PHILHEALTH CIRCULAR 2023 – 0024
ACCREDITATION of
HEALTH CARE PROFESSIONALS
(HCProfs) (Revision 1)
Accreditation
• A process to verify the capabilities and qualifications of healthcare
providers which are in accordance with the guidelines and standards
set by the Corporation
• Grants the privilege of participating in the program for healthcare
providers
• Assures that healthcare services are rendered to members of the
desired and expected quality
• Initial process wherein the healthcare providers may avail claims
reimbursement
Who do we accredit?
Doctors
General Physician (GP)
GP with Training (GT)
Medical Specialist (MS)
Primary Care Physician* (PCP)
Dentists
General Dentist (GD)
Dental Specialist (DS)
Primary Care Dentist* (PCD)
Optometrists
Registered Nurses
Registered Midwives
*Primary Care Physician/Dentist as Yakap Package Provider
Types of Accreditation When to Apply
1. Initial Anytime
- applying for the first time
2. Re-accreditation Anytime
- there is a gap in accreditation
- previous accreditation was denied
or withdrawn
- applying for upgrade/downgrade
3. Renewal 120 to 20 days prior to
- continuous accreditation the expiration of the
current accreditation
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Doctors: General Physician (GP)
Certificate of Good Standing (CGS) from PMA
or its local component society
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Doctors: General Physician with Training (GT)
Certificate of Good Standing (CGS) from PMA
or its local component society
For Initial/Upgrade: Certificate of Completed
Residency Training
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Doctors: Medical Specialist
Certificate of Good Standing (CGS) from PMA
or its local component society
Certificate of Good Standing (CGS) from
Specialty/Subspecialty Society
For Initial/Upgrade: Specialty Board Certificate
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Doctors: Primary Care Physician (PCP)
Certification as Primary Care Worker for
Universal Health Care (UHC) from DOH
*Any type of doctor may also apply as a PCP
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Dentists: General Dentist (GD)
Certificate of Good Standing (CGS) from the
Philippine Dental Association (PDA)
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Dentists: Dentist Specialist (DS)
Certificate of Good Standing (CGS) from the
Philippine Dental Association (PDA)
Certificate of Good Standing (CGS) from
Specialty Society
For Initial/Upgrade: Specialty Board Certificate
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Dentists: Primary Care Dentist (PCD)
Declare affiliation to a Primary Care Facility in
the Provider Data Record
*No need for CGS from PDA
*Any type of dentist may also apply as a PCD
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Midwives: For non-hospital MCP / NSD package
For Initial:
*for graduates from school year 1994 and earlier
Training Certificate from a CPE-accredited PRC program, OR
Training Certificate from a DOH-PRC training
provider/institution, OR
Apprenticeship Certificate for at least 1 year with a PHIC
accredited OB-Gyne or Midwife done in an accredited facility
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Midwives: Family Planning (FP) provider
For Initial or Reaccreditation due to Additional Skills
IUD Insertion:
Certificate of Family Planning Competency Based Training
(FPCBT) Level 2/Comprehensive Family Planning Course, OR
Post-Partum Training Course
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Midwives: Family Planning (FP) provider
For Initial or Reaccreditation due to Additional Skills
Subdermal Contraceptive Implant Package:
Certificate of Training on Subdermal Implant Insertion and
Removal
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Midwives: Family Planning (FP) provider
For Initial or Reaccreditation due to Additional Skills
Post-partum IUD Insertion:
Proof of completion of Post-partum IUD Training Course
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Midwives:
For Renewal or Reaccreditation due to gap in accreditation
General Requirements only.
Reminders:
Midwife Accreditation
• No need for Memorandum of
Agreement (MOA) with accredited
& specialist partner physicians
(Pediatricians & OB-Gynes)
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Nurses
For Initial: Certificate of Training on the Basic Emergency
Obstetric and Newborn Care (BEmONC) for nurses from a
DOH-recognized training center for BEmONC skills
For Initial: Certificate of work experience for at least 2 years
in the labor and delivery room of at least a Level 1 Hospital
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Nurses
For Renewal or Reaccreditation due to gap in accreditation
General Requirements only.
Checklist of Requirements:
General Requirements
1. Provider Data Record – properly accomplished & signed
2. Performance Commitment Form – originally signed on all pages
and duly notarized
3. Updated PRC License – photocopy, front & back
4. Passport size photo (35mm x 45mm) – 2 copies
5. Proof of PhilHealth Contributions
Optometrists PC 2025-0002
Certificate of Good Standing (CGS) during PRC
renewal,
OR
CGS from the Integrated Philippine Association of
Optometrists, Inc. (IPAO)
Forms and Requirements
Reminders:
Provider Data Record
• MUST have correct PIN
• Mailing Address is within NCR & Rizal
- If outside: application will be mailed to
the region of origin, & the processing
period will be prolonged
• MUST have an email address
- for GAMOT App purposes
- Gmail is preferred
Reminders:
Provider Data Record
Regarding Hospital Affiliations…
• MUST be complete & updated.
Undeclared affiliations will be deleted
from the existing records.
• If none, write “No Affiliations” or
“N/A”, with signature.
• Indicate if full time (40hrs/week) or
par time (<40hrs/week)
For LHIOs: Complete RECEIVING
MODULE before transmitting to
PRO NCR HCDMD.
Provider
Data Record
Reminders:
Performance Commitment
• Completely printed 25 warranties
• Originally signed on ALL pages
• Must have a DATE on the 1st page
• Must be DULY NOTARIZED
- With DATE of notarization
- Date must be ON or AFTER the
date of form accomplishment
• No erasures/alterations
- If with corrections, must be stuck
through and countersigned by
both the professional & the
notary public
Performance
Commitment
Reminders:
PRC License
• If approved, Accreditation Validity
will follow the PRC license end
validity date
• If unavailable, PRC-issued claim
stub AND official receipt of
renewal fee are acceptable
PRC License
Reminders:
PhilHealth Contributions
• For Employed:
Certification of paid contributions
from the employer, within 3 months
prior to application
• For Direct Contributors:
Proof of least 1 month contribution
during the month of application
PhilHealth
Contributions
Reminders:
Certificates of Good Standing
• Should be valid at the time of
application
- For PMA CGS valid until May 31st of
the current year: still acceptable for
applications received from June 1st to
July 31st
Good Standing
Certificates of
Local Component Society
PRC
PMA
Good Standing
Certificates of
Philippine Dental
Association
Specialty Society
Certificates from PMA Affiliate
Societies are not accepted.
Residency Training
Certificate
Specialty Board
Certificate
Primary Care
Worker Certificate
Updating of Records
Updating of Records:
Change in Name and/or Marital Status
• Properly accomplished &
signed PDR
• Photocopy of PSA-issued
Marriage Certificate or
Nulled/Void Marriage or Death
Certificate of deceased spouse
Updating of Records:
Correction of Name or Sex
• Properly accomplished &
signed PDR
• Photocopy of PSA-issued Birth
Certificate
Updating of Records:
Correction of Personal Information
• Updating of mailing address,
telephone/mobile number, email
address
• Properly accomplished &
signed PDR
Updating of Records:
Updating of Hospital Affiliations
• Properly accomplished &
signed PDR
• Letter of Request to add/delete
hospital affiliation, signed by
both the HCProf & the medical
director of the health facility
FINAL REMINDERS
• Applications received at the LHIOs must be
forwarded to HCDMD within five (5) working
days from the date of receipt.
FINAL REMINDERS
• Compliances for incomplete applications
will be the responsibility of the Receiving
LHIOs
Accreditation will only be processed once
application has complete requirements
FINAL REMINDERS
• LHIOs may print and issue Approval Letters
& Electronic IDs for APPROVED HCProfs,
ONLY to the HCProf
Authorization Letters are allowed, but must
include signatures & government IDs of the
HCProf and the assigned representative
FINAL REMINDERS
• For Inquiries and concerns, kindly email:
[Link]@[Link]