QuestionsQuestions (PHILHEALTH CIRCULAR NO. 002-2012)
To strengthen PhilHealth’s partnership with accredited Institutional Health Care Providers (IHCPs) by providing a web-based portal for online verification of Sponsored Program (SP) members’ membership status under NHTS-PR during benefits availment.
PhilHealth Identification Number (PIN), member’s name and date of birth, and list of declared dependents.
Significant modules such as e-logbook, benchbook, and MMHR are mentioned as eventually being incorporated to expand the efficiency of online transactions between IHCPs and PhilHealth.
All qualified accredited IHCPs.
IT hardware (computer and printer) and an internet connection.
The IHCP may visit PhilHealth’s official website (www.philhealth.gov.ph) to access the PhilHealth Online Access Form (POAF, No. 002) module for downloading the application form and attached certificate of non-disclosure agreement.
To the Health Care Delivery and Management Division of the PhilHealth Regional Office for proper verification and evaluation.
PhilHealth will visit the qualified IHCP for installation of the IHCP portal, provide orientation on its application, and then the facility will be ready for verification.
At the facility level prior to the availment of PhilHealth benefits by Sponsored Program (NHTS-PR) members and their dependents.
A Reference Number (RN) will be generated based on specified information.
Accreditation number; name of hospital; name of patient; confinement period; name of member; date of coverage; and account name of the computer operator that accessed the IHCP portal.
The generated RN shall be attached to the claims replacing the MDR and other secondary documents like birth certificate and marriage contract.
Yes. Properly accomplished PhilHealth Claim Form 1 is still required for claims submission.
IHCPs currently enrolled in the e-claims project are no longer required to apply for installation of the IHCP portal because eligibility verification of NHTS-PR Sponsored Program Members is already covered.
Fifteen (15) days after publication of the circular in any newspaper of general circulation.
It is deposited thereafter with the National Administrative Register at the University of the Philippines Law Center.
All other provisions of previous issuances that are inconsistent are hereby repealed/modified or amended accordingly.
Adopted on 17 January 2012 and signed by Dr. Eduardo P. Banzon (President and CEO).