Forms and Guides from Philippine Health Insurance Corporation (PhilHealth) Philippines

A premier government corporation that ensures sustainable, affordable and progressive social health insurance which endeavors to influence the delivery of accessible quality health care for all Filipinos.

CityState Center, 709 Shaw Boulevard, Pasig City, Philippines

Telephone:
(632) 637-9999

Email:
Website: http://www.philhealth.gov.ph

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ACCREDITATION INSTITUTIONAL HEALTH CARE PROVIDERS

Benefits Effective December 1999, PhilHealth is implementing a unified benefit package for all PhilHealth members.

Contributions The new task of collecting the premium contributions of members in the government sector entailed the accreditation of banks ...

EMPLOYED SECTOR

Implementing Guidelines For Accreditation Of Banks

INDIVIDUALLY PAYING PROGRAM

Accreditation Documents: Performance Commitment

Annex A Performance Commitment for HCI

Performance Commitment with Additional Provision for PCB1 Providers

Accreditation Documents: Collecting Agents

CAAF Collecting Agents Accreditation Form

Accreditation Documents: Health Care Facilities

PDR Health Care Institution Provider Data Record

MMHR Monthly Mandatory Hospital Report

SOI Statement of Intent (Initial/Re-accreditation)

Accreditation Documents: Health Care Professionals

General Requrements for professionals

Health Care Professional Provider Data Record

Annex B Professional Commitment for Health Care Professionals

Claims

CSF Claim Signature Form

CF1 Member and Patient Information

CF3 Patient's Clinical Record

CF2 Provider Information

Dialysis-Database

Certification on Diagnosis and Management of CKD Stage 5

Registration Form

E-Claims

NDA Non-Disclosure Agreement

SCA Software Accreditation Agreement

SCAF Software Certification Application Form

Employers

ER3 Employer Data Amendment Form

ER1 Employer Data Record

RF1 Employer's Remittance Report

ER2 Report of Employee-Members

Kasambahay

PPS-HEUR1 Household Employer Unified Registration Form

PPS-HEUR2 Household Employment Unified Report Form

PPS Household Payment Slip

PPS-KUR FORM Kasambahay Unified Registration Form

Membership

PMRF PhilHealth Member Registration Form

PMRF-FN PhilHealth Member Registration Form for Foreign Nationals

Payment

PPPS PhilHealth Premium Payment Slip