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Processing of Application for Accreditation of Health Care Institution

You get your health care institution accredited to participate in the National Health Insurance Program.

At a glance

  • Office: Philippine Health Insurance Corporation
  • Classification: Highly Technical
  • Who may apply: Hospital, Primary Care Facility/Infirmary, Ambulatory Surgical Clinic, Free Standing Dialysis Clinic, Maternity Package Provider, TB DOTS Package Provider, Out Patient Malaria Package Provider, Animal Bite Package Provider, Free Standing Family Planning Clinic, OHAT Package Provider, SARS COV 2 Testing Facility using RT PCR, COVID 19 Community Isolation Benefit Package Provider
  • Total fees: None

Requirements

RequirementWhere to get it
1. Provider Data RecordPhilHealth Website/Offices
2. Performance Commitment (Rev.3)PhilHealth Website/Offices
3. Updated DOH License (Photocopy)Provided by the Applicant
4. Application FeeProvided by the Applicant
5. Accredited Medical DirectorProof of Accreditation may be provided by the applicant/verified in the Accreditation database (IPAS)
6. Audited Financial StatementProvided by the Applicant
7. JPEG Photo of the facility (also for reaccreditation for change in location)Provided by the Applicant
8. Proof of 3 years in Operation or Qualifier for exemption per PhilHealth Circular 11 s.2013Provided by the Applicant
9. Copy of SEC Certificate/General Information SheetProvided by the Applicant
10. Statement of Intent (if applying during the last quarter of the year)–

Steps

What you doWhat the office doesFeeTime
Submission of Application to LHIO/PROReceive and screen initially the application (LHIO/PRO Receiving Officer)None5 -10 Mins/Application
Wait result of Screening of ApplicationProvide Order of Payment (LHIO/PRO Receiving Officer)None5 -10 Mins/Application
If incomplete application, get the application together with attached checklist of requirements with list of deficiency/iesReturn the application to applicant together with copy of the checklist of requirements and list of deficiency/ies (LHIO/PRO Receiving Officer)None5 -10 Mins/Application
If application is completeEncode in the IPAS Receiving Module (LHIO/PRO Receiving Officer)None5 -10 Mins/Application
Applicant gets Order of PaymentPrepares Order of Payment (LHIO/PRO Receiving Officer)None5 -10 Mins/Application
Pays Applicable Fee/sProcess payment, issues Official Receipt (Cashier)PCF/Infirmary - P3,000, Level 1 - P5,000, Level 2 - P8,000, Level 3 - P10,00010 -15 Mins/Application
NoneTransmit application to PRO if application was filed at the LHIO (LHIO Receiving Officer)NoneTransmits within 5 working days from receipt of application
Determines the process of accreditation if for automatice accreditation encodes details in the Data Entry Module of IPAS (SIO-AQAS)NoneWithin the day
Wait for Notice of SurveyIf for Non Automatic Accreditation, schedule notice of survey generated and emailed to facility (SIO-AQAS)None5-10 Mins/Application notice of survey generated and emailed to facility
NoneConduct Pre Accreditation Survey (AQAS (MS III, MS I, SIO III, SIO I))NoneConducts survey within 30 days from receipt of application
Submit Compliance/s within the prescribed compliance periodNote: During the pandemic, facility visit/conduct of Pre-Accreditation Survey is waived, Health Care Institutions are instructed to submit proof of compliance to accreditation requirements within 60 calendar daysNoneCompliance period 60 calendar days
Claims certificate of accreditation and approval letter at the PRO Signs receiving copyProvides Certificate of Accreditation and Approval Letters, Files receiving copy (HCDMD Clerk)None5 -10 Mins/Application

Source

Read from the office's Citizen's Charter by Muse Spark. Fees and steps change: check the PDF and the office before you go.

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