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eClaims 3.0 Implementation Advisory

The Philippine Health Insurance Corporation has announced the availability of eClaims Service 3.0 for accredited health facilities and service providers. This new version requires the submission of electronic Statements of Accounts, Diagnosis Related Group information, and the implementation of a QR code during patient admission. Providers must comply with certification processes outlined in previous circulars to receive compliance notices and certificates.

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444 views1 page

eClaims 3.0 Implementation Advisory

The Philippine Health Insurance Corporation has announced the availability of eClaims Service 3.0 for accredited health facilities and service providers. This new version requires the submission of electronic Statements of Accounts, Diagnosis Related Group information, and the implementation of a QR code during patient admission. Providers must comply with certification processes outlined in previous circulars to receive compliance notices and certificates.

Uploaded by

CJ Acido
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd

Philippine Health Insurance Corporation

ADVISORY
No. 2024 - 0032

To: All Accredited Health Facilities and Service Providers Connecting to


the eClaims Web Services

Availability of eClaims 3.0


This is to inform all accredited health facilities with in-house developed systems and certified
service providers already using the Electronic Claims Services that the new version of the
eClaims Service 3.0 is now available. The test environment is already open for connection
and the final version of the eClaims 3.0 Implementing Guidelines can be accessed using
this link [Link] 3.0.

The eClaims Services 3.0 is centered on the following requirements:


a. Submission of the electronic Statement of Accounts (eSOA) in compliance to PhilHealth
Circular No. 2023-0026 “Electronic Submission of the Statement of Account (SOA) for All
Case Rates (ACR) Claims and Identified PhilHealth Benefits (Revision 1).
b. Submission of Diagnosis Related Group (DRG) information in relation to PhilHealth
Circular No. 2024-0006 “Implementation of the Shadow Billing for the Transition to
Diagnosis-Related Groups (DRG) (Revision 1)
c. Implementation of the eGov Super App QR Code during the patient admission process;

The process for compliance certification shall be the same following PhilHealth Circular No.
2017-0017 “Software Certification for the Unified PhilHealth Electronic Claims System Using
Electronic Medical Record (UPECS-EMR)”. Providers may submit their application for
software certification for each individual requirement. Upon passing the compliance
testing, a Compliance Notice will be issued per requirement. A Compliance Certificate will
be issued upon complying with all the requirements.

Kindly send your concerns or inquiries to upecsemr@[Link].

For your information and proper guidance.

(Sgd.) EMMANUEL R. LEDESMA, JR.


President and Chief Executive Officer
Date signed: July 1, 2024

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