Law Summary
IHCP Portal Features and Eligibility Verification
- Provides a secure, on-line linkage between PhilHealth and accredited IHCPs.
- Verifies eligibility information for Sponsored Members under NHTS-PR, including:
- PhilHealth Identification Number (PIN)
- Member's name and date of birth
- List of declared dependents
- Future enhancements to include modules such as e-logbook, benchbook, and MMHR to improve transaction efficiency.
Requirements for IHCP Portal Access
- Open to all qualified and accredited Institutional Health Care Providers.
- Mandatory hardware requirements prior to registration:
- Computer
- Printer
- Internet connection
Registration Procedures for IHCPs
- IHCPs must download and complete the PhilHealth Online Access Form (POAF) and a certificate of non-disclosure agreement from the official PhilHealth website.
- Submit the accomplished forms to the Health Care Delivery and Management Division of the PhilHealth Regional Office for verification.
- Upon approval, PhilHealth will conduct an installation of the IHCP portal and provide orientation for its use.
- The facility is then authorized to conduct membership verification.
Generation and Use of Reference Number (RN)
- Eligibility verification is conducted at the facility level before benefits are availed.
- A Reference Number (RN) is generated upon successful verification, containing:
- Accreditation Number
- Hospital name
- Patient name
- Confinement period
- Member name
- Date of coverage
- Account name of the computer operator who accessed the portal
- The RN substitutes the Member Data Record (MDR) and secondary documents like birth certificates or marriage contracts in claims submission.
- PhilHealth Claim Form 1 must still be properly completed and submitted.
Participation in the E-Claims Project
- IHCPs already enrolled in the e-claims project are exempt from applying for the IHCP portal installation.
- Eligibility verification for Sponsored Program Members under NHTS-PR is incorporated into the e-claims system.
Availability and Legal Provisions
- The IHCP portal shall be accessible fifteen (15) days after the publication of the circular in a newspaper of general circulation.
- The circular will be deposited with the National Administrative Register at the University of the Philippines Law Center.
- Previous inconsistent provisions are amended, modified, or repealed accordingly.