NAVOTAS CITY (PIA) — The Philippine Health Insurance Corporation (PhilHealth) is requiring all accredited healthcare facilities (HFs) to migrate to the eClaims 3.0 system, with the mandatory shift taking effect on April 1, 2026.
PhilHealth is set to disable all earlier iterations of eClaims on March 31, 2026, making version 3.0 the exclusive platform for submitting healthcare claims. This aims to enable a more efficient, standardized, and digital-first submission process.
To ensure uninterrupted service and claim processing, all healthcare providers are encouraged to complete their migration to the eClaims version 3.0 ahead of the scheduled deadline.
Key changes to claims processing
In addition to the software upgrade, the system migration introduces enhanced digital standards for documentation. The full implementation of the eClaims 3.0 now enforces strict digital filing rules for financial records:
Mandatory electronic SOA: For all admissions starting April 2026, claims must include a Statement of Account (SOA) in electronic format.
No more scanned PDFs: PhilHealth warned that claims submitted with SOAs in scanned PDF format will be automatically Returned to Hospital (RTH). This aligns with PhilHealth Circular 2023-0026, which aims to standardize electronic data submission for All Case Rates (ACR) and other identified benefits.
eClaims, or the electronic claims submission system, allows PhilHealth-accredited healthcare institutions to submit claims for patients’ reimbursements directly to the state insurer, streamlining the process from patient admission to payment while reducing the need for physical paperwork and speeding up turnaround times.
The move to eClaims 3.0 and electronic SOAs is part of PhilHealth’s initiative to automate data validation, reduce manual errors, and expedite the reimbursement cycle for healthcare providers.
To avoid disruptions in claim reimbursements, PhilHealth advises all accredited facilities to coordinate with their service providers and the PhilHealth Regional Office – IT unit to schedule the system upgrade and receive technical guidance during the migration process.
For assistance or further clarification, healthcare providers may reach out to PhilHealth through the Corporate Action Center Hotline at (02) 8662-2588 or via email at actioncenter@philhealth.gov.ph. (JMP/PIA-NCR)
