J

-
~,~
; .
' -~·-
,, ,,. -· .'
..: . \·".

.q
.
Republic oftire Plrllippi11es
PHILIPPINE HEALTH INSURANCE CORPORATION
Citystate Centre, 709 Shaw Boulevard, Pasig City
Call Center (02) 441-7442 Trunkline (02) 441-7444
www.philhealth.gov.ph __
--~·
--~
_.. .........,
....Jt•~··"''

PHILHEALTH CIRCULAR
NO. 2017- OO:Z.3

TO ALL ACCREDITED HEALTH CARE INSTITUTIONS AND

PROFESSIONALS, PHILHEALTH REGIONAL OFFICES,
LOCAL HEA,LTH INSURANCE OFFICES AND ALL OTHERS
CONCERNEI)

SUBJECT Accreditation of Nurses for Maternal and Child Health Services

(Revision -{J

I. RATIONALE:
Phi!Health is committed to help save mothers and newborns by providing them with
financial access to essential health services that will ensure their survival and well-being.
With this commitment and recognizing the role of the nurses in the health care delivery
system, the Corporation shall accredit nurses as professional health care providers for the
maternity care package (MCP), normal spontaneous delivery package (NSD), and newborn
care package (N CP) in accredited birthing homes.

The Revised Implementing Rules and Regulation/ s (RIRR) of RA 787 5 as amended, defines
a health care professional as any doctor of medicine, nurse, midwife, dentist, pl~armacist or
other health care professional or practitioner duly licensed to practice in the Philippines and
accredited by the Corporation. Furthermore, Sections 61 and 62 of the RIRR provide for
the requirements and process for accreditation of health care professionals, including
nurses.

The nurses play a vital role in the health care delivery system in the country. They comprise
a number of health care professionals and are one of the promoters of primary health care,
acting as front liners in communities to deliver public health care services.

This poliry shall serve as the guidelines in the accreditation of nurses as prwider for the maternity care
package (MCP), notmal spontaneous delivery package (NSD), and newborn care package (NCP) in
accredited birthing homes.

II. OBJECTIVES
The policy shall ensure that the health care services rendered I:J nurses to mothers and their newborn in
the birthing homes are of the desired and expected quality.

IlL SCOPE
This Circular shall apply to RN s seeking accreditation to become professional health care
providers for the MCP, NSD and NCP in birthing homes. The poliry also covers nurses who shall

~ teamphilhealth mwww.facebook.com/Phi!Health YouE www.youtube.com/teamphilhealth ~ [email protected]

 I ' 1 ,1'

~· •
•' .. '
. '

provide IUD insertion, subdermal contraceptive implant package and other family planning
services subject to additional requirements.

IV. GENERAL GUIDELINES

A. The RN s applying for accreditation shall be guided by the provisions of Phi!Health

Circular 10 s. 2014 "The New Accreditation Process for Health Care Professionals and
Guidelines for Credentialing and Privileging of Professionals".
B. The said nurse shall render sefllices for the matemi~ care package (M.CP), normal spontaneous delivery
package (NSD) and newborn care package (NCP) in accredited birthing homes.
C. The RN shall be allowed affiliation with a maximum of three (3) accredited non-hospital
birthing facilities.
D.AII Phi/Health Offices shall ensure appropriate and massive il!formation campaign efforts regarding this
issuance.

V. STANDARDS FOR ACCREDITATION OF NURSES

A. The nurse must be a licensed practitioner.
B. The RNs must adhere to the standards of nursing practice and Code of Ethics for RNs.
C. They must comply with the provisions set forth in the Performance Commitment for
professionals and any other requirements that may be determined by the Corporation.
D. They must be members of the National Health Insurance Program \vith qualifying
premium contributions. · .
E. The nurse must have completed training on Basic Emergency Obstetric and Newborn
Care from DOH institutions.
F. The nurse must have work experience for at least 2 years in the labor and delivery room
of at least a level one hospital.

VI. REQUIREMENTS FOR ACCREDITATION

A. Initial and Renewal
1. Updated PRC license or its equivalent;
2. Completely filled out Provider Data Record (PDR) (Atrnex A)
3. Filled out and signed performance commitment (PC) for health care professionals.
4. 2 pieces of 1" x 1" photo with the applicant's name at the back
5. Proof of payment of Premium contributions

B. Additional Requirements for Initial Accreditation

1. Certificate of training on the Basic Emergency Obstetric· and Newborn Care
(BEmONC) for nurses from a DOH-recognized training center for BEmONC skills
2. Certification of work experience for at least two (2) years in the labor and delivery
room of at least a level one (1) hospital
'
-':::'
..--
c. Additional Requirements For Professional Providers Who Will Provide Famify Planning Sefllices
Professional Health Care Providers who are accreditedfor Phi/Health's Matemi~ Care Package/NSD
.,_a;
ffi>-
I-lL 0 "'
Package in accredited birthing homes/ matemi~ and fying-in clinics are also qualified to provide health
services for some famify planning related procedures that are covered lqy Phi/Health, Thry are required to
(1)0 have competency/ ies to perform sitch procedures and shall be required to submit the following certificates of
~(.) ~ trainingfrom DOH recognized trainers prior to claims reimbursement:

u
C>

~ teamphilhealth IJ www.facebook.com/Phi!Heallh Yaallll!! www.youtubc.com/teamphilheallh ~ [email protected]

I '
.•'
~ ,''

.,

Provider Procedure to perform/ claim Certificate ofTraining to Submit

Nurse IUD insertion as ftrrt case rate on!J Fami!J Planning Competenry Based
Training (FPCBT) Level2, or
Comprehensive Family PlanninJ!. Courre
IUD insertion as first case rate Post-partum IUD Training Courre
IUD insertion as second case rate (e.g. post-
partum IUD insertion)
Subdermal Contraceptive Implant Package Certificate of Training on Subdermal
Implant Insertion and Removal

VII. MONITORING
Accredited nurses shall be subjected to performance monitoring as provided for in
Phi/Health Cif'CII/ar 2016-0026 "Health Care Provider Performance Assessment System Revi.rion 1".

VIII. SANCTIONS AND PENALTIES

Any violation of tbis circular, the terms and conditions of the Performance Commitment
and all existing related Phi!Health circulars, corporate office orders and directives shall be
dealt with and penalized in accordance with the pertinent provisions of RA 7875, as
amended, and its Implementing Rules and Regulations.

IX. REPEALING CLAUSE

All provisions of Phi/Health .Cif'CIIIar 0048-:- 2016 and Phi/Health CirC11far 10 s. 2014 that
are inconsistent with any provision of tbis circular are hereby amended/ modified/ or
repealed accordingly.

X. SEPARABILITY CLAUSE
In the event that a part or provision of tbis Circular is declared unauthorized or
rendered invalid by any Court of Law or competent authority, those provisions not
affected by such declaration shall remain valid and effective.

XI. DATE OF EFFECTIVITY:

This Cif'CIIIar shall take effect 011 October 1, 2017.

fir. fk,4; .
DR. CELE~TINA MA. JUDE P. DE LA SERNA
Interim/ OIC- President and CEO
n. gned f~:J.)- :1011

a:
llJ >-
fl "ro
1ti
i-0.. 0

<((_')
<OQ
2 ~
0
0

GJ teamphilhealth I) www.facebook.com/PhiiHealth You[ll) www.youtube.com/teamphilbealth ~ [email protected]

 ' ' .
• Republic of the Philippines
~
•
PHILIPPINE HEALTH INSURANCE CORPORATION
''' City State 709 Shaw Blvd., Pasig City
~
.

'' Health line 441-7442; 441-7444; www.philhealth.gov.ph

PHIC-ACCRE·AF-5
HEALTH CARE PROFESSIONALPROVIDER DATA RECORD

THE PRESIDENT & CEO

Philippine Health Insurance Corporation
Pasig City,

Sir/Madam:

I, , of legal age, hereby applies for accreditation under Sec. 52 of R.A.

7875 as amended by R.A 10606 and its Implementing Rules and Regulations thereto. For this purpose, 1 hereby submit
the following pertinent information and documentary requirements.

•NNO.I I I I I I I I I I I I -H I IATION NO.I 1- I I I I I I 1-1

rr 0 TION 12. TYPE OF IV"
General Practitioner (GP) 0 Dentist lo Initial 0 Re-accreditation
0 GP w/ Training Training : 0 Midwife I 0 Continuous
0 Medical i I: 0 Nurse
13. NAME OF PROFESSIONAL 14. For Females Only (Mother's Maiden Surname)
!First .
. . . ' .
·
IMiddie
IS. SEX
'
'

' '
16. CIVIL ::iiA~:;
. ' ' rr ' '
' ' ' ' ' '

0 Male 0 Female 1 "'""'" 0 Widow 0 Married D Separated

I7.BIRTI pATE,, E-MAIL
·r "" lB. 19. FAX NO. 110. oNO.

!Em~
No. I St. I Brgy. Municipality I City
-~
TOVIn<;e I ~ Zip Code No.
~ fY" :>- ',,; I
f2: ~
No. I St. I Brgy.
G;~ d
I 1 vii)'

1Zip 'Code
~(.)~ t No.

13. ·~•«>liT
:;,:> .14. YEAR \TED

(15. PRC NO.

t 1s. Data l•r•ct , 17. Valid up o
' ' I

fj8. RESIDENCY TRAINING (ForMS/ GP with Training) fear

Name of Hospital: Address of Hospital: !Started IEnded

19.
.
I ~
11
12
13
14
I2Q. t"AK I Nt:K I ,.;:_
!Care 'only)
~ ~ Middle-Name i No.
108
IPedia
For Phi!Health Use Only

'oate Evaluated: LHIO I IBy:

l-IllY I
PRO IPRO I
Control No.
;oate Received: ILHIO IBy: ILHIO
IPR() OR No.
~BQ Date Paid:
Date Encoded: I~~~:~a~aCE~~~;•hriog Mod11IB) \sy:
I L'"-·-..,('1
PR0
Am!. Paid.