Guidelines for Application for Accreditation of Health Care Institutions for 2017, Revision 1

2017

PHILHEALTH ADVISORY NO. 2017-0031

GUIDELINES FOR APPLICATION FOR ACCREDITATION OF HEALTH CARE INSTITUTIONS FOR 2017, REVISION 1

As mandated, the Corporation shall prescribe the requirements for the accreditation of Health Care Institutions (HCIs) applying for accreditation. The following shall guide the HCIs in filing of application for renewal of accreditation for 2017:

1. HCIs applying for continuous accreditation shall submit the following requirements on or prior to the prescribed filing period from January 1 to January 31, 2017:

a. Updated DOH license/certificate/business permit (as applicable);

b. Fully accomplished and signed Performance Commitment, revision 2 (attached to PhilHealth Circular No. 2015-37);

c. Completely filled-out provider data record (PDR) indicating the services it provides;

d. Latest Audited Financial Statement signed by the head of facility and treasurer of the facility or provincial/municipal or city treasurer, as applicable (may be submitted until June 30, 2017);

e. Valid Certificate of Good Standing from the Philippine Hospital Association or Private Hospital Association of the Philippines, Inc. (for hospitals and infirmaries only);

f. Functional PhilHealth portal in compliance to PC No. 0002-2014;

g. Accredited Medical Directors/Chief of Hospitals, infirmaries, ASCs, FDCs and professional providers of TB DOTS and MCP packages (PC 21, s. 2008, PC 30, s. 2009, PC 14, s. 2014);

h. Updated MOAs and other applicable contracts/MOUs entered into by the HCIs with relevance to reimbursement of claims;

i. For PCB Providers: The signed and duly accomplished Electronic Medical Record (EMR) Engagement Form shall be submitted as an alternative document to the Memorandum of Agreement (MOA) and Service Level Agreement (SLA). In case the PCB provider fails to comply with any of these documentary requirements, the PCB provider shall still be deemed accredited to allow family/member assignment, but no PFP claims shall be processed. A functional EMR system is required to proceed with enlistment and profiling. Please see Annex A for complete illustration;

j. Payment of accreditation fee

2. All applications for accreditation shall be deliberated in the Accreditation Subcommittee (ASc) in the PhilHealth Regional Offices (PRO).

3. A valid license to operate (LTO) from the Department of Health shall be mandatory for all Maternity Care Package providers (MCP)/birthing homes (BH) applying for initial accreditation. However, MCP providers/BHs applying for continuous accreditation may still submit the business permit/mayor's permit in lieu of the DOH LTO until further notice.

For other inquiries, please call the PhilHealth Regional Office in your area. CAIHTE

 

(SGD.) DR. CELESTINA MA. JUDE P. DE LA SERNAInterim/OIC, President and CEO

ANNEX A

 

Scenario 1 When compliance made on or before March 31, 2017

 

Scenario 2 When compliance made beyond March 31, 2017