BenepisyoPatas: Hospital bill and pharmacy receipt auditor for Senior, PWD, Solo Parent, and PhilHealth rights

Problem Statement

Philippine laws guarantee strong financial protections for vulnerable citizens: Senior Citizens (RA 9994) and Persons with Disabilities (RA 10754) are entitled to a 12 percent VAT exemption plus a 20 percent discount (an effective 28.57 percent reduction off VAT-inclusive prices) on medicines, medical/dental services, diagnostic lab fees, professional fees, restaurants, and transport; low-income Solo Parents receive a 10 percent discount and VAT exemption on baby milk, diapers, and vaccines (RA 11861); and indigent/senior/ward patients in public hospitals are entitled to No Balance Billing (NBB) and fixed PhilHealth Case Rate deductions under the Universal Health Care Act (RA 11223).

In practice, families standing at a hospital cashier or pharmacy counter are handed multi-page itemized Statements of Account (SOA) or thermal receipts where VAT is not removed before applying the 20 percent discount, eligible diagnostic supplies are marked “non-discountable,” or PhilHealth case rates and mandatory 20 percent professional-fee discounts are miscalculated. Grieving or stressed families pay thousands of pesos in unlawful overcharges simply because they cannot audit 80 line items and BIR Revenue Regulations on the spot.

Proposed Solution

BenepisyoPatas is an instant statutory billing auditor and citizen rights calculator that works from a single smartphone photo of any receipt or hospital Statement of Account:

1. Document Table & Receipt Extraction (LayoutLM Pattern): The user snaps a photo of a pharmacy receipt, restaurant bill, or multi-column hospital Statement of Account and selects the beneficiary category (Senior Citizen, PWD, Solo Parent, or PhilHealth Ward / Case Rate Patient).
2. Centavo-Exact Statutory Audit Engine: While AI extracts the spatial table rows (Item Description, Gross Amount, VAT Applied, Discount Given, PhilHealth Deduction, Net Payable), all arithmetic is verified by a deterministic statutory math engine implementing BIR Revenue Regulations No. 7-2010 and RR 5-2017: $$\text{Correct Net Price} = \left(\frac{\text{VAT-Inclusive Price}}{1.12}\right) \times 0.80$$ For hospital bills, it cross-checks the ICD-10 / RVS code against the official PhilHealth Case Rate Circular and DOH Drug Price Reference Index (DPRI) ceilings, flagging:
   • Failure to deduct 12 percent VAT before computing the 20 percent Senior/PWD discount.
   • Missing 20 percent Senior/PWD discount on doctors’ professional fees and laboratory/imaging charges.
   • Unlawful balance billing on No Balance Billing (NBB) eligible ward admissions.
   • “Double-discount” confusion where establishments apply an inferior store promo instead of the higher statutory Senior/PWD discount (violating the “whichever is higher” rule under RA 9994).
3. Polite Cashier Correction Slip & OSCA/DTI Complaint Packet: Outputs a clear, side-by-side table showing Billed vs. Legally Correct Amount, total pesos overcharged, and a polite Tagalog/English summary citing the exact Republic Act and BIR Revenue Regulation section to show the cashier or hospital billing supervisor—plus a one-click formal complaint form for OSCA, PDAO, DTI, or PhilHealth CARES if refused.

Target Market

• Primary users: 12+ million Filipino Senior Citizens, 1.9+ million registered PWDs, Solo Parents, and every Filipino family paying a hospital or pharmacy bill.
• Public-sector and civic buyers: Office for Senior Citizens Affairs (OSCA), Persons with Disability Affairs Offices (PDAO), National Council on Disability Affairs (NCDA), National Commission of Senior Citizens (NCSC), PhilHealth CARES desks, and DTI Consumer Protection Group.
• Community benefit: Directly puts hundreds to thousands of pesos of legally mandated savings back into families’ pockets at the pharmacy and hospital counter.

How AI Is Used

• Layout-aware receipt and SOA table understanding (LayoutLM / Multimodal VLM): Parses crumpled thermal receipts, dot-matrix hospital printouts, and multi-column Statements of Account into structured JSON rows while classifying each line item into statutory buckets (Essential Medicine, Medical Supply, Diagnostic Lab, Room & Board, Professional Fee, Non-Eligible Comfort Item).
• Deterministic statutory rule engine (zero math hallucination): Once line items are classified, exact peso calculations run in pure deterministic code so the legal arithmetic is 100 percent exact to the centavo.
• Tagalog and Bisaya rights explainer: Explains in plain language why a specific line item was miscalculated so the citizen can confidently speak to the billing clerk.

Community & Ecosystem Integration

• Grounded in BIR RR 7-2010, RR 5-2017, RA 9994, RA 10754, RA 11861, and PhilHealth Case Rate circulars: Cites the exact revenue regulation formula that every cashier’s POS system is legally required to follow.
• Empowers OSCA and PDAO barangay desks: Gives local senior and PWD officers an instant verification tool when members bring in disputed receipts.
• Works offline for quick receipt checks: Includes a fast offline calculator mode alongside full photo-SOA auditing.

Demo Scenario (3 minutes for judges)

1. Place two real-world sample documents on the judge table: a pharmacy/restaurant receipt where a senior was given only a flat 20 percent discount without removing the 12 percent VAT, and a 2-page hospital Statement of Account for a senior pneumonia admission.
2. Snap the hospital Statement of Account. Within 4 seconds, BenepisyoPatas extracts all 18 rows and flags 3 billing errors in red:
   • 12% VAT was charged on diagnostic X-ray and laboratory rows (+₱1,840 overcharge).
   • The attending physician’s professional fee omitted the mandatory 20% Senior discount after PhilHealth deduction (+₱3,200 overcharge).
   • Nebulizer medicines were billed at 3x the DOH Maximum Drug Retail Price (+₱960 overcharge).
3. The screen displays: Total Legal Overcharge Detected: ₱6,000.00.
4. Click Print Cashier Correction Slip to generate the itemized audit sheet citing RA 9994 Sec. 4 & BIR RR 7-2010 that the family hands to the hospital billing supervisor to reduce their bill immediately.

30-Hour Build Plan

Suggested stack: Python FastAPI, LayoutLMv3 / Gemini Multimodal API (with strict table JSON schema), Decimal deterministic math engine, PostgreSQL, Next.js PWA. Public data / APIs: BIR Revenue Regulations No. 7-2010 (Senior Citizens) and RR No. 5-2017 (PWDs), PhilHealth Annex of Medical and Procedural Case Rates (ACR), DOH Drug Price Reference Index (DPRI), DTI/DA Joint Administrative Orders on basic necessities.

Research & Literature References

1. Yiheng Xu, Minghao Li, Lei Cui, Shaohan Huang, Furu Wei, and Ming Zhou, “LayoutLM: Pre-training of Text and Layout for Document Image Understanding,” Proceedings of the 26th ACM SIGKDD International Conference on Knowledge Discovery & Data Mining (KDD ’20), pp. 1192-1200, 2020. DOI: 10.1145/3394486.3403172
   • How BenepisyoPatas uses this study: Uses joint text and 2D spatial bounding-box layout representations to accurately link line-item descriptions with their corresponding gross price, VAT column, discount column, and net payable amounts across varied receipt and hospital invoice layouts.

Risks & Privacy Notes

• Deterministic math guarantee: The LLM never performs the arithmetic itself; it only extracts the printed numbers and item categories, while a deterministic Python Decimal module computes the exact statutory VAT and discount math so there are zero calculation hallucinations.
• Patient privacy (RA 10173): Patient names, hospital registry numbers, and Senior/PWD ID numbers are masked on-device before table extraction unless the user chooses to generate a named DTI/OSCA complaint form.

AI Use Disclosure (draft)

BenepisyoPatas uses layout-aware document AI to extract structured line items from receipts and hospital Statements of Account, a deterministic statutory calculation engine for RA 9994/10754/11223 math, and an LLM to write plain Tagalog explanations of billing discrepancies. AI coding assistants helped build the table overlay UI and PDF slip template. All tax and discount formulas were verified against official BIR Revenue Regulations.

Rubric Scoring