PhilHealth, PSA launch ID-linked claims safeguards

The Philippine Health Insurance Corp. and the Philippine Statistics Authority strengthened their partnership on March 26 by signing a memorandum of agreement for Philippine Identification System co-location and launching the PhilHealth Check Utility, a move aimed at modernizing systems, preventing fraudulent claims, and ensuring benefits reach every Filipino.

PhilHealth President and CEO Dr. Edwin M. Mercado said the initiative is part of a broader effort to make the state health insurer’s services more secure and dependable.

“Filipinos deserve a health insurance system that is modern, secure, and reliable,” Mercado said.

“Through our partnership with the PSA, we are strengthening our systems, improving the accuracy of our records, and ensuring that every peso of the health fund supports legitimate claims and reaches every Filipino,” he added.

Mercado said tighter safeguards will not come at the expense of patient access to services.

“As we clean and modernize our systems, we remain committed to ensuring that no eligible member is denied service. Our priority is to deliver services that are both secure and accessible for all,” he said.

Under the co-location initiative, PhilSys registration will be offered directly at selected PhilHealth offices, allowing members to apply for their National ID while also availing themselves of PhilHealth services.

PhilHealth said the newly launched PhilHealth Check Utility, or PCU, integrates PhilSys data to verify identities in real time, perform biometric liveness checks, and match records for accuracy.

The agency said the system is designed to ensure that only valid claims are processed.

PhilHealth said the PCU has already been integrated into key programs, including the Yaman ng Kalusugan Program, or YAKAP, and the GAMOT benefit availment process.

The agency said the integration is intended to streamline the patient journey from consultation to access to medicines.

The initiatives form part of PhilHealth’s wider digital transformation and modernization efforts under the Universal Health Care Act, which seeks to expand access to health services and improve the efficiency of health financing.

PhilHealth and the PSA said the partnership is expected to strengthen identity verification, improve data integrity, and streamline processes across the system.

The two agencies said the agreement reaffirms their commitment to building a more accountable, efficient, and people-centered health system for all Filipinos.