) are eligible for accessibility or linkage to the IHCP portal.
The IHCP must have a computer and a printer, along with an internet connection.
Steps include downloading the application form and non-disclosure agreement from the PhilHealth website, submitting accomplished forms to the PhilHealth Regional Office for verification, and, upon approval, undergoing installation and orientation of the IHCP portal at the facility.
The RN is generated upon verification and is used in claims substituting the Membership Data Record (MDR) and other supporting documents like birth certificates, effectively streamlining claims processing.
The RN includes accreditation number, name of hospital, name of patient, confinement period, name of member, date of coverage, and the account name of the computer operator who accessed the portal.
No, IHCPs in the e-claims project are already covered for eligibility verification under that project and do not need to apply separately.
The portal was made available fifteen (15) days after the publication of the circular in any newspaper of general circulation and deposited with the National Administrative Register.
All provisions of previous issuances inconsistent with this circular are repealed, modified, or amended accordingly.