Guidelines for Filing of Applications for Accreditation of Hospitals

Reiwhlii of Hie P/iMp/tinn
PHILIPPINE HEALTH INSURANCE CORPORATION
CihhUile Ccnlrc Building. 7( Slviw Blvd.. 1'asie Cily
Hcallhline 637->-l;5 mnr.phillietillh.gor ph
30 November 2010
PHILHEALTH CIRCULAR
NO. 02-S-2O1 I
TO
SUBJECT
ALL ACCREDITED HOSPITALS, PHILHEALTH
REGIONAL OFFICES (PhROs) AND SERVICE
OFFICES (SOS) AND ALL OTHERS
CONCERNED
Guidelines for Filing of Applications for
Accreditation of Hospitals
lie following are guidelines tor. the filing of applications tor accreditation of hospitals:
Hospuals applying lor accreditation shall conduct :i self- assessment ot their
compliance to the Bcnchhook Standards of Accreditalion tor hospitals prior to
submission or" (hen1 application tor accreditation. The Bcnchbook Sclf-assessmeni
and Survey Tool shall be available at Phil Health Regional/Service Office. It
mayalso be downloaded from the Phil Health website at
hrtp://www.philhealrh.^nv.ph/providers/download/bnchhk sit asscssmnr.pdr".
Prior to applying for accreditation, hospitals should address Lhcir areas tor
improvement u.i qualify foi: the accreditation award they are applying tor. They shall
deiermine the accreditation award ihey will apply for based on \lu-ir actual self
assessment scores
!. The mode of pre-accreditation survey shall be based on the actual scolds reflected in
the Benchbook Self-assessment Summary, ns follows:
AwardAppliedfor
Ccntcrofr.xcellcncc
Centerol"Quality
CenteiotS:ilety
Sclf-^sst:^sinencRcpulr
CenterofP/.xrcllence
CciHtitot(^u;ilir\'
CenterofS;iferv
[@ailed
CenterofQualityorhigher
CemerofS:ife!v
Pniled
CenterofS^tetx*oi:liij>hct
Fnilcd
SllLTCV
CenterofF.xceilence
OntcuofQunlirv
CenterofSnt'etv
CenterofSiiferv
CenteroiQnaltt\'
CenterotSnteiv
CenlerotS^tetv
CenterotSafety
CenterofSafety
^:,
Eijiii-1 tvv iFI'!:'-A. OUI/'CiT

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?Republic of the PhilippinesS' ^y/^'
WPHILIPPINE HEALTH INSURANCE CORPORATIONr @@'//""}
Jj|CilvsluU: Centre HuilJiiiu. 70'' Shaw IiKcL Pasig Cil\Lr ^
IIMealtnlinc (>37-W-99 www.phithaalih.iioY ph/^/
/ ixawpk: @ I hospital applied for Ccnh'v of Quality but failed the se/fasse.\sn/ent; i.e., it did
no! meet I he iiiiniiiiiuii scores required for Center oj Saj'ety. Ihe PhiiO will surrey the hospital as if it
applied only for Center oj ,\ajety~ only the 51 core indicators and the three hawi sajety perjorniiiace areas
(patient rights and or^ini-^iilionul ethics, patient care, andsa/e praclice and enrironuienl} null he assessed
ihiring the pre-accredilalion .surrey. \ hits, the length and extent oj the pre-accieditaliun surrey will he
reduced, saving time and resources holh for the hospital and Phiil lea/th. In this exa/i/p/e. the highest
award that the hospital ca// receire is (-enter oj Sajety. Ij it mints to upgrade to a higher award, the
hospital should apply j'oi re-accreditation for upgrading oj award after receipt of the decision on its
itpp/ica/ion and prepare for a re-si/rrey for the higher award
1 Iospitnls that billed tlu- self--assessment may still apply tor accrcditanon. I (owevet, ilie-i
should already address then- areas for impmvnnenr, espeei;ill\ the core indicators, before
rhe acrual dale f pre-accreduarion survey.
3.Hospivals shall submit the foil owing when applying for accreditarion:
a.Phill Iealth application form for accreditation - properly accomplished
b.Warranties of accreditation @duly notarized
c.Proof of payment of accreditation lee
d.DOf I license @ with validily applicable to the accreditation period
c. Certificate of Membership in PI IA/PIIAP - with validity applicable lo ihe
accreditation period
f.Benchbook Score Sheet (part 2 ot the Benchbook Self'-.issessment forms- Nfaiuial
2)
g.Benchbook Self-Assessment Summnry (part 3 ot the Benchbook Self-assessment
forms- Manual 2)
h. Statements of Intent (SCII) - if applicable (PC no. 32 s. 2010 as Annex A)
1.I *'or initial Accreditation/Re-A ccrcdirnrion
2.I fir Downgrading of Accreditation Award
The accomplished Self-Assessment and Survey Tool (part I of the Benchbook Selfassessment
torms @ Manual 2) shall be retained in the hospital and included in the
document review during rhc acfunl pre-accrcditation survey by Pin ill lealth.
4.For renewal of accreditation, hospitals shall file their applications during the mceniivc
period, December 1 @ 31 or the current year or unnl the prescribed tiling period,
January 1 - 31 of rhe succeeding \ car. (For the Mav 1, 2011 ro April 30, 2012
accreditation period, the regular tiling period tor renewal shall be on January 1 to 31,
2UI i.)
5.Hospitals that are awarded as Centers ot Quality or F.xccllencc (currently or in ihe
future) shall submit their updated DOH-OSS licenses and pay the application fees
trom January 1-31 ot ihe succeeding year(S). Claims ot said hospitals for patienis
with admission dales starring January I shall only be processed upon submission of
their updated DOl 1 license to operate and payment fit accreditation tee.
1L,-:-.:l .^'UJtl % @

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Republic of the Philippines
PHILIPPINE HEALTH INSURANCE CORPORATION
Cil>slate C'enne Building. 71W Slum- Illvd.. PasigCily
I Icallllliiu' h."!7-'-W tnni:phlllicullh.gm- pli
d. I-'or hospitals that were granted provisional accreditation upon the effect!vily of this
2011.
issuance, applications for renewnl of accreditation shall be riled on );inu;iry 1-31,
7. Applications k>r initial accreditation or re-accreditation mny be hied iinytimc.
K. The accreditation of hospitals whose applications fur renewal of accreditation for
accreditation period Mny 1, 2010 to April 30, 2011 were denied shall be valid only
from May 1, 2010 up to .10 calendar dnys from the receipt of the notice of denial of
accreditation or until rhe end ot the current accreditation period on April 30, 2011,
whichever comes first. These hospitals have rwo options, namely:
a.Option 1. Apply for rc-accredilation for the remaining days of the current
accreditation period ending April 30, 201 1. Tf the application is approved, rhe
hospital shall again apply lor renewal ot accrcditaiion within 30 days from receipt
ot the nonce ot approval ot accreditation.
b.Option 2. Apply tor re-accrcditalion tot the accreditation period May 1, 201 1 to
April 30, 2012 with the start date of accreditation effective Mav 1, 2011 if
approved. The hospital mav incur a gap from the entl of the previous
accrcditaiion up to A pal 30, 2011.
'). Attached is the revised Checklist" of Requirements for Application for Accreditaiion
or Institutional ! leal I h (^are Providers (Annex 1) and Pre-Accreditation Survey
Report (Annex 2).
The provisions of 1'tiilI lealth Circular Nos. 50 s. 2009 and 15 s. 2010 that art. consistent
with this circular shall remain in effect. All other existing issuances inconsistent with this
circular arc hereby repealed and/or amended accordingly.
This circular shall take effect fifteen (15) d;iys after its publication in the Official Gazette
or in a i^tsyspaper of general circulation.
Dr. Rey Mj\quino
Prcsidi-nlKS: C] :.O
PhilHealth
i|->Wn
@fa
OP-S10-36626

ANNEX 1
CHECKLIST OF REQUIREMENTS FOR APPLICATION FOR ACCREDITATION
INSTITUTIONAL HEALTH CARE PROVIDERS (IHCPs)
I.General Requirements:
1. PhilHealth application form - properly accomplished
2. Warranties of Accreditation - duly notarized
3. Accreditation fee - proof of payment (see back for appropriate fee schedule).
II.Specific Requirements: (in addition to the above, the following are specific requirements per type of
institution)
A.Hospitals (Levels 1, 2, 3 and 4)
1. DOH License - with validity applicable to the accreditation period applied for
2. Certificate of Membership in PHA or PHAP - with validity applicable to the
accreditation period applied for
3. Benchbook Score Sheet
4. Self-Assessment Summary
5. Statement of Intent (SOI) - if applicable
a. For Hospitals applying for initial/re-accreditation from January to April regarding to
validity of accreditation, and/or
b For hospitals applying as Centers of Quality/Excellence
Additional Requirement for Initial Accreditation:
DOH licenses for 3 previous years or its required * alternative document
B.Ambulatory Surgical Clinics & Free Standing Dialysis Clinics
1 Current DOH license
2. Statement of Intent (SOI) - if applicable
* For FSDCs and ASCs applying for initial/re-accreditation from January to April
regarding to validity of accreditation
Additional Requirements for Initial Accreditation:
DOH license for 3 previous years or its required * alternative document
C.Out Patient Benefit Package, Maternity Care Package, and Anti-TB/DOTS Package
Providers:
1. Location map
2. PhilCAT Certificate - optional for initial accreditation of DOTS Providers
3. Proof of Affiliation with at least a Level 2 PhilHealth Accredited Hospital - if applicable
for an MCP Clinic
4 Statement of Intent (SOI) - if applicable
* For providers applying for initial/re-accreditation from September to December
regarding to validity of accreditation
@ NOTE:
Applications for initial accreditation that are non-compliant with the three (3) year rule
requirement may refer to PhilHealth Circ 21 s 2009 for alternative requirements.
III. Schedule of Accreditation Fees:

* Applicable to government facilities only
INSTITUTIONS
Level1Hospitals
LevelIIHospitals
LevelIIIHospitals
LevelIVHospitals(withtraining
programs)
AmbulatorySurgicalCenters
(ASCs)
FreeStandingDialysisCenters
(FSDCs)
OPBProviders
TB-DOTSProvider
Non-HospitalMaternity
CareProviders
3-in-1Providers
OPBandDOTSProviders
OPBandMCPProviders
MCPandDOTSProviders
(PRIVATE/
GOVERNMENT)
P3,000.00
P5,000.00
P8,000.00
P10,000.00
P5,000.00
P5,000.00
P1,000.00*
P1.00000
P1,500.00
P1,000.00@
P1,000.00*
P1,500.00*
P1.500.00
RENEWAL
(WITH10%
INCENTIVES)
P1,800.00
P3,600.00
P7,200.00
P9.000.00
P3,600.00
P4,500.00
P900.00
P900.00
P900.00
P900.00
P900.00
P1,350.00
P1,350.00
PRESCRIBED
FILING
PERIOD
P2,000.00
P4,000.00
P8,000.00
P10.000.00
P4,000.00
P5,000.00
P1,000.00
P1,000.00
P1.00000
P1,000.00
P1,000.00
P1.500.00
P1.500.00
RENEWAL(LATEFILERS)
(additionalfee)
31-90daysprior
toexpiration
P4,000.00
P8,000.00
P16,000.00
P20,000.00
P8,000.00
P10,000.00
P2.000.00
P2,000.00
P2,00000
P2,000.00
P2,000.00
P3,000.00
P3,000.00
1-30dayspnor
toexpiration
P8,00000
P16,00000
P32,00000
P40.00000
P16,000.00
P20.00000
P4,000.00
P4,00000
P4,00000
P4,00000
P4,00000
P6,000.00
P6,00000

applicable):
*@@%?@*@
Republic uf the Pliilip/iiin/s
PHILIPPINE HEALTH INSURANCE CORPORATION
Cil>suite Cenirj. 7iW Slum Huulewird. I'asidi. itv
lk;ilihliiij(i37-'-WW u-n-u- pliillidiilrli xv />h
Preliminary Survey Report
ANNEX 2
PSR rev. 112510
X. Hospital information
Nameofhospital
Address
HospitalLevel
?Level1
?Leve
2
?Level
3 ?Level4
Awardappliedfor
DCenterofSafety
?
Center
ofQuality
?CenterofExcellence
Dateofapplication
Date/softhesurvey
II. Survey Results
In relation to your hospital's application for accreditation, your compliance to the Benchbook
core indicators is summarized below:
. l.l.a.l
. 2.3.5.a.2
. 3.2.1.x.l
. 6.1.2.a.2
. 6.2.3.x.l
. S.3.3.b.l
. 2.1.l.b.l
. 2.5.5.a.2
. 4.1.1.b.2
. 6.1.2.b.l
. 6.2.4.x.1
. 6.3.4.x.l
. 2.1.2.a.1
,2.5.5.c.l
. 4.1.2.a.3
.. 6.1.2.b.2
. 6.3.1.x.l
6.3.5.X.I
. 2.1.2.b.l
. 2.5.5.e.l
. 5.1.1.e.l
. 6.1.2.c.l
.6.3.1.x.2
. 6.4.3.x.l
. 2.1.2.c.l
. 2.5.5.e.2
. 5.2.1.a.1
. 6.1.2.e.l
_6.3.2.b.l
.6.5.1.x.l
. 2.2.3.a.2
. 2.5.5.1.1
_5.2.1.b.l
_ 6.1.2.f.2
^6.3.2.b.2
. 6.5.2.x.2
. 2.3.1.a.1
. 2.7.I.X.I
. 6.1.1.a.1
_6.1.3.b.l
_6.3.2.b.3
.7.1.x.l
. 2.3.2.c.l
. 3.1.3.x.l
6.1.1.b.l
_ 6.2.1.x.l
_6.3.3.a.l
7.6.x.1
. 2.3.3.d.3
3.1.4.x.1
. 6.1.I.e.2
Thefollowingare
inadequate):
ourgeneral observations (please attach separate sheet it spaceis
Accomplishments:
Areas for improvement (deficiencies):
Page 1 of 2

III. Recommendations
(None: These are suggested measures to resolve problems and/or ways to improve deficiencies.)
IV. Pursuant to PhilHealth Circular No. 50 s. 2009, a hospital that is granted provisional
accreditation shall correct the above-mentioned areas of improvement to achieve the Center
of Safety award no later than (m) / (d)/ (y)This date of compliance does
not apply to hospitals that are recommended for denial of accreditation
NOTE: This feedback report contains raw data needed to generate the scores. It does not include the actual
scores of compliance to pertinent areas required for the Accreditation Award applied for. The surveyors are not
required to generate the scores during the survey process. The recommendation on what Accreditation Award to
be given can only be formulated after the final scores are generated
The applicant hospital may follow-up from their respective regional offices the actual scores/result of the preaccreditation
survey two (2) weeks after the conduct of the pre-accreditation survey.
Surveyors:
Signature:
Date Sig ature:
Date Sig nature:
Date
(Nan
ne)
(Name)
(Name)
Received by hospital representative/s:
s gn atur
Date Sig atu re
Date
(Name&designation
(Nar ne &des qn
ationl