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Table of Contents
How to login on Easy Claims
How to login on Easy Claims Connect
How to file a claim?
​File a claim
​Check Eligibility
​ Member Information
Fetch
Verify
​ Patient Information
Save for E-Claims?
Claim Identity
Bypass Eligibility Check
Confinement Information
​Health Care Institution Information
​Patient Confinement Information
How to Add Diagnosis?
How to Input Valid Item Code Properly?
​Special Considerations
Fees and Charges
​ ​Claim Type
​Professional Fees and Charges
​ Are there enough benefits?
​Consent to Access Patient Record
​Claim Particulars
​Claim Receipts
​Claim Documents
Admission Information
​ N/A
​New
​Old
Claim Summary
Save Claim

How to Generate CF4?


Generate CF4
Patient Enlistment
Patient Profiling
Patient Consultation
Generate Claim
Link Claim

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 1 


How to file a claim with CF4?
File a claim
Link Consultation
Generate Consultation
Link Consultation

How to Submit a claim with CF4?


Completed Claims
Submit Selected
Check Claim List

How to Submit all claims? (Submit All)


Submit All
Check Claim List

How to Submit selected claims? (Submit Selected)


Completed Claims
Submit Selected
Check Claim List

How to Refile CF4?

 
 
 
 
Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 2 
 

 
 

 
 

HOW TO LOGIN ON EASY 


CLAIMS?

 
 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 3 


 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 4 


1. ​Input your ​username 

​2.. ​Input your ​password 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 5 


2.. ​Click ​Log in 

You must be redirected on this page 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 6 


 

 
 

HOW TO LOGIN ON EASY 


CLAIMS CONNECT?

 
 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 7 


 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 8 


1. ​Input your ​connect​ ​username 

2. ​Input your ​connect​ ​password 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 9 


3. Click ​Connect

The system should display the following information on the same page

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 10 


 

 
 

HOW TO FILE A CLAIM?

 
 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 11 


 

1. ​ ote:​ A
Choose from the following options below on how to start. N ​ ll options will
redirect to the creation of claims.

Note: All fields with ​*​ are required


 
1.a Go to ​Home​ then click ​File Claim ​button

1.b Go to ​Claims​ then choose ​File Claim​ on the submenu

1.c Go to ​Claim List​ then click ​File Claim​ button

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 12 


 
2. Fill out the ​CHECK ELIGIBILITY​ form [Claim Form 1]
 
​Complete the Member Information

​ etch ​button - ​Provide correct member PIN and it will auto-populate


F
member ’s complete name and date of birth and don’t forget to select the gender
of the member.

Example: [Successful Fetching] Example: [Failed Fetching]


Member information successfully fetched. Member PIN does not exists!

Verify ​button - ​Provide member’s complete name, and date of birth ​it
will auto-populate member’s PIN

Example: [Successful Verification] Example: [Failed Verification]


PIN successfully verified NO RECORDS FOUND. PLEASE PROCEED TO ANY
PHILHEALTH OFFICE FOR PIN REGISTRATION​.

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 13 


Note: Fetch and Verify functions are not available on offline mode.

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 14 


 
​Complete the Patient Information

​ pouse​,​ ​Child​, or​ ​Parent​: Input the Patient


If the patient is not the member but the S
Name, Birth Date, Gender and PIN.

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 15 


 
2.1 Choose saving options ​Save for E-Claims?
a.) ​Yes​ - to continue filing the claim

 
2.1.a.1 ​Input Claim Identity
Transmittal Number​ -​ ​Unique identifier of a group of claims or specific claim

Claim Number​ -​Unique identifier of the claim

2.1.a.2 ​Click ​Continue t​ o proceed on PBEF and to Confinement Information

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 16 


Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 17 
 
Note: Tick ​Bypass Eligibility Check​ checkbox to skip the eligibility checking

b.) ​No ​- to check the member’s eligibility only. This won’t allow you to
proceed on the next page. If you wish to, tick Yes on Check Eligibility page.

2.2.b.1 Click ​Continue t​ o navigate to Philhealth Benefit Eligibility Form only.

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 18 


Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 19 
 
3. Complete the ​CONFINEMENT INFORMATION ​[Claim Form 2]
 
3.1 Identify the Health Care Institution Information

 
3.2 Complete the​ Patient Confinement Information

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 20 


Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 21 
 
How to Add Diagnosis?
1. Click the ​Add Diagnosis​ button

2. Input the Discharge Diagnosis

3. Click the ​+ Add ICD Code​ button

4. Choose one ICD code from the dropdown then click [​Update​]

​ Note: Repeat step 3 and 4 for multiple ICD Codes.

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 22 


 
How to Input Valid Item Code Properly?

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 23 


Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 24 
 
3.3 Tick the checkbox of the ​Special Consideration​ that applies

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 25 


Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 26 
Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 27 
3.4 Click ​Continue ​to navigate to Fees and Charge

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 28 


 
4. Fill out the ​FEES and CHARGES ​[Claim Form 2]
 
4.1 Select Claim Type​ [All Case Rate]

4.1.1 Select Case Rate Type

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 29 


4.1.2 Select Case Rate Type

Note: ​Do not input multiple ICD and multiple RVS at the same time

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 30 


 
4.2 Add ​Professional Fees and Charges​ Information
4.2.1 ​Click the ​+ Add Professional Fees and Charges ​button

4.2.2 ​Complete the Professional Information then click [​Update​]

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 31 


 
4.3.a Identify if there are enough benefits? [​NO​]
Complete the Health Care Institution Fees and Professional Fees

4.3.b Identify if there are enough benefits? [​YES​]

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 32 


 
​Complete the Consent to access Patient Records

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 33 


Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 34 
 
​Complete the Claim Particulars​ (if applicable)
1. Click the​ + Add Drugs Or Medicines ​button

2. Complete the Drugs Or Medicines Information then click [​Update​]

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 35 


3. Click the ​+ Add X-Ray, Laboratory, And Supplies​ button

4. ​Complete the X-Ray, Laboratory, And Supplies information then click [​Update​]

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 36 


 
​Complete the Claim Receipts​ (if applicable)
1. Click the ​Add Receipt​ button

2. Complete the Add Receipt information

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 37 


3. Click the ​+ Add Receipt Item​ button

4. Complete the Receipt Information then click [​Update​]

5. Click ​Save

Note: Repeat steps 1-4 for multiple Claim Receipts.

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 38 


 
​Add Claim Documents
1. Select a file to be uploaded
​ ote: The system only accepts ​.pdf ​file format ​and​ .xml ​file format for CF4
N

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 39 


2. Click Select files button to select the file to be uploaded

​The image below shows the selected document attached in the system

3. Click ​Continue

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 40 


 
5. Fill out the ​ADMISSION INFORMATION ​[Claim Form 3] (​If applicable)
 
5.1 N/A

5.1.1 Click ​Continue ​to proceed on Claim Summary

 
5.2 New

5.2.1 ​Complete the Admission Information

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 41 


5.2.2 ​Complete the Physical Examination

5.2.3 Click Continue to proceed on Claim Summary

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 42 


 
5.3 Old
5.3.1 ​Complete the​ ​Admission Information

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 43 


5.3.2 ​Complete the Physical Examination

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 44 


5.3.3​ Complete the Maternity Information

5.3.4 ​Complete the​ ​Clinical History Details

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 45 


5.3.5 ​Complete the Risk Factors

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 46 


5.3.6​ Complete the Consultations
5.3.6.1 ​Click the ​+ Add Consultation ​button

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 47 


5.3.6.2 ​Complete the Consultation details then click [​Update​]

5.3.7 ​ Complete the Delivery Details

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 48 


5.3.8​ Complete the Post-Partum Details

5.3.9 Click ​Continue​ to proceed on Claim Summary

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 49 


 
6. Review the​ Claim Summary

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 50 


Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 51 
6.1 Click the ​Export As PDF​ button to save a copy of the summary

 
6.2 Click the ​Save Claim ​button to save the claim

6.2.1 Click the ​ADD NEW ​ button to file another claim

6.2.2 Click the ​NO​ button to view the created claim and you will be redirected
to Claim List page

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 52 


Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 53 
 
 
 
 
HOW TO GENERATE CF4 
 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 54 


1. Go to Patients on the menu bar then click ​Register ​button

 
1.1 Fill-out the ​Patient Information

 
1.2 Click the ​Save & Add Profiing​ button

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 55 


1.2.1 Complete the ​ Past Medical History
1.2.1.1Tick the checkbox of the Medical History and its specifics that applies

Example:

1.2.1.2 Click ​Save & Proceed​ button

1.2.2 Complete OB-GYNE History


If Menstrual and Pregnancy History does not apply tick ​Not Applicable checkbox

If Patient is ​MALE​ OB-GYNE History is automatically not available

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 56 


1.2.2.1 Fill-out the Menstrual History

1.2.2.1.1 Input the Last Menstrual Period

1.2.2.2 Fill-out the Pregnancy History

1.2.2.2.1 Click the ​Add History​ button

1.2.2.2.2 Add the History Information then click ​Add​ button

1.2.2.3 Click ​Save & Proceed ​button

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 57 


1.3 Review the CF4 Summary then click [​Save & Add Consultation​]

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 58 


 
1.3.1 Click the ​Add Consultation/SOAP​ button

1.3.1.1Fill-out the Subjective

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 59 


1.3.1.1.1 Click the ​Save & Proceed​ button

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 60 


1.3.1.2 Fill-out the Pertinent Physical Examination Findings

Note: Physical Examination is automatically set to


Essentially Normal, if nothing is ticked

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 61 


Example:

1.3.1.2.1 Click the ​Save & Proceed​ button

1.3.1.3 Fill-out the Course in the Ward

1.3.1.3.1 Click the ​+ Add Doctor’s Action​ button

1.3.1.3.2 Complete the Add Action information then click​ Add​ button

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 62 


1.3.1.3.3 Click the ​Save​ button

1.3.1.4 Complete the Medicine

If Medicines does not apply tick ​Not Applicable ​checkbox

1.3.1.4.1 If it applies, click the ​Add Medicines​ button

1.3.1.4.2 Complete the ​ Medicines ​Information then click ​Add​ button

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 63 


Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 64 
Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 65 
Note: Tick the checkbox ​Manually Input Drug Description​ if the Drug Code is not available on the
dropdown

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 66 


Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 67 
1.3.1.5 Click ​Create New Record​ button to add another consultation

1.3.1.5.1 Click​ Cancel​ you will be redirected on Consultation page

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 68 


2. Click the ​Link Claim​ button on Consultation/SOAPS page

 
2.1 ​If there is no existing claim​, click the ​Generate Claim​ button

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 69 


2.1.1 Click the ​Generate​ button from the modal

Note: This notification should appear

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 70 


 
2.2​ ​If there is an existing claim​, click the auto populated claim.

2.2.1. Click the ​Link Claim ​button​ ​to link the claim

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 71 


2.2.2 Check the details before linking

2.2.3 Click the ​Link​ button to proceed on linking the claim

2.2.3.1 This notification should appear

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 72 


 

 
 
 

 
 
HOW TO FILE A CLAIM WITH CF4
 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 73 


 

 
 
1. File a claim [​Follow the steps on How to file a claim​]
 
2. On your created claim found on the Claim List, click the ​Link Consultation​ button

 
2.1​If there is no existing consultation​, click the ​Generate Consultation​ button

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 74 


 

2.1.1 Click the ​Generate ​button from the modal

Note: This notification should appear

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 75 


 
2.2​ ​If there is an existing consultation​, click the auto populated consultation.
Note: Existing consultation means a consultation has been added before the linking process.

2.2.1 Click the ​Link Consultation ​button to link the consultation

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 76 


2.2.2. Check the details before linking

Note: If the transmittal Id and Claim Id of the Consultation is ​not equal​ to the
transmittal Id and Claim Id of the Claim, t​ he transmittal Id and Claim Id of the Claim
will be followed​.

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 77 


2.2.3. Click the ​link​ button to proceed on linking the consultation

2.2.3.1 This notification should display

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 78 


HOW TO SUBMIT A CLAIM WITH CF4?  
 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 79 


 
1. Identify a ​completed claim​ indicated by ​orange​ text and white background.
Notice: [Unlink Consultation] button is enabled​.​ Identifies Claim with CF4

2. Tick the corresponding checkbox of the claim

 
3. Click the ​Submit Selected ​button

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 80 


A modal will appear with ​Hospital Information.
3.1 Click ​Continue​ to proceed

3.2 Click ​proceed​ to confirm you are using a correct account

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 81 


A Receipt Ticket modal will appear. Identifies that the claim was submitted
successfully.
3.3 Click ​OK ​to close the modal

 
4. Go to ​Claim List​ to check the submitted claim. You can use the search box to
find the submitted claim. ​You may use the​ ​Transmittal No, Receipt Ticket No.,
Claim No. Claim Series LHIO and Patient Name for searching

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 82 


HOW TO SUBMIT A CLAIM? (SUBMIT ALL)   
 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 83 


 
1. Go to ​Home​ page then click ​Submit All​ button

A modal will appear with ​Hospital Information


1.1 Click ​Continue​ to proceed

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 84 


1.2 Click ​Proceed​ to confirm you are using a correct account

A Receipt Ticket modal will appear. Identifies that ​all completed claims were
submitted successfully.
​1.3 Click ​OK ​to close the modal

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 85 


 
2. Go to ​Claim List to check [​all completed​] submitted claims. You can use the
search box to find the submitted claim. ​You may use the ​Transmittal No, Receipt Ticket
No., Claim No. Claim Series LHIO and Patient Name for searching

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 86 


 

HOW TO SUBMIT CLAIM? (SELECTED)   


 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 87 


 
1. Identify ​completed claims​ indicated by ​orange​ text and white background.
Notice: [Link Consultation] button is enabled​.​ Identifies Claim without CF4

2. Tick the corresponding checkbox of the claims

 
3. Click the ​Submit Selected ​button

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 88 


A modal will appear with ​Hospital Information.
3.1 Click ​Continue​ to proceed

3.2 Click ​proceed​ to confirm you are using a correct account

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 89 


A Receipt Ticket modal will appear. Identifies that claims were submitted
successfully. ​Notice that each claim has its own Receipt Ticket Number
3.3 Click ​OK ​to close the modal

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 90 


 
4. Go to ​Claim List​ to check the submitted claims. You can use the search box to
find the submitted claim. ​You may use the​ ​Transmittal No, Receipt Ticket No.,
Claim No. Claim Series LHIO and Patient Name for searching 

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 91 


 

HOW TO REFILE CF4?    

​ ​COMING SOON

Easy Claims Gallium (7.0.0.0) 2019​ ​|​ ​page​ 92