Designing PhilHealth (Philippine Health Insurance) integration before official SOAP APIs are available (.NET)

11 hours ago 2
ARTICLE AD BOX

I am working on integrating PhilHealth (Philippine Health Insurance Corporation) into an existing hospital management system built with ASP.NET Core (.NET), Entity Framework Core, and SQL Server.

At this stage:

We do not yet have access to official PhilHealth APIs, WSDLs, or sandbox endpoints

We do not have finalized XML schemas

Management still expects us to begin architectural and design work based on publicly available PhilHealth guidelines (CF1, CF2, eligibility, and claims workflow)

What I’m unsure about

Recommended overall architecture when official SOAP APIs are not yet available

How to properly split responsibilities between:

Domain services vs repositories

XML builders/serializers vs business logic

How to design the system so it can later support:

SOAP endpoints

Mutual TLS / certificate-based authentication

Separate test and production environments

Real-world handling of:

Eligibility → claim submission → claim status lifecycle

Retry, resubmission, and reconciliation strategies

Audit and compliance logging

Common mistakes to avoid when starting a PhilHealth (or similar government insurance) integration early

What I am not asking for

PhilHealth credentials

Proprietary WSDLs or internal documentation

Complete working implementations

What I am looking for

High-level architecture guidance

Design patterns suitable for SOAP/XML healthcare integrations

Lessons learned from similar government insurance systems

Advice on future-proofing the design before official onboarding

Any guidance from developers who have worked on PhilHealth, government insurance integrations, or similar SOAP/XML healthcare systems would be greatly appreciated.

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