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(NAR) VOL. 24 NO. 2 / APRIL - JUNE 2013
[ PHILHEALTH CIRCULAR NO. 0005, S. 2013, April 04, 2013 ]
EFFECTIVITY OF NEW CLASSIFICATION OF HEALTH CARE FACILITIES IN PHILHEALTH DATABASE SHALL BE MAY 1, 2013
With the aim of the Department of Health (DOH) and Philippine Health Insurance Corporation to effectively and efficiently operationalize the new classification of health care facilities based on the Administrative Order 2012- 0012 re: Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines which took effect August 18, 2012, currently engaged/accredited Institutional Health Care Providers (IHCPs) shall retain their category based on the old classification with its corresponding benefits with PhilHealth until April 30, 2013. The new classification of hospitals based on their DOH license for CY 2013 shall be reflected in the PhilHealth accreditation database effective May 1, 2013. This shall enable DOH and PhilHealth to address issues raised by all concerned and most importantly no delays in the processing of claims and reimbursements to health care facilities. However, should there be downgrading of category based on service capability, decrease in authorized beds and removal of service it shall be effective on the date stated in the DOH license.
IHCPs that applied for PhilHealth-engagement from January 1, 2013 and onwards whether initial or after an incurred gap, the effectivity of the new classification of hospitals and other health facilities shall be on the start date of the participation approved by PhilHealth (i.e date of application, date of submission of all the required documents). The PhilHealth benefit shall be based on the new classification stated in their DOH license.
(SGD.) ENRIQUE T. ONA, MD
Secretary of Health/Chairman of the Board and
OIC President and CEO