CPs in acquiring digital certificates thtough the designated certificate authority ..... lrCs and Directing the ,\pplica
Republic of the Philippines
PHILIPPINE HEALTH INSURANCE CORPORATION Ci tys tctl c Cc nlt"c B u if cling. 709 S IHnv B (H& f evard. Pasig Ci ty
lleallhline 441· 7444 WI\W.phi!IH;alth.g,ov.ph
PHILHEALTH CIRCULAR No. 03 ~ s. 2012
ct:.!
TO:
SUBJECT: I.
ALL HEALTH INFORMATION TECHNOLOGY PROVIDERS SPECIALIZING IN ONLINE INFORMATION SYSTEMS, PHILHEALTH REGIONAL OFFICES AND LOCAL HEALTH INSURANCE OFFICE S, INSTITUTIONAL HEALTH CARE PROVIDERS AND OTHER STAKEHOLDERS Accreditation of Health Information Technology Providers
RATIONALE
l~cpu b lic
,\ ct' 8792 (e-Commerce I\ct of 2000) mand ates all governme nt agencies to transact· goYcrn mcnt· and pe rform government fun ctions using electronic data m essages or electroni c dCJ cumcnt ~. It prm·idcs fo r the legal recognitio n of electronic docum ents, data messages, electronic signa tures, and dectronic con tra cts, among others . It also sets the framework and envirotunent. for th e Philll enlth cCiaims Project (Phill-lealtb Circular No. 14, s. 20 11). IJU~ inc ~s
,\sa strntq;i c instrument to impron: efficiency of health insurance transactions under the gon·rnmcnt's thrus t to achieve Univen;alllealtb Care for all Filipinos, PhiiHealtb is initiating a p npcrless o nlin e clnims 1rnnsaction system called cClnims syst·em. V ital to this innovation .is th e partn ership engagem ent of hcalt h info rmation technology pro-viders (I IITP) to emure th at Ins titutional H ealth Care Providers (11 !CPs) arc able to conn ect to and utili ze this electro nic sys tem.
II.
COVERAGE
This program policy sh all be open to participation by duly-r egistered comp an ies and corpo ration~ intcrc:>tC'd in b eing accredited by Philllealth as a llealth Informatio n T echn o logy Provider (III TP). To bt· a III T P, th ey hav e to meet th e following criteria: a. ;1t kast (ill " 'n hlipino-owncd informati o n technology scn·ice company o pernling and m aint;tining :1 data center ph ysically located in th e Phili ppines; b. experie nced in providing h ealth informatio n sys tem~ fur h ealth facili ties for at least J ycnrs; c. able to co mply with Philll enlth standards fo r electro nic transactio ns; d . an o rgani:r.a tion NOT owned b y or regis tered under a pnrticulnr h eaiLh main tcnnn ce organiza tio n. o r :1 single ins titutio nal health care provider (IHCP); and, c. in good paymen t ~Hnnding with Phill-Ienlth on premium contributions of its emplo~·ces.
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III. I.
GENERAL RULES
i~i\:·
Mi\. TERESA A.
OUIAO~;/
· 1\.0.IV, 1w· . ~ELMS /'P a. an application fro nt- end for the utilit-y applied (i.e., eC iaims/7.-C ia.ims/ P .B cl~11fe~ls ; (~ b. a n after sales servi ce (h elpdes k) and/ o r co nsulting sen ·ices; c. cnp abili ty building for II JC P pe rsonnel; d . :1ssisrance to II !CP s in acquiring digital certifica tes th tough the designa ted certifica te auth o ri ty for auth en tication; c. secure data storage back-end; and, f. prm·ision of a leased line to Phil I Icnlth for purposes of trammitling electronic messages ,\ ll l'l'P npplicant may opt to be accredited for the fo llowing clnims tramac tion utili ty sen·ices: a. eCinims utility am.!/ or Z-Ciaim ~ - an o nline claims tramactio n service, consisting o f member vc rificnt.ion for elit,ribility, claim~ SLlbmissions, and claims tracking, that w ill be used for pa ti ents co nfined in hospirals and o th er nccrcdited henlth facilities that admit patient s; b . PCB cReports utility - an o nline data ;-~ggregation service th;-~t accepts c:lcctropic rcpo1Ts ft•o tn rnc ili tiy applies for accreditation as prO\·ided for under Phil Health Circular No. s.20 12. In I his connection, I subtuit the following pertinent information and documentary requirements. Company Na me: - -- - - -- -- - - - -- -- -- -- - - - -- - - - - - -- - - -- Busim·ss ,\dc..lress : - -- -- - - - - - - - - - -- -- -- - - -- - - -- - - - - - - - Jlhill k allh I •:mp loye r N umber (PEN);._ _ _ _ _ _ __ __ _ __ _ _ _ __ __ _ _ _ _ _ __ 'l'l·k-plwn c No: - - - - - - - - - - - - - - - - -
Fax No.: - - - - - - -- - - -- -
CP t npan~· wcbs ile (LIR I.): - - - -- -- - -- - --
NanK' of I lead of () (lic e : - - - - - - - - - - - - - - - - - - -- - - - - - - - - -- - -- - - - Nature of Business: - - -- - - - - -- -- - -- - - - - - - - - - - -- - -- - - -- - No. of" n ·ars in t·he business : _ _ __
IT Socie ty r\ ffiliation (if any):
I•:lcct ronic Sen· ices applied for:
0
chill kalth OR No.: _ __ __ _
Dat·e Paid:_ __ __ __
. \ nH l ll tll
Paid: - -- - - -- - -
ANNEXC BUSINESS AGREEMENT DESCRIPTION OF PROGRAM ENGAGE MENT
Til i ~ .\ grt't'lll t'll t
T he
i~
111ade and e ntl'l'ed int o by and bt· t\vecn:
Philipp i n e
Jl ca l t h
ln s ur a n cc
Co rp o r a tio u
(" Ph i Ill e a It h '')
and
t
11 ('
(" IIITP")
'I.
GENERAL PROVISIONS A. Purpose and Intent
IIITP h a~ agrt'l'd to perfor m certain ~erv ice~ for or in b eh alf of Philll calrh. \vhich ~en·icc ma~· inn>kt· till' creati o n. mai nte nan ce, w;c, Lran ~ mi ssion or clisclosu rc of p rotec ted in formation. Th i~ .\grcemt·nt ~ uh~cri bes l the p;trties' agreement for sen·ices and is in te nded an d shall be in terpn:tcd so as ' ' ' sa tis f\ th e requin:ments for I UTP contracts as set fort h in Phill-fealth Circ ular No. __ se ries 20 12 011 _ _ _ _ l{q1ublic . \c t ~792 (E-Commerce Law), a nd Executi,·e O rder. 8 1() (lnsLituLiotlalizing 1he Ccnificat ion Scheme o r Digital Signall.lrCs a nd D irec ting th e ,\ pplica tio n o f Digital Signa tures in e-CoYCl'llt11t'll l Scn ·ices). IIITP h e reb y agrees to co mply with th e applicable p ru,·isio n s of Phill--Ieal th C ircular No. __ s. _ _. ' 11H.: I l!TP ~ hall assist Philf lcalth, th rough it~ com p lia nce with the fo llowing terms an d co n dit io n s: B. Definition ofTe rms H ITP - a I hird pany in rorm ation techno logy provide r th at has met the ll1l l11llltllll l'l'lllli rt·men ts of l'h illl ealth for managing Lra tu,;actio ns between instit utio nal hea lth care: p rm ·idcrs (IIIC P) and Phil llcalth proYicling sen·ices to both, and who h andles or di sclose~ Pnsonal l lcal th In format ion t'o r th e pu rpo~c o r Pe rso nal I I ealth Records
or
Data center - a ce ntralized ph y:;ical rep ository for the ~;to rage, manage me nt, a nd llissemina I ion o f da 1a and inform a tio n o rga nized arouml 'n particula r bo dy of knowleuge o r pert aini ng to a p nr tic ulnr bu~i n cs~ S tandards- a SC I or specillca Lio ns w hich sho ulu be com p lied \Yith in order to COill nH111icatc \Vith another sys tem.
ciTc c tiH·I ~
C. Obligatio n s and Unde rtaking s of HITP I.
Bas ic se rvices . IIITP agrees to provide I H CPs with the following minim um services: a. an application fro n t-end for the utili ty ap plied (eClaim ~/Z-Cinims/ PCI3 eRcp urts); b. a n aft er ~a les service 01elp desk) an d/or consulting se rvice; c. c:tpabili ty b uilding for I I-ICP p erson nel; d. as~ ista n cc in acqui ring digital ce rtifica tes thro ugh the d esigna ted cer tificate authorit\' nut hen tic:lt io n; c. s to ttpdnte its sys t em~ . n~sis t n nce
.").
l'hilllealth :tgrccs to provide tec h nical COilll CCt i,·iI Y·
-1.
l'hilllealth agr.
5.
Phil! lenlt h ngnTs ro prm·ide IIITP wit h ample time for it to comply with Phil l lcnlt h tTchnic;tl slnndards.
Ci.
l'hilllcalth ngrees to con duct m o nitori ng nnd evalua tion acti,·ities regardin g I IITP in a sys 1e mnric nnd orderly mnn ncr and inform I IITP o f the findings thereo f.
7.
l'hill lt:alth agrees to im·ok e IIITP in COilSttltatiom and o nl ine fon.m1 s.
II.
to IIIT P. such as, but not limi ted to, network
BREACH AND TERMINATION O F B US INESS AGREEMENT .
. \ny ,·iolntion of any of th e provisions of this Busi ness .\greement whether d irectly or indirectly, shall constitute n brcnch of th is Agrc
