3.3 Patients - Personal Health Numbers
General Policy Description
In British Columbia, each patient needs a Personal Health Number (PHN) in order to access medical care, including prescription drugs.
To process a prescription on PharmaNet, the patient’s PHN is required.
Every reasonable effort must be taken to obtain a patient’s PHN. This includes asking the patient (or patient’s relatives), searching local files, performing a name search on PharmaNet, and, if necessary, calling the prescriber and/or the PharmaNet Help Desk (see How to Search for a PHN).
If a pharmacist is certain that a patient does not have a PHN, they can assign one through PharmaNet.
PHNs must be assigned only for the following types of patients:
- Non-residents of B.C. who have not lived in or used a B.C. health service (e.g., lab work, hospital visit, prescription fill) since 1995 (which is as far back as PharmaNet can search)
- B.C. residents who do not have BC Medical Services Plan (MSP) coverage
- Newborns (in rare cases)
Be cautious in assigning PHNs. Perform a thorough search on PharmaNet before concluding that a PHN does not exist.
- The creation of duplicate PHNs is a serious data integrity problem that may deprive patients of benefits and endanger their health (refer to Multiple PHNs Assigned to One Patient)
- If PharmaNet is offline and preventing you from performing a search or assigning a PHN, refer to Section 2.6–Dealing with PharmaNet Network Outages, Dispensing Offline
To receive medical care (including prescription drugs) in B.C., every patient must have a PHN whether or not they are a B.C. resident.
However, having a PHN does not mean the patient is eligible for MSP or PharmaCare assistance. PHNs created by pharmacies do not entitle the patient to MSP or PharmaCare coverage, even if they are B.C. residents, and are treated in the same way as PHNs for out-of-province patients.
Any PHN assigned at the pharmacy will be used by MSP and PharmaCare if the patient is enrolled in the future.
Prescriptions for a patient without MSP or PharmaCare coverage adjudicate to $0.00. That is, the patient’s expenditures do not count toward the annual Fair PharmaCare deductible, even if they register later for Fair PharmaCare.
Prescriptions for a patient who has MSP coverage but who has not registered for Fair PharmaCare will also likely adjudicate to $0.00. Patients who have not registered for Fair PharmaCare have a default deductible of $10,000. If, however, the patient registers for Fair PharmaCare before the end of the calendar year and submits a consent form within the requested timelines, the patient’s eligible expenditures for the rest of the year will count toward their Fair PharmaCare deductible.
For information regarding the adjudication of claims for individuals who are enrolled in MSP but who are not registered for Fair PharmaCare, please refer to Section 7.2–Fair PharmaCare, Coverage Start Date.
If a patient’s MSP coverage is cancelled because they have taken up permanent residence outside of B.C., they are ineligible for PharmaCare assistance, even if they have a PHN and still possess a BC Services Card. In these cases, the patient’s PharmaCare claims adjudicate to $0.00 and they will have to pay in full.
A patient does not have to be a B.C. resident to receive a PHN. Visitors from another province or country who need to fill a prescription in B.C. must be assigned a PHN before the prescription can be dispensed.
Before assigning a PHN for a non-resident, perform a name search to ensure that the patient has not been assigned a PHN at another pharmacy or another healthcare point of service during an earlier visit to British Columbia, or during a previous period of residency in the province.
PHNs must not be assigned to animals.
When dispensing a prescription for an animal, use the animal owner’s PHN and the veterinarian’s veterinary association ID number. The dispense will not affect the animal owner’s patient record or Drug Utilization Evaluation (DUE) results or contribute to their Fair PharmaCare deductible or co-pay.
PHNs must not be assigned for stock transfers, office-use supplies or emergency supplies. For more information, see Office-Use Supplies and Transactions not to be Entered into PharmNet.
PHNs must not be assigned to pharmacies, practitioners’ offices, clinics or facilities.
Procedures for Pharmacists
No prescription can be processed on PharmaNet unless the patient has a PHN.
Any patient who is a resident of B.C. and has enrolled in MSP has a PHN. A PHN may also exist for patients visiting from outside the province, either because they used a B.C. health service (e.g., lab work, hospital visit, prescription fill) or lived in B.C. at some time since 1995 (which is as far back as PharmaNet can search).
You must make every reasonable effort to obtain a patient’s PHN. This includes asking the patient (or patient’s relatives), searching local files and/or performing a name search on PharmaNet. Please refer to the procedure below or to the Quick Guide. As a last resort, call the prescriber and/or the PharmaNet Help Desk.
How to perform a name search
If the patient or their authorized representative does not have the patient’s BC Services Card or know their PHN, you will need to perform a name search.
1. Confirm the patient’s or representative’s identity in accordance with the requirements set forth in Section 9.1–Positive Identification of Patients.
2. Access PharmaNet and perform a Patient Name search (TPN transaction) using:
- Full surname
- Full first name
- First name initial (see below)
- Date of birth
3. If only one PHN is returned, verify it by cross-checking the patient’s full name and address.
4. If the name search does not find a PHN, perform an advanced name search
- Make sure the first and last name on the prescription matches the name on the identification
- Ask if the patient is married or divorced and/or has changed their last name
- Ask if the patient has a hyphenated name (e.g. with spouse’s name)
- Check for embedded spaces in the last name (e.g., van der Ham vs. Vanderham)
- Search under the patient’s first name and/or second-name initial with a surname in the Last Name and Given Name fields (e.g., Michelle Georgina Bertelli can be searched under M. Bertelli or G. Bertelli)
- Search using the patient’s full middle name (e.g., Georgina Bertelli)
- Check whether the patient uses a nickname, which might begin with a different letter (e.g., Robert may be entered as Bob or Bobby)
- Try variant spellings of the given name (e.g., Chris may be Christopher, Christophe or Krystof)
- Try closely related names (e.g., Mac vs. Mc)
- Switch the patient’s first name or second name with their surname; many cultures record the family name first and the given name second
- For people with only one legal name, enter that name in both the Last Name and Given Name fields. If that does not work, enter the patient’s legal name in the Last Name field and a title (e.g., Mr.) in the Given Name field
- Confirm the birthdate. The system returns results only for the year given. The year must be exact
- If the patient is a newborn, a PHN may exist, but under a different surname. Ask for any other name the newborn may be registered under. For newborns, enter “Baby Girl” or “Baby Boy” in the First Name field
If you still cannot find the PHN and the patient is a B.C. resident, contact the prescriber. If the prescriber does not have sufficient information, call the PharmaNet Help Desk.
If PharmaNet Help Desk cannot find a PHN, you can assign one. See Assigning a PHN.
If you find multiple PHNs for the same patient
Follow the procedure Multiple PHNs Assigned to One Patient.
If the patient information appears to be wrong
If the search returns information that does not match the information provided by the patient, check that you have the correct PHN.
If the mailing address is incorrect or outdated, update PharmaNet with the new information using the Patient Address Update (TPA) function.
If any information other than the above needs to be corrected, refer the patient to the
- Medical Services Plan of British Columbia, or
- B.C. Vital Statistics Agency
- For non-B.C. residents, contact the PharmaNet Help Desk
Print off the one-page guide, Searching for PHNs on PharmaNet.
Only pharmacies and acute healthcare points of service can assign PHNs. The PharmaNet Help Desk cannot assign a PHN.
To assign a PHN, the pharmacy sends a transaction via their local system (POS) to PharmaNet to create a new patient and PharmaNet will assign an unused PHN and return it to the pharmacy. The information will be updated in the Enterprise Master Patient Index (EMPI) later.
To reduce the creation of multiple records, the pharmacy or acute healthcare point of service must accurately identify the patient before assigning a new PHN.
>> Refer to Section 3.2–Patients—Identification.
Before assigning a new PHN, pharmacists must perform a thorough PHN search.
If a patient cannot provide a BC Services Card, and you are sure a PHN does not already exist, a PHN may be assigned.
If the client is incarcerated (in a federal or provincial facility) please do not create a duplicate PHN. Use the PHN that the demographics (name, gender, DOB) match, even if the address is different.
Before assigning a PHN, the patient must have been positively identified. See Section 9.1–Positive Identification of Patients.
Assign the new PHN using the full name that appears on the patient’s identification documents. Do not use initials or nicknames. The use of first initials instead of a full name is a major cause of duplicate PHNs.
When a patient has only one legal name, enter the one name twice, in both the Last Name and Given Name fields.
The address recorded must be the patient’s mailing address – no PO boxes.
PHNs are typically assigned to newborns at birth. However, if a baby has not been assigned a PHN, a pharmacist may assign one that conforms to the rules below.
If known, the baby’s legal surname must be entered.
If not known, use the mother’s legal surname.
Newborn given name
If known, the baby’s legal given name must be entered.
If not known, the baby’s legal given name must be entered as:
- For single births: BABY BOY or BABY GIRL
- For multiple births: The appended letter must indicate the sequence of birth. For example for triplets: BABY BOY A, BABY GIRL B, BABY BOY C
Note: The baby’s legal given name will appear on PharmaNet files once HIBC has received the request for coverage.
The patient address should be the patient’s mailing address.
For out-of-province or out-of-country patients, record their permanent home mailing address and not their temporary visiting address in B.C.
Assigning a new PHN
- Collect positive patient identification.
For a list of acceptable identification, refer to Section 9.1–Positive Identification of Patients.
- Assign a new PHN on PharmaNet.
- The minimum information required to generate a PHN is:
- full first name (not a nickname) OR a first initial only when the person does not have or know the first name. Initials should be used only as a last resort.
- mailing address
- municipality, city or town
- postal code
- date of birth
- The minimum information required to generate a PHN is:
- Assign the new PHN to the local system and process the prescription as usual.
If the patient is a B.C. resident who has never been enrolled in MSP, refer them to MSP to enroll (otherwise, PharmaNet will list the patient as a non-resident). Each enrollment is checked by MSP versus the Enterprise Master Patient Index for existing PHN.
On occasion, more than one PHN is assigned to the same person.
Note: Records of the PHNs previously assigned to a patient are displayed, so there may be multiple matches with the same PHN.
HCIM has duplicate detection, and all PHN merges are performed by HCIM staff. HCIM will notify PharmaNet of a merge when this happens to ensure the PHNs are merged in the PharmaNet tables.
If you suspect a duplicate, contact the PharmaNet Help Desk.
Multiple PHNs for the same person may, for example:
- Cause inaccurate information about deductibles, as the patient’s accumulated expenditures are divided between the two or more PHNs
- Create a split in the patient record, affecting DUE checks.
- Deprive patients of government and private insurance benefits,
- Compromise their health care in an acute or long term-care hospital, emergency room, doctor’s office or walk-in clinic (e.g., the drug interaction check fails to catch potentially harmful combinations as the medication history is incomplete).
If you find multiple PHNs for a single patient
- Ensure you have searched with the correct full name and address
- Confirm the name and address with the patient and find the exact match
- If there is no exact match, verify patient details such as address, telephone number and date of birth
- If there is more than one exact match under different PHNs and you are satisfied that they are the same person, call the PharmaNet Help Desk for instructions on which one to use.
Note: The PharmaNet Help Desk applies complex criteria to determine which PHN to retain when two records are merged. HIBC forwards information about the duplication to the HealthCare Client Identity Management (HCIM) and to MSP Rapid for further action.
- Enter the PHN determined for use by the Help Desk on the local system.
When entering patient name information into PharmaNet
- Check the spelling of both the first and last name with the spelling on the patient’s identification
- Check for spaces between parts of a name (e.g., van der Kamp vs. Vanderkamp)
- Confirm the spelling of abbreviations (e.g., Mac vs. Mc; Saint vs. St or Ste)
- Type carefully and verify that the name you have entered is accurate
- Do not add punctuation to a name field
- Do not add a title (e.g., Mr., Rev., Sr., Col.) in either name field