HCI Portal: Health Care Providers’ Online Link to PhilHealth

The internet has become an important aspect of society as a key resource for researching information, engaging in professional discussion, accessing published material, and even checking on news and weather bulletins. It has become the foundation for the electronic community by providing access not only to media but also to government agencies, with websites now made accessible to its clientele. It is also enabling engagement with friends and families through social networking sites.

With the internet’s popularity, government agencies have tapped its potential as a channel for its clients through online services. The Philippine Health Insurance Corporation (PhilHealth) has joined the bandwagon with its Health Care Institution (HCI) Portal.

The HCI Portal aims to establish a linkage between PhilHealth and its accredited institutional health care providers through an online connection. It simplifies filing of claims and availment procedures by cutting down on the documentary requirements through the generation of the PhilHealth Benefit Eligibility Form (PBEF) which replaces the Member Data Record (MDR) earlier needed to avail of the benefits.

PhilHealth required its accredited HCIs to install the HCI Portal in their respective facilities and HCIs have started installing the portal as early as April 2013. Orientation seminars were immediately scheduled to familiarize the staff members who will be tasked to handle the portal. But the number of engaged facilities within Region IV-A posed a challenge: instead of going from one facility to another, PhilHealth Regional Office IVA opted to schedule orientations in the regional office. HCI representatives attending the orientation brought their computers since installation of the HCI Portal was done simultaneous with the orientation.

To date, 319 facilities within the jurisdiction of PRO IV-A have been oriented and given access to the portal.

How did these hospitals find the HCI Portal? For most of them, installation of the portal generated more positive experience, both for the facility and for the members. As Asia Medic Family Hospital and Medical Center in Imus, Cavite puts it, “the portal enables us to provide better customer service to our patients while providing them with information on their eligibility to avail of their benefits.” Verification of member’s eligibility is quicker as it is done with just one click.

Calamba Doctors Hospital said they are able to provide members, especially from the formal economy, with updated information on their contributions, as well as check on their list of declared dependents. The HCI Portal has lessened the burden for members in terms of documentary requirements since submission of supporting documents is no longer required by the facilities once the PBEF generates a “Yes,” thereby enabling paperless transactions.

Some facilities declared that the number of return-to-hospital (RTH) claims is reduced. RAKKK Prophet Medical Center in Gumaca, Quezon testified that the portal minimized their RTH and denied claims. “Eligibility of members to avail of their PhilHealth benefits and the requirements to facilitate the processing of claims are readily available in the portal.”

Users of the HCI Portal commend its user-friendly features. Lucena MMG General Hospital said that, “it is easy to use and log-in.” St. Paul Hospital Cavite agrees, saying that “the system is not complicated.”

The portal may have its benefits but there is always room for improvement. “We see the portal’s internet-dependent features as a disadvantage since connectivity is always dependent on the internet provider,” says RAKKK Prophet Medical Center. Candelaria Municipal Hospital in Quezon complained about instances when the portal is offline, which defeats the purpose of providing immediate eligibility checking for members.

With PhilHealth’s commitment towards continual improvement, these portal users hope that some adjustments will be included in the portal. Gentri Medical Center Hospital Inc. in General Trias, Cavite recommends the inclusion of the verification of single period of confinement in the portal module while RAKKK suggests the addition of another portal user which will be activated during weekends. Lucena MMG Hospital proposed to include the posting of payments made through banks and Bayad Centers.

Health care providers continue to flock to the regional office as they too, want to experience the comforts of using the HCI Portal.

Source: www.philhealth.gov.ph