Scope and Coverage
- Applies specifically to all birthing homes and lying-in/maternity clinics.
General Guidelines for Accreditation
- Accreditation is based on health care institutions' capability and integrity.
- Requirement of a valid DOH License to Operate (LTO) for initial, renewal, and re-accreditation applications.
- Fraudulent or unethical practices diminish integrity affecting accreditation.
- All health professionals attending deliveries and related procedures in these facilities must be PhilHealth accredited.
Document Submission Requirements
- Initial and Re-accreditation require:
- Valid DOH License to Operate
- Signed performance commitment
- Provider data record (PDR)
- Accreditation fee (Php1,500)
- Updated certificates as Newborn Screening and Hearing Screening Facility or Memorandum of Agreement
- Photographs of the facility
- Location map
- Statement of intent (if applicable)
- Renewal submissions within January 1-31 must include:
- Valid DOH LTO
- Signed performance commitment
- PDR
- Accreditation fee
- Updated newborn screening certificates or agreements
- Latest audited financial statement (by June 30 of the succeeding accreditation cycle)
Pre-accreditation Survey
- Conducted by PhilHealth for initial accreditation, re-accreditation due to gaps, or transfer of location.
Additional Requirements for Family Planning Services
- Health staff must have certificates from DOH recognized training providers as per PhilHealth Circulars 25-2015 and 38-2015.
Monitoring and Evaluation
- PhilHealth conducts monitoring visits assessing compliance with standards, quality of care, patient satisfaction, financial risk protection, and fraud prevention.
- Uses PhilHealth's Health Care Provider Assessment System (HCP PAS).
- Employs DOH licensing requirements and additional PhilHealth requirements for monitoring.
Repealing Clause
- This circular supersedes and amends provisions of prior PhilHealth Circulars on maternity and newborn care provider accreditation.
- Conflicting provisions of earlier issuances are repealed; consistent provisions remain valid.
Effectivity
- The circular takes effect 15 days after publication in a newspaper of general circulation.
- It will be deposited with the National Administrative Register at the University of the Philippines Law Center.