Easy Claims ePCB and CF4 Integration

Implementation Guide
Introduction
As part of PHIC provided universal health care, ePCB has been implemented since January 2019. In line with
this, the use of electronic CF4, in other words, XML format of all information found in the CF4 is expected
to be implemented on March 1, 2019 – scanned document attachments of CF4 and other documents related
to it will not be accepted anymore in eClaims (except for certain packages which do not need CF4.) For
more information, you can review PhilHealth Circular No. 2019-0002. In order to meet the
aforementioned requirements, this document will guide you on developing the integration of your systems
to our Easy Claims ePCB and CF4 Interface.

Transition for development

For the meantime, you are allowed to use PHIC’s interim offline application which is the eXPS. This is for
your facilities to start using the newly implemented CF4 document for claims submissions as mentioned in
the circular while you develop the integration module in your systems and the Easy Claims.

Installation of eXPS
Philhealth is the only one allowed to install the interim offline application eXPS while the Service Providers
are not allowed as of writing. The facility shall be requesting the installation to their designated server in
order for them to start using it. Please coordinate with your facilities to request to PhilHealth an installation
of eXPS to their respective servers.

CF4 from eXPS as claim document attachment

The old CF4 document attachment which is scanned and included for claims submissions will now be
replaced with the XML format of all the data related with the CF4. This means that all information found in
CF4 will now be encoded through the system starting March 1, 2019. Below are the steps on using eXPS for
generating CF4 XML data as an interim approach:

<Encoding and exporting procedures, we are still coordinating with our clients with eXPS in order to provide
screenshots and comprehensive directions>

Easy Claims and Easy Claims Connect, inclusive of its Host ICT Infrastructure are solely owned by EUROLINK including its copyright,
patent, trademark, and all other intellectual property rights thereto. Nothing in this Agreement shall be construed as a transfer of
ownership of Easy Claims and Easy Claims Connect to the contracting party as utilized for the purpose of this Agreement.
Integration Development
CF4 XML follows the same format of ePCB where there are selected fields which will be only provided for
CF4 use. Following are the separate steps for database dump setup (applicable only starting from Easy
Claims Version 7 which is due to be released on April 2019), and for those who used API or ECCMD
integration.

Database Dump

1. Execute your usual eClaims database dump procedures to the Easy Claims database.
2. You have the option of fully automating the generation of CF4 data, if you choose to do so, proceed
to Automated CF4 for Database Dump but If you choose to skip those multiple inserts and just let
the Easy Claims do that for you (only that your encoder will have to provide all missing information
since not all information is available from the eClaim record) proceed to next step.
3. Head to [Home] or [Claims] and then select which claim to create CF4 data. Click [Generate CF4]
4. You will be redirected to [Patient] page where some of the fields are auto-populated through the
information from the source claim.
5. Edit all necessary fields for completion from [Register] to [Profile].
6. After you have provided necessary all information from enlistment to profiling, click [Save & View
Consultations]
7. Select from the list of [Consultation] the ‘partner’ record for the claim you just finished from Step
4 then click [Link Claim]
8. [Link Claim] popup window will appear and the list of Claims not yet linked to a [Consultation]
will be displayed. Select from the claims which to link, the claim list is already filtered by [Patient
PIN] and [Admission Date] and for easier lookup.
9. Verify if the selected claim details is the correct one for linking to [Consultation]. Details are
displayed below the claim list.
10. Click [Link Claim] then the confirmation window will pop up for linking the [Claim] to the
[Consultation].
11. Click [Link] after you have verified the [Claim] and [Consultation] to link.
12. The list of [Consultation] will reload making the [Link Claim] button of the previously selected
[Consultation] disabled.
13. CF4 data is now good for uploading. Easy Claims will automatically generate and attach the CF4
XML in the linked claims for you upon submission of transmittal.

Easy Claims and Easy Claims Connect, inclusive of its Host ICT Infrastructure are solely owned by EUROLINK including its copyright,
patent, trademark, and all other intellectual property rights thereto. Nothing in this Agreement shall be construed as a transfer of
ownership of Easy Claims and Easy Claims Connect to the contracting party as utilized for the purpose of this Agreement.
Automated CF4 for Database Dump

In the event that you have successfully implemented CF4 already, this time around, you will have to insert
specific records to separate tables unlike in eClaims where you usually insert to only one table. The
advantage of this approach is that your encoders will not input all the missing information one-by-one. By
efficiency, this is the most productive approach since it will save your encoders time yet you will have to
invest for development in order to insert the specific records. There’s a risk of mapping incorrect records so
proceed with caution since the foreign keys shall be correctly mapped for each record.

1. Execute your CF4 database dump procedures to the Easy Claims database.
2. Given that all information are already inserted to respective tables, with foreign keys correctly
mapped that is, insert new record in [dbo].[CF4Claim] composite table where the primary keys
from [dbo].[EClaim] and [dbo].[ConsultationSOAP] and also [dbo].[Patient] able will be
used.
3. CF4 data is now good for uploading. Easy Claims will automatically generate and attach the CF4
XML in the linked claims for you upon submission of transmittal.

API or ECCMD

1. Construct the ePCB XML provided only with the fields needed for CF4. DTD for the ePCB with
remarks for CF4 fields is included along this document. You can use the CF4 generated from eXPS
instead if you are still developing the module for generating CF4 XML.
2. Save the constructed XML as .xml file extension.
3. Upload the document to Easy Claims Connect
a. For API Integration – use Docs/Upload method
b. For ECCMD – use uploaddoc command
4. Response from Step 3 by default is in JSON format. Get the Xml values for each document to form
the DOCUMENTS node. Below is a sample document uploaded:

[
{
“Url”: “https://docs.easyclaimsph.com/hcicode/date/transno/claimno/cf4.enc”,
“Type”: “CF4”,
“Xml”: “<DOCUMENT pDocumentType="CF4" pDocumentURL="https://docs.easyclaimsph.com/hcicode/
date/transno/claimno/cf4.enc"/>”
}
]

5. Extract from the response the Url or DOCUMENT XML node for adding to the DOCUMENTS of the claim.
This procedure is just the same with how you upload required document attachments.
6. Append the DOCUMENT XML node of the uploaded CF4 to the XML Data of the claim.
7. CF4 is now good as uploaded to Easy Claims Connect. The URL generated is expected to be
accessible already and the CF4 can now be downloaded by PHIC.

Easy Claims and Easy Claims Connect, inclusive of its Host ICT Infrastructure are solely owned by EUROLINK including its copyright,
patent, trademark, and all other intellectual property rights thereto. Nothing in this Agreement shall be construed as a transfer of
ownership of Easy Claims and Easy Claims Connect to the contracting party as utilized for the purpose of this Agreement.