PhilHealth Capability Matrix
UltraVisit Health System – Feature Alignment
Purpose of This Matrix
This matrix outlines how UltraVisit supports operational and documentation readiness for healthcare providers participating in programs under PhilHealth, including Primary Care Benefit (PCB / Konsulta / Konsulta+), outpatient services, and telemedicine-enabled care.
UltraVisit does not claim to replace PhilHealth accreditation or claims systems. Instead, it enables clinics to maintain structured, auditable, and policy-aligned clinical workflows.
Capability Alignment Table
| PhilHealth Capability Area | PhilHealth Expectation (High Level) | UltraVisit Support | Notes / Positioning |
|---|---|---|---|
| Patient Identification & Demographics | Accurate patient records for eligibility and continuity |  Structured patient profiles | Supports standardized patient data capture |
| Encounter Documentation | Proper documentation of outpatient and primary care visits | Integrated EMR encounter records | Supports in-person & teleconsult encounters |
| Primary Care Visits (Konsulta / PCB) | Longitudinal primary care documentation | Visit tracking & clinical notes | Enables continuity across visits |
| Telemedicine Consultations | Secure, documented teleconsults | Video & async telehealth | Designed in line with DOH telemedicine guidance |
| Informed Consent (Telemedicine) | Consent documentation required | Consent capture within encounter | Stored as part of patient record |
| Appointment Scheduling | Traceable visit scheduling | Scheduling & visit logs | Supports audit & utilization review |
| Provider Attribution | Clear provider responsibility per encounter | User & role-based attribution | Supports accountability |
| Clinical Notes & Assessments | SOAP / structured clinical notes | Configurable documentation | Adaptable to clinic workflows |
| Care Continuity | Longitudinal patient history | Unified patient timeline | Supports chronic & preventive care |
| Data Privacy & Access Control | Compliance with Data Privacy Act | Role-based access & audit logs | Supports RA 10173 expectations |
| Audit Readiness | Traceability of access & changes | Activity logs & timestamps | Supports internal & external review |
| Outpatient Service Tracking | Documentation of outpatient encounters | Encounter classification | Can tag visit types |
| Reporting Readiness | Organized data for review or extraction | Structured data model | Export/reporting configurable |
| LGU / Program Support | Community-based care documentation | Multi-clinic & org support | Suitable for LGU & NGO programs |
| Scalability | Multi-provider, multi-site readiness | Multi-tenant architecture | Supports networks & growing clinics |
What UltraVisit Supports
UltraVisit is Designed to support:
- Clinical documentation and encounter capture
- Telemedicine workflows consistent with DOH guidance
- Structured patient records suitable for PhilHealth-related programs
- Audit and compliance readiness
- Operational preparation for primary care benefit participation
What UltraVisit Does NOT Replace
UltraVisit does not replace:
- PhilHealth provider accreditation
- PhilHealth claims submission systems
- Official eligibility verification portals
- Regulatory approval processes
- These remain under the authority of PhilHealth and relevant government agencies.
Recommended Use of This Matrix
This matrix is suitable for:
- DOH or LGU proposal annexes
- PhilHealth readiness discussions
- NGO / donor digital health programs
- Internal compliance documentation
- Vendor due diligence reviews
