QuestionsQuestions (Act No. 2356)
The circular distinguishes (1) Initial Accreditation (no previous accreditation), (2) Renewal of Accreditation (active accreditation filed within the incentive/prescribed period; or late filing before expiry), and (3) Re-accreditation (previous accreditation lapsed regardless of gap; or renewal application denied; and also cases of upgrading, transfer of location, increase in beds, additional services, change in ownership, and resumption after closure/cease of operation).
For upgrading, the application is treated as re-accreditation. The circular states that upgrading to another Level (2, 3, or 4) falls under re-accreditation categories. Documentary requirements are stated as “same as application for renewal of accreditation,” plus any additional required documents for the specific change.
Late filers are hospitals with active accreditation that filed beyond the prescribed filing period but before their accreditation expires. The circular notes these may incur a gap in accreditation depending on the length of processing time.
The changes take effect on May 1 of the applicable accreditation year. The application is considered renewal of accreditation, and the hospital must submit the corresponding documentary requirements for re-accreditation for each applicable case.
It must file a separate application for re-accreditation to obtain an earlier date of effectivity.
The SOI indicates (a) the preferred start date of accreditation and (b) acceptance of downgrading if the hospital does not qualify for the award applied for. Once PhilHealth receives and stamps the application complete, the SOI may no longer be changed.
Yes. A hospital may change the accreditation award prior to the pre-accreditation survey and before March 31 of the current year. It must submit a letter of intent to the concerned PhilHealth Regional Office and file another application for re-accreditation (upgrading) with the corresponding regular application fee. The previously paid renewal application fee is forfeited.
No. The circular provides that such hospitals do not require a pre-accreditation survey.
Critical file updates are specific changes that PhilHealth must record upon receipt of documentary requirements. Examples include downgrading category, decrease in beds, changes in accreditation validity as reflected in the DOH-OSS license, reduction in service capability, change in name of the IHCP, change in medical director/head of facility, and termination due to closure/cease of operation. Each category has stated documentary bases such as DOH license, LOI with effectivity date, SEC/DTI or MOA/deed of sale (where ownership is involved), and validation/notice documents for closure.
File updates 1, 2, 3, and 4 take effect based on the date indicated in the DOH license. File updates 5 and 6 take effect on the date of the PhRO Accreditation Subcommittee Meeting or on the date reflected in the LOI. File update 7 takes effect on the date of actual closure.
No. The circular states these critical file updates shall not require application fees and survey.
Each survey team must be composed of at least two (2) surveyors.
Ramps are required only for new hospitals or for an existing hospital that has undergone expansion, upgrading involving physical plant/facility, or transfer of site after March 24, 2010. Otherwise, the evidence should be marked as N/A in self-assessment and survey tools.
Re-survey may only be conducted after the hospital is granted provisional accreditation. Corrections requiring only documentary proof (licenses, permits, certifications, written policies for current practices, etc.) no longer require re-survey; the hospital submits copies of such documents to PhilHealth.
Review of medical charts is limited to those dated at least one (1) week after the last day of the previous pre-accreditation survey and onwards.
The Accreditation Subcommittee and Accreditation Committee evaluate pre-accreditation survey findings and may correlate them with monitoring/performance data. Their recommendation may modify the surveyors’ findings. The President and CEO then approves, modifies, or denies the recommendation using discretionary authority.