THE country's social health insurer recently introduced five (5) electronic innovations designed to improve operational efficiency and access to members, and reduce turnaround time for benefits eligibility verification and claims processing.
In ceremonies held at the Discovery Suites, the Philippine Health Insurance Corporation (PhilHealth) introduced its new corporate website, www.philhealth.gov.ph, its online mapping services, the electronic registration system, the health insurance card and Phase 1 of the e-Claims Project.
PhilHealth President and CEO Dr. Eduardo P. Banzon said that information technology continues to be "...a tool to further push the agenda of poverty alleviation" and that PhilHealth will continue to tap IT's vast potentials to cater to the needs of its members globally.
"Patuloy naming itutulak ang IT within the context of poverty reduction," he said, adding that "...we are going to use cloud servers, electronic ID cards, and mobile and on-line systems, and we are not afraid to partner with the private sector. All these will simplify health insurance for the poor as we do away with forms and papers. Kalusugan Pangkalahatan is doable and it will happen soon."
For his part, Health Secretary and PhilHealth Board Chairman Dr. Enrique T. Ona said that "...with the launching of IT implementation, we will make sure that our physicians shall be paid adequately and fast. The e-Registration will make it easy for PhilHealth members to register."
The new website sports a cleaner, less cluttered look, and opens with three major panels, namely, MEMBERS, CORPORATE PARTNERS and ONLINE SERVICES. It includes several online services in response to what PhilHealth’s stakeholders need.
One of these is the online mapping service, a facility for viewing the locations of PhilHealth’s Regional and Branch Offices, as well as those of accredited health facilities. It also provides a visualization of various corporate data using statistical maps, and can be accessed through three locations in the corporate website: About Us, Health Facilities Locations and PhilGIS.
A demonstration on the use of the e-Registration Facility was also done. This is a web-based application for those who want to sign up for the National Health Insurance Program. It is offered to the public at no cost, and will primarily cater to individual registration via the Internet.
The event also introduced the Health Insurance Card. It is an instrument for proper identification, eligibility verification and utilization recording. It comes with a space for the member's photograph, and will eventually serve as a key to availing their benefits with partner hospitals and health facilities.
For accredited institutional health care providers, PhilHealth introduced Phase 1 of its eClaims Project, called the Claims Eligibility Web Service (CEWS), a facility that will enable them to check whether or not the patients are registered with PhilHealth and have the required contributions to avail of benefits. This project is expected to speed up the eligibility verification process at the hospital level and minimize the incidence of Return-to-Hospital claims due to member eligibility concerns.
Dr. Alvin B. Marcelo, PhilHealth's Chief Information Officer is optimistic that with the full implementation of all three phases of the eClaims Project, "claims processing can be done within 72 hours," adding that pilot implementations in government hospitals will be ready by June. "This is going to be adopted by Levels 2,3 and 4 hospitals to make benefits available to members without delay," he said. (END)