Phil Health

Your Partner in Health

Philippine Health
Insurance Corporation

CITIZEN'S
CIIARIER
DBOOK
2020
I. Mandate
The National Health Insurance Program was established to provide health insurance coverage and ensure affordable, acceptable,
available and accessible health care services for all citizens of the Philippines. It shall serve as the means for the healthy to help pay
for the care of the sick and for those who can afford medical care to subsidize those who cannot. It shall initially consist of Programs
I and II or Medicare and be expanded progressively to constitute one universal health insurance program for the entire population.
The program shall include a sustainable system of funds constitution, collection, management and disbursement for financing
the availment of a basic minimum package and other supplementary packages of health insurance benefits by a progressively
expanding proportion of the population. The program shall be limited to paying for the utilization of health services by covered
beneficiaries. It shall be prohibited from providing health care directly, from buying and dispensing drugs and pharmaceuticals,
from employing physicians and other professionals for the purpose of directly rendering care, and from owning or investing in
health care facilities. (Article III, Section 5 of RA 7875 as amended)

II. Vision
“Bawat Filipino, Miyembro,
Bawat Miyembro, Protektado,
Kalusugan ng Lahat, Segurado”
III. Mission
“Benepisyong Pangkalusugang Sapat at De-kalidad para sa Lahat”

IV. Service Pledge

Kami ay nangangakong ilalaan ang mga sarili sa pagsasakatuparan ng Kalusugang Pangkalahatan.
Sisikapin naming makapagbigay nang mabilis at dekalidad na serbisyong pangkalusugan sa lahat ng Pilipino, ano man ang edad,
kasarian o estado ng pamumuhay.
Kaagapay namin ang mga miyembro sa pagtataguyod ng pagkakaisa bilang isang konseptong mahalaga sa pagkamit ng aming
layunin.
Patuloy naming paghuhusayin ang aming mga serbisyo at titiyaking ang mga ito’y umaayon sa nagbabagong panahon at
sumasabay sa pandaigdigang pamantayan.
Titiyakin naming laging mauuna ang serbisyo-publiko at taas-noo na maglilingkod sa bayan.
Sisikapin naming maging huwarang kawani at makamit ang tunay na pagbabago sa ating bansa.
 LIST OF SERVICES
External Services
Operations Sector
Central Office - Office of the Area Vice Presidents (Areas I, II, III & IV)

1. Processing of Letter of Requests/queries/issues/concerns sent by internal and external clients

PhilHealth Regional Offices (PROs CAR, I, II, III, IVA, IVB, V, VI, VII, VIII, IX, X, XI, XII, Caraga & BARMM)
I. Office of the Regional Vice-President
A. Planning Unit
1. PhilHealth Regional Office Level Data Request of National Health Insurance Program
Stakeholders
II. Management Services Division
A. General Services Unit
1. Sale/Issuance of Bidding Documents
B. Fund Management Section
1. Payment of Benefit Claims to Health Care Institutions (HCIs)
III. Health Care Delivery Management Division
A. Benefits Administration Section
1. Filing of Claims
2. Processing of Filed Benefit Claims of Health Care Institutions (HCIs)
B. Accreditation Section
1. Processing of Application for Accreditation of Health Care Institution
IV. Field Operations Division
Local Health Insurance Office (ALL PROs)
A. Membership Section
1. Enrollment/Registration of Members
2. Enrollment/Registration of Employers
3. Updating of MDR through Online Methods (LHIO Emails)
4. Member Registration through Online Method
5. Processing of Inquiry of walk in clients
B. Collection Section
1. Inquiry on PhilHealth Collection
2. Request for refund of Double Payment per CO No. 2020-0025
3. Collection of Premium Payment
C. Support Services

1. Approval of Requests by the Regional Vice-Presidents concerning Membership and Collection

2. Approval of Requests for Orientation
D. Local Health Insurance Office Services
1. Public Assistance Services
2. Member Registration through Online Method
3. Online Application and processing of Inquiry of walk in clients
4. Enrollment of Formal Sector Employees (5 employees and below)
5. Enrollment of Household Employees (5 employees and below)
6. Enrollment of Individuals - Lifetime Members
7. Enrollment of Individuals - Senior Citizens
8. Enrollment of Individuals - Informal Sector
9. Enrollment of Individuals - Foreign Nationals
10. Enrollment of Individuals - Landbased Migrant Workers
11. Declaration of Dependents
12. Updating of Membership Records
13. Request for Records (Client is the owner of the requested record)
14. Request for Records (Requested through a representative)
15. Registration of Employers
16. Registration of Household Employers
17.Collection of Premium Contribution (Formal economy, Informal economy and Landbased
Migrant Workers)
18. Submission of Remittance Report (RF1) for employers in Geographically Isolated and
Depressed Areas (GIDA) only.
19. Receiving of directly filed claims
20. Receiving of application for accreditation by Health Care Institutions
21. Receiving of application for accreditation by Health Care Professionals
22. Check Releasing (Member)
 23. Check Releasing (picked-up by stakeholders)
24. Request for Other Services
V. PhilHealth Express Office
1. Member Registration and Issuance of Member Data Record and PhilHealth Identification Card
VI. POEA-OFP Operations Satellite Office
1. Member Registration and Issuance of Member Data Record and PhilHealth Identification Card
** Office of the Area Vice-President/Office of the Regional Vice-President - Health Care Delivery
1. Manage Release of Funds through Interim Reimbursement Mechanism (IRM)
Corporate Affairs Group (CAG)
I. Corporate Action Center(CAC)
1. Handling of Simple Client Queries and Feedback thru Calls
2. Handling of Complex Client Queries and Feedback thru Calls
3.Handling of Technical Client Queries and Feedback thru Calls
4. Handling of Client Queries and Feedback thru Email (Level 1- for direct resolution)
5. Handling of Client Queries and Feedback thru Email (Level 2- for endorsement to other office)

6. Handling of Client Queries and Feedback via Email

7. Handling of Client Queries and Feedback via Social Media and SMS (Level 1- for direct
resolution)
8. Handling of Client Queries and Feedback via Social Media and SMS (Level 2- for endorsement
to other office)
9. Handling of Technical Client Queries and Feedback via Social Media and SMS
10. Handling of Complex Client Queries and Feedback via letter
11.Handling of Client Queries and Feedback via letter (Level 2 - for initial response of CAC and
resolution of other office)
12. Handling of Simple Client Queries and Feedback lodged to Government Channels (Level 1 -
for direct resolution of CAC)
13. Handling of Complex Client Queries and Feedback lodged to Government Channels
(Level 1 - direct resolution, Complex - with no available spiel)
14. Handling of Client Queries and Feedback lodged to Government Channels
(Level 2 - for endorsement to other office)
15. Handling of Client Queries and Feedback lodged to Government Channels
16. Handling of Simple Client Queries and Feedback via CAC Walk-In Counter
 17. Handling of Complex Client Queries and Feedback via CAC Walk-In Counter
18. Handling of Technical Client Queries and Feedback via CAC Walk-In Counter
II. Corporate Marketing Department (CorMar)
1. Request for Clearance of Material/s from External Partners
2. Request for Approval of Sponsorship Proposal
III. International and Local Engagement Department (ILED)
1. Evaluation of Project Proposals for Local Engagement
2. Evaluation of Project Proposal on Foreign Assisted Projects Evaluation of Invitation to
International Events/Activities
3. Evaluation of Invitation to International Events/Activities
IV. Social Health Insurance Academy (SHIA)
1. Conduct of Certificate Course on ICD-10 Training
Fund Management Sector (FMS)
I. Comptrollership Department
A. Corporate Accounting Section (CAS)
1. Securing Order of Payment Document
2. Preparation of Financial Statements
B. Disbursement Administration Section (DAS)
1. Processing of Disbursement Vouchers
C. Fiscal Management Division (FMD)
1. Budget Proposal for the National Government Subsidy (NG) - Sponsored Members
II. OSVP-Fund Management Sector
A. Managerial Finance Section
1. Issuance of Financial Reports
III. Treasury Department
A. Agents Relations Unit Accreditation Team
1. Accreditation of Collecting Agents - Processing of PhilHealth Accredited Collecting Agents
Application
2. Accreditation of Collecting Agents - Evaluation of the Audited FS of the Applicant
3. Accreditation of Collecting Agents - Conduct of Meetings
4. Accreditation of Collecting Agents -Processing of the Non-Disclosure Agreement of the
Applicant
5. Accreditation of Collecting Agents - Conduct of User Acceptance Test of Applicant's System
 6. Accreditation of Collecting Agents - Preparation of the PCA AccreCom Resolution
7. Accreditation of Collecting Agents -Processing of the Collection and Remittance Agreement

8. Accreditation of Collecting Agents - Processing of the Accreditation Fee Payment of ACAs

9. Accreditation of Collecting Agents - Preparation of the Advisory
10. Accreditation of Collecting Agents - Processing of the BUR for the Payment of Transaction
Fees to ACAs
B. Data Management and Systems Monitoring Unit (DMSMU), Accreditation Team
1. Distribution of PhilHealth Agents Receipt (PAR)
C. Standards, Enforcement and Reconciliation (SERU), Accreditation Team
1. Monitoring of Accredited Collecting Agents’ (ACA) Remittances, Reports and Documents
2. Refund Of Premium Contribution
D. Cash Division
1. Remittances
2. Payment of Approved Disbursement Vouchers
E. Investments Division
1. Accreditation of Government Securities Eligible Dealers (GSEDs)
Health Finance Policy Sector (HFPS)
I. Accreditation Department
A. Accreditation Compliance Review Division
1. Receiving & Processing of Appeal/Motion for Reconsideration of HCPs
2. Receiving & Processing of Data Amendment Form (DAF) in the Integrated PhilHealth
Accreditation System (iPAS)
3. Processing of Data Amendment Form (DAF) in the Integrated PhilHealth Accreditation System
(iPAS)
4. Enhancement of Integrated PhilHealth Accreditation System (iPAS)
B. Accreditation Policy Research Development Division
1. Receiving and Processing of Contracts of HCIs as Z benefit package providers
2. Policy Development
C. Office of the Manager
1. Inquiries from Internal/External Stakeholders thru Email/Mail (Simple)
2. Inquiries from Internal/External Stakeholders thru Email/Mail (Complex)
3. Inquiries from Internal/External Stakeholders thru Email/Mail (Highly Technical)
 II. Office of the Senior Vice President-HFPS
1. Inquiries from Internal/External Stakeholders thru Email/Mail
III. Philhealth CARES
1. Customer Assistance
2. Conduct of PhilHealth Patient Exit Survey
IV. PhilHealth Malasakit Center
1. P- Malasakit Center Customer Assistance
Information Management Sector (IMS)
I. Information Technology Management Department (ITMD)
A. Information System Management Division (ISMD)
1. Processing of Software Certification/ Compliance Request
2. Registration to PhilHealth Systems and Integration Services
3. Software Development Services
4. Support Management Services
5. System Integration and Data Sharing Services
II. Project Management Office- PhilHealth Identity Management System (PMO-PIMS)
1. External Collaboration
Legal Sector
I. Fact-Finding Investigation and Enforcement Department
1. Conduct of Fact-Finding Investigation
2. Processing Of Complaints From Walk-In Clients
II. Protest and Appeals Review Department
1. Resolution of Appeals on Denied or Reduced Benefit Claims Filed by the Member and Hospital
Appellant
Member Management Group
I. All Departments
1. Coordinate External Events / Activities of Formal Sector
2. Evaluation of Billing Documents by the Head Collection Division.
3. Evaluation of Received Documents for Review/Action and Approval of Collection Head.
4. Formulation and Development of Programs / Policies and Activities pertinent to membership
and contributions.
II. Overseas Filipino Program
1. Adjustment, Correction and Deletion of Premium Contribution (Walk-in and Through E-mail)
 2. Amendment of Member Data Record (Walk-in and through e-mail)
3. Enrolment Procedures (Walk-in and Through E-mail)
4. Handling of Inquiries: Guidelines on Membership, Contribution and Benefit Availment and
Claims Concerns
5. Issuance of PhilHealth ID (Walk-in)
6. Issuance of Member Data Record (Walk-in and Through E-mail)
7. PIN Verification (Walk-in and Through E-mail)
8. Posting of Premium Contribution (Walk-in and through e-mail)
9. Receiving and Endorsement of Overseas Confinement Claims (Filed through E-mail)
Office of the President and Chief Executive Officer (OPCEO)
1.Management of Documents - External
I. Corporate Planning (CorPlan)
A. Knowledge Management Unit (KMU)
1. Processing of External Data Requests (Highly Technical)
2. Processing of External Data Requests (Complex)
3. Processing of External Data Requests (Simple)
4. Processing of External Data Requests (through eFOI Portal)
II. Office of the Corporate Secretary (CorSeC)
1. Issuance of Minutes of Meeting
2. Issuance of Philhealth Board Resolutions (PBRs)
III. Secretariat for the Bids and Awards Committees (SBAC)
1. BAC Secretariat Services
2. Procurement Services

Internal Services
Operations Sector
Central Office - Office of the Area Vice Presidents (Areas I, II, III & IV)
1. Monitoring of PhilHealth Regional Offices concerns communicated to the Central Office
2. Processing of Letter of Requests/queries/issues/concerns sent by internal clients
3. Manage Release of Funds through Interim Reimbursement Mechanism (IRM)
 PhilHealth Regional Offices (PROs CAR, I, II, III, IVA, IVB, V, VI, VII, VIII, IX, X, XI, XII, Caraga & BARMM)
I. Office of the Regional Vice-President
A. Information Technology Management Section
1. Manage System or Application Account
2. Manage Resetting of Network and email account
B. Public Affairs Unit
1. Issuance of Radio Program Scripts and Discussion Guides by LHIOs
2. UHC Orientation to New Employees
3. Approval of Social Media Content Development
4. Approval of Design and Layout of Tarpaulin and Collaterals
5. Request for Events Documentation and Assistance
6. Issuance of Corporate Identity Clearance (Brand Monitoring)
7. Provision of News Briefer to RVP and Officers
C. Legal Services Unit
1. Issuance of Legal Opinions
2. Conduct of Contract Review for Contracts / Agreements entered into by the PRO
3. Issuance of Final Demand Letter
4. Filing of Collection Cases Against Erring/Non-Remitting/Non-Compliant Employers or
Members
Actuarial Services and Risk Management Sector
I. Corporate Information Security Department (InfoSec)
1. Information Security Incident Management (Simple)
2. Information Security Incident Management (Complex)
3. Information Security Incident Management (Highly Technical)
4. Information Security Policy and Protocols Development
5. Monitoring of Information Security Policy and Protocols
6. Safekeeping of Tape Vault Storage
7. Retrieval Tape Vault Storage
II. Office of the Actuary
1. Estimation of Claims Liability Reserve: Incurred But Not Paid (IBNP) & Incurred But Not
Reported (IBNR)
2. Issuance of Actuarial Certification for Membership and Contribution Updates
3. Issuance of Actuarial Certification for Membership and Contribution Updates
 III. Project Management Team for Risk Management (PMT-RM)
1. Issuance of Risk Assessment Certification (RAC) for New and Amended Programs, Projects,
and Policies
Corporate Affairs Group (CAG)
I. Corporate Action Center(CAC)
1. Request for Existing Client Feedback Report
2. Request for Generation of New Client Feedback Report
II. Creative Arts and Design Team (CADT)
1. Development of Design/Lay-out of Printed Information Materials
2. Request for the Development of Design/Lay-Out for Marketing Collaterals
3. Request for the Development of An Audio-Visual Material/Production (AVP) or Corporate
Video
4. Request for the Development of Lay-Out/Design for Social Media Cards and Other Digital
Materials
5. Request for the Development of Lay-Out/Design for Brand Elements and Other Corporate
Materials
III. Corporate Communication Department (CORCOM)
1. Communications Development- Social Media
2. Communications Development- PC Tamang Sagot
3. Communication Management- Website Management
4. Monitoring and Evaluation- Press Releases- (NRUR)
5. Communication Management- Press Releases
6. Monitoring and Evaluation- News Releases
7. Communication Management- Preparation of PRs
IV. Corporate Marketing Department (CorMar)
1. Request for Existing Marketing Materials
2. Request for Procurement of Corporate Giveaways, Promotional Items, Event Material (i.e.
Tarpaulin Banner, Invitations)
3. Request for Clearance of Corporate Giveaways/Promotional Items/Event Materials Developed
by Other Offices Especially PROs
4. Request from Other PhilHealth Offices for Customized Material
5. Request for Development of Audio-Video Presentation (AVP) including Procurement
6. Request for Development of Print Information Material Including Procurement
 7. Request for Marketing Campaign/Plan for a Specific Benefit or Service
8. Request for Event Assistance (Includes selection of venue, venue set-up, invitation, program,
and other event requirements) Including Procurement
9. Endorsement to Proponent/End-User of Requested Information Material/Corporate
Giveaway/Promotional Item/ Event Material
V. International and Local Engagement Department (ILED)
1. Evaluation of Project Proposals for Local Engagement
2. Evaluation of Project Proposal on Foreign Assisted Projects
3. Assistance in Application/renewal of Official Passports
VI. Social Health Insurance Academy (SHIA)
1. Request for Orientation on UHC IRR
2. Request for a Conduct 5-Day Training of Certificate Course on ICD-10
Fund Management Sector (FMS)
I. Comptrollership
A. Branch Accounting Unit
1. Preparation of PRO Consolidated Trial Balance
B. Corporate Accounting Section (CAS)
1. Preparation of Financial Statements
2. Securing Order of Payment
C. Disbursement Administration Section (DAS) Remittance Unit
1. Processing of Disbursement for Statutory Remittances
D. Disbursement Administration Section (DAS)
1. Processing of Bonds for Accountable officers (SDOs, SCOs and property officers)
2. Processing of CAF
3. Processing of Disbursement Vouchers
4. Processing of Payroll Deduction-GSIS, Pag-Ibig, Provident Fund
E. Fiscal Management Division (FMD)
1. Corporate Operating Budget (COB) Preparation
2. Funding of Financial Transactions
3. Release of Funds
F. Budget Administration Section (BAS)
1. Budget Execution -Earmarking - Processing of Financial Transactions Needing Certification of
Budget Availability in the Head Office (ABC)
 2. Budget Execution -Earmarking - Processing of Financial Transactions Needing Certification of
Budget Availability in the Head Office (CPO)
3. Budget Execution - Obligation of Budget Utilization (CAPEX)
4. Budget Execution - Obligation of Budget Utilization (MOOE)
5. Budget Execution - Obligation of Budget Utilization (PS)
G. System Support and Development Office
1. Clearance Request
2. FARU Data Extraction
3. FARU Library Maintenance
4. FARU Support for FMS Personnel
5. FARU Hardware/Software System Support
II. Office of the Senior Vice President-Fund Management Sector
A. Managerial Finance Section
1. Issuance of Financial Reports
III. Treasury Department
1. Payment of Approved Disbursement Vouchers
Health Finace Policy Sector (HFPS)
I. Accreditation Department (AD)
A. Office of the Manager
1. Inquiries from Internal/External Stakeholders thru Email/Mail (Simple)
2. Inquiries from Internal/External Stakeholders thru Email/Mail (Complex)
3. Inquiries from Internal/External Stakeholders thru Email/Mail (Highly Technical)
II. Benefits Development and Research Department (BDRD)
1. Development of New Benefits
2. Review of Existing Benefit Packages
III. Office of the Senior Vice President-HFPS
1. Inquiries from Internal/External Stakeholders thru Email/Mail
IV. Philhealth CARES Management Office (PCMO)
1.Consolidation of Quarterly Reports for P-CARES
2. Consolidation of Quarterly Reports for P-Malasakit Personnel
3. Consolidation of Quarterly Reports for Reachout
4. Policy Development for P-CARES, Reachout and P-Malasakit
5. Processing of PhilHealth Patient Feedback Form
 V. Program Management Team for Claims (PMT-Claims)
1. Approval of Data Amendment Requests
2. Generation of Requested Reports on PhilHealth Corporate Dashboard / NCLAIMS
3. Policy Development for Claims Processing
4. System Enhancement Requests
VI. Standards and Monitoring Department
1. Health Care Provider Performance Assessment Systen (HCPPAS) - Management of
Complaints/Reports/Referrals (Complex)
2. Health Care Provider Performance Assessment Systen (HCPPAS) - Management of
Complaints/Reports/Referrals (Highly Technical)
3. Health Care Provider Performance Assessment Systen (HCPPAS) - Referral to Quality
Assurance Committee (QAC) from PROs
4. Provide technical assistance to other organizational units that require expert medical advice
and inputs (Complex)
5. Provide technical assistance to other organizational units that require expert medical advice
and inputs (Highly Technical)
Information Management Sector (IMS)
I. ICT Planning, Policy and Standards Division (IPPSD-OCIO)
1. Preparation of Initial Draft of ICT Policy/Standard Operating Procedure (SOP)
2. Review of ICT Policy/Standard Operating Procedure (SOP) (Initial Draft)
3. Sending Out of ICT Policy/Standard Operating Procedure (SOP) for Review
4. Finalization and Approval of Policy/SOP
5. Conduct Risk Assessment
6. Assessment of Standards on Corporate Issuance
7. Conduct Policy/SOP Review-Other Offices
8. ICT TOR / Tech Specs Review
9. Preparation of IT Preventive Maintenance (ITPM) Analytical Report
10. Preparation of Analytical Report on the IMS Client Satisfaction Feedback
11. IT Procurement Clearance
12. Arrangement of ISSP Development Meeting / Forum / Workshop
13. Conduct of Meeting, Forum, or Workshop on ISSP Development, Validation or Updating
14. Memorandum and Materials Preparation for ISSP-related Data/Information Gathering
15. ISSP Data Consolidation - Narrative, Diagrams, and Annexes
 16. ISSP Preparation of Initial Draft - Narrative, Diagrams, and Annexes
17. Data and Information Gathering for the ISSP-ICT Resource Requirements
18. Preparation of ICT Resource Proposals
19. ISSP Revision (Draft Original or Revised Version of an Approved ISSP)
20. Finalization of ISSP (Draft Original or Revised Version of an Approved ISSP)
21. Submission of PCEO-Approved ISSP (Original or Revision of an Approved ISSP) to DICT for
Review and Endorsement
22. Dissemination of DICT-endorsed ISSP
a. IT Helpdesk
1. Escalation and Monitoring
2. Issuance of IT Advisory
3. Management of User Accounts
II. Information Technology Management Department (ITMD)
a. Information Technology Resource Management Division (ITRMD)
1. Manage Request for Data Editing Service
2. Manage Auto Renewal of Sponsored Members
3. Manage Request for Uploading of External Data
4. Managed Request for Database Update
5. Manage Request for Deactivation of Database Account
6. Manage Request for Clearance of Separated Employees
7. Manage Request for Replication of New Tables
8. Manage Request for Document Review
9. Management of New Server Creation
10. Management Request for System Update
11. Management of Operating System Repair and Installation
b. Information System Management Division (ISMD)
1. Processing of Software Certification/ Compliance Request
2. Registration to PhilHealth Systems and Integration Services
3. Software Development Services
4. Software Outsourcing Services
5. Software Quality Assurance Services
6. Support Management Services
7. System Integration and Data Sharing Services
 8. Website and Intranet Management Services
III. Project Management Office – PhilHealth Identity Management System (PMO-PIMS)
1. Conduct Problem Management
2. Provide support to Integrated Project Management Tool (IPMT) Users
3. Generate Microsoft Teams (MS Teams) Link for Video Conference
IV. Task Force Informatics (TFI)
1. Data Extraction
2. Dashboard or Reports Creation
Legal Sector
I. Arbitration Office
1. Issuance of Documents
2. Issuance of Certification on Pending or No Pending Administrative Case Against Health Care
Providers (HCPS) and Members
II. Fact-Finding Investigation and Enforcement Department
1. Issuance of Certificate of Ongoing/Pending Investigation Against a Health Care Provider
III. Internal Legal Department
1. Issuance of Contract Review from Internal Legal Department
2. Issuance of Legal Opinion from Internal Legal Department
3. Handling of Appeals and Special Cases
4. Remittance Enforcement
IV. Office of the Senior Vice President, Legal Sector
1. Issuance of Contract Review from Office of the Senior Vice President, Legal Sector
2. Issuance of Legal Opinion from Office of the Senior Vice President, Legal Sector
V. Prosecution Department
1. Certification on Pending/Ongoing Administrative Complaints against Health Care Providers
(HCPS) and Members
Member Management Group (MMG)
I. All Departments
1. Coordinate Internal Events/Meetings/Activities of Program Monitoring and Database
Management Division
2. Evaluation of received documents for review/action and approval of Collection Head.
3. Evaluation of received documents for review/approval of Vice President, Member
Management Group
 4. Formulation and Development of Programs / Policies and Activities pertinent to membership
and contributions.
5. Periodical Submission of Progress Report pursuant to Institutionalization of the PhilHealth
Accounts Management and Monitoring Strategy (PAMMS)
6. Evaluation of Billing Documents by the Head Collection Division
II. Formal Sector
1. Improvement of collection effort thru closely monitoring of all issued Memos to attain the
objective of various OCOO Memos pursuant to PhilHealth Accounts Management and
Monitoring Strategy (PAMMS)
III. Operation Support Division
1. Development of Business or User Requirements Specificationf for the the Development and
Enhancement of IT Support System Applications for Membership and Contributions
2. Technical Support on Membershi and Contributrions Information
IV. Program Monitoring and Database Management Division (PMDMD)
1. Database Quality and Analysis
Management Services Sector (MSS)
1. Corporate Personnel Order for MSS Approval
2. Request for Emergency Fund
3. Technical Evaluation for MSS Approval
I. Human Resource Department
1. Application for Leave
2. Issuance of Certificate of Performance Rating
3. Issuance of Certificate of No Pending Case
4. Issuance of Employee Record
5. Processing of Application for Study Leave /Vacation Leave for purposes of Study
6. Processing of Salary
7. Process Request for External Training
8. Request for Employee Record
a. Clinic
1. Clinic Services Availment
2. Medical Consultation
b. Daycare
1. Daycare Service
 II. Physical Resources and Infrastructure Department (PRID)
a. Property and Supply Management Division (PSMD)
1. Documentation and Distribution of Property to End User
2. Inspection of Property
3. Supplies Management
4. Supplies Management - Semi-Expendable Items
b. General Services Building Management Division (GSBMD)
1. Request for Fund for Leasehold Improvements Project
2. Request for the Provision of Corporate’s Vehicles
3. Request for Replacement of Busted Lights and other Building Maintenance Concerns
4. Request for Technical Assistance for MYOA and Office Space Evaluations
5. Request for Technical Assistance for Office Design
Office of the President (OP)
I. Corporate Planning (CorPlan)
a. Performance Management Unit (PMU)
1. Issuance of Corporate Quarterly and Annual scorecard (in compliance to Governance
Commission for GOCCs)
2. Issuance of Corporate Performance and GCG Commitment Reports
3. Onsite Validation of Scorecard
II. Office of the Corporate Legal Counsel (OCLC)
1. Corporate Legal Services - Review of documents prior to approval of the President and CEO
(Legal Documents)
2. Corporate Legal Services - Review of documents prior to approval of the President and CEO
(MOA/Contracts)
III. Office of the Corporate Secretary (CorSec)
1. Issuance of Board and Committee Directives
2. Issuance of Minutes of Meeting
3. Issuance of Philhealth Board Resolutions (PBRs)
4. Issuance of for Secretary’s Certificate
IV. Office of the President and CEO (OPCEO)
1. Management of Documents - Internal
V. Organization and Systems Development Office (OSDO)
1. Procedural Document Review
 2. Staffing Assessment
VI. Secretariat for the Bids and Awards Committees (SBAC)
1. Procurement, Planning, Policy and Monitoring
EXTERNAL SERVICES
OPERATIONS SECTOR
1. Processing of Letter of Requests/queries/issues/concerns sent by internal and external clients
The Office of the Area Vice-President shall facilitate the processing of letter of requests, queries, issues and concerns of external clients .

Office/Division: Office of the Area Vice Presidents (Areas I, II, III & IV)
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who may avail: Local Health Insurance Office Heads
and Local Health Insurance Office
Information Officer-designate
CHECKLIST OF REQUIREMENT WHERE TO SECURE
Letter of Request/Memoranda/Instructions/Routing Slips (1 Original/Scanned Central Office Sectors/Departments/Other Stakeholders
Copy)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Forward Memo/Instructions/ 1.1 Receive memo/instructions/ None 1 Day Clerk III,
Routing Slip to Area Office concerned routing slip from offices concerned Office of the Area Vice Presidents
communicating their concerns thru
private mail/email/personal delivery
1.2 Print and write control number at the None Clerk III,
bottom of the documents and logs it Office of the Area Vice Presidents
1.3 Review communication and None Executive Assistant III,
proposes course of action or completed Office of the Area Vice Presidents
staff work before forwarding the
document to the AVP
2. Receive reply memo from Area 2.1 If concern can be resolved within None 2 Days Chief Social Insurance Officer/
Office/PRO AVP’s authority, Area Office staff Executive Assistant/Senior Social
prepares reply within 2 days Insurance Officer
2.2 For issues needing the intervention None
of the PROs, the Area Office transmits
the scanned documents via email to
the PRO concerned and the PRO shall
then prepares reply within 2 days upon
receipt.
3. Mark as “closed” in incoming/ 3.1 Mark as “closed” in incoming None Clerk III,
outgoing logbook/e-logbook logbook/e-logbook Office of the Area Vice Presidents
Total: None 3 days
1. PhilHealth Regional Office Level Data Request of National Health Insurance Program Stakeholders
Planning Unit shall provide and clear NHIP Records and Data to the requesting party
Office/Division: Office of the Regional Vice-President - Planning Unit
Classification: Highly Technical
Type of Transaction: G2G - Government to Government ; G2B - Government to Business
Who May Avail: PhilHealth Divisions/ Sections/ LHIOs/ Stakeholders
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
For external clients : Letter of Request addressed to the RVP (1 original Client’s request letter
copy)
For internal clients : Data Request Form (DRF) - 1 original copy Planning Unit
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit Request letter to 1. Planning Unit to evaluate the request For government agencies/ donors/ sponsors and 3 days Planning Officer
LHIOs/ Regional Office and Data Request Form (DRF) for as directed by judicial courts: Office of the Regional Vice-
completeness of entries President
1.1 For requests concerning the a. Data published in corporate website- free of 7 days Compliance Officer for Privacy
provisions of the Data Privacy Law, charge Office of the Regional Vice-
secure clearance from the Compliance b. Customized format data President
Officer for Privacy (COP) - Labor cost - Php 75.00 per hour
None 2. Seek approval of Data from the - Computer Time & Operating Cost - Php 10.00 3 days Regional Vice President
Regional Vice President per hour Office of the Regional Vice-
-Printing/ Duplication/ Reproduction Cost - Php President
2.00 per page
For Research Organizations/ Researches/ Students
and Agencies with Jurisdiction over institutions
and individuals
a. Data published in corporate website = Php 25.00
for the 1st Page documents print and additional
cost per table/ page document print
None 3. If fees are required, refer to cashier for b. Customized format data 3 days Cashier Section
payment - Labor cost - Php 150.00 per hour
- Computer Time & Operating Cost - Php 20.00
per hour
-Printing/ Duplication/ Reproduction Cost - Php
5.00 per page
Total: 19 days
1. Sale/Issuance of Bidding Documents
The General Services Unit of the regional offices shall inform the public for prospective bidders to purchase bidding documents for them to qualify to join in
a specific project using Competitive Bidding as procurement mode

Office/Division: Management Services Division (MSD) - General Services Unit

Classification: Simple Transaction
Type of Transaction: G2G - Government to Government ; G2B - Government to Business
Who may avail: Prospective Suppliers
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
1. Letter of Intent to purchase the bidding documents (1 original copy) Prospective Bidder/Supplier
2. Order of Payment Slip (1 original copy) Cashier of the PhilHealth Regional Office
3. Offical Receipt/Proof of Payment (1 original copy) Cashier of the PhilHealth Regional Office
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME* PERSON RESPONSIBLE
1. The prospective bidders will inform the 1. Issuance of Order of Payment to None 30 minutes PRO SBAC
PRO SBAC of their intent to purchase the prospective bidders
bidding documents
2. The prospective bidders shall proceed to 2. Issuance of Official Receipt/Proof of depends on the amount indicated in 2 hrs PRO Cashier
the Cashier to payment the corresonding fee Payment the Bidding Documents (should be
indicated in the Order of Payment in accordance with RA 9184)
3. The prospective bidders shall present 3. Issuance of Bidding Documents None 1 hr PRO SBAC
to SBAC the official receipt for issuance of
Bidding Documents
Total: 3 hours and 30 mins
1. Payment of Benefit Claims to Health Care Institutions (HCIs)
The Fund Management Section of the regional office shall generate checks and/or credits payment to HCI bank accounts for all benefit claims received from
Benefit Administration Section (BAS)
Office/Division: Management Services Division (MSD) - Fund Management Section (FMS)
Classification: Complex
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who may avail: Health Care Institutions
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
1. Benefit Disbursment Voucher Summary (BDVS) (1 original copy) Benefit Administration Section (BAS) of the PRO
2. Provider Account Benefit Notice (PABN) (1 original copy) Benefit Administration Section (BAS) of the PRO
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
None Receive and route Benefit None 2 Working Days Clerk
Disbursment Voucher Summary Management Services Division
(BDVS) for signature of Box B and Box
C
None Processing of Benefit Disbursment None 1 Working Day Fiscal Planning Assistant B
Voucher Summary (BDVS) payment
1. Regularly monitor their Bank Releasing of Authority to Debit None Every Wednesday after cut-off period Head-Cashiering Unit
Account Account
2. Pick-up ACPN on the nearest Releasing of Auto Credit Payment None 3 Working Days Fiscal Clerk III
LHIO Notice to Health Care Institutions
(HCIs)
3. Issuance of Official Receipt Encode details of ORs to BPS None 3 minutes Cashier/Fiscal Clerk III
TOTAL: None 4-7 days
1. Filing of Claims
External Service that is responsible for the processing and payment of benefit claims; Pay all good claims submitted by HCIs and individual members and their
Office: Branch Offices
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: HCPs (doctors & facilities), OFW, member beneficiaries and their dependents
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
For HCIs: Claim Summary Form (CSF) - 1 scanned copy
Statement of Account (SOA) - 1 scanned copy
Claim Form 3 (CF3), Maternity Related as may be applicable - 1
scanned copy
Claim Form 4 (CF4) - 1 scanned copy
Other required documents depending on the illness (1 scanned
copy) Health Care Institution's (HCIs)/Health Care Providers (HCPs)
- Clinical Chart , Laboratories, X-Ray
- PhilHealth Accredited
-Claim Summary Form (CSF for COVID Testing)
For members filing directly: Claim Form 1/Claim Form 2
(CF1/CF2) - 1 original copy
Original Receipt (OR) - 1 original copy)
Complete hospital records - 1 original copy
Statement of Account (SOA) - 1 original copy
Waiver - 1 Original copy
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
For HCIs: Submission of claims ( E- 1.1 Received the claims through the
Claims) Certified Service Providers
*Claims may be filed within 60
days from the date of
confinement of the patient

HCI submits E-Claims through

Certified Service Providers None 1 Hour Claims Assignor
TOTAL: None 5 Minutes
For members Filing Directly : 1.1 Direct client/s to the
*Claims may be filed within 60 appropriate front line service.
days from the date of Provide the priority number to
confinement of the patient client/s.
* Claims Confinement Abroad may
be filed with 180 days from the
date of confinement

1. Secure information and/or

queuing number at the Public
Assistance Desk or if applicable,
Special Lane Section for PWDs/
pregnant women and Senior
Citizens 1 Minute Public Assistance Staff
2.
When priority number is called,
proceed to Frontline Service 2.1 Receive and screen claims as to
Counter and submit claims the correct number and names of None
together with the transmittal list claimants against transmittal list.
3. Affix initials to copy of 3. Stamp “received” on the
transmittal list, if with correction. transmittal list if there are no
deficiencies in the transmittal and
total number of claim; if there is/are
name/s listed but no claims attached,
cross-out name/s in the list and have
the transmittal list initialed by the
hospital representative/health care
provider.

5. Return received copy of transmittal

list to hospital representative/health
care provider and advise client that
4.Receive copy of acknowledged processing of claims will be done 30 minutes for every 100
transmittal list within the 60-day period Claims Receiving Clerk
TOTAL: None 31 Minutes
2. Processing of Filed Benefit Claims of Health Care Institutions (HCIs)
The Benefits Administration Section of the regional office shall pay all good claims submitted by HCIs and individual members and their dependents for their in-patient
Office/Division: Health Care Delivery Management Division - Benefits Administration Section
Classification: Highly Technical
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: Health Care Institutions
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
1. For HCIs: CSF (1 scanned copy) Health Care Institutions (HCIs)
2. SOA (1 scanned copy) Health Care Institutions (HCIs)
3. CF4 (1 scanned copy) Health Care Institutions (HCIs)
4. Other required documents depending on the illness Health Care Institutions (HCIs)
5. For members filing directly: CSF (1 original copy) Health Care Institutions (HCIs)
or (1 original copy) Health Care Institutions (HCIs)
Complete hospital records (1 original copy) Health Care Institutions (HCIs)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME* PERSON RESPONSIBLE
1. For Health Care Institutions 1.1 Receive the documents None 1 day Claims Assignor
1.2 Assess Claim None 1 day Claims Assignor
None 1.3 Medical Prepayment Review None 5 days Medical Evaluator

Claims Processing
None 1.4 Assign eClaims/Post MPR None 5 days
Chief/Designated

None 1.5 Adjudication of Claims None 10 days Adjudicator

1.6 Payment Approval/Generate

None None 5 days Claims Processor
Benefits Disbursement Vouchers

1.7 Certify budget and Funds Budget Officer/Accounting

None None 5 days
available/account codes proper Chief

None 1.8 Payment Generation (ACPS) None 5 days Cashier

1.9 Generate and prepare voucher if

None None (If paid) 7 days Voucher processor
paid
 1.10 If for return to hospital, review
None None (If RTH/Denied) 13 days Adjudicator
and prepare transmittal for mailing

1.11 Crediting to PhilHealth Servicing

None None 3 days Cashier
Bank

TOTAL: None 60 days

2. For members filing directly:
1.1 Receive the documents None 1 day Receiving clerk
Submission of Claims

None 1.2 Assess Claim None 1 day Claims Assignor

None 1.3 Medical Prepayment Review None 5 days Medical Evaluator

Claims Processing
None 1.4 Assign eClaims/Post MPR None 5 days
Chief/Designated

None 1.5 Adjudication of Claims None 10 days Adjudicator

1.6 Payment Approval/Generate

None None 5 days Claims Processor
Benefits Disbursement Vouchers

1.7 Generate and prepare voucher if

None None (If paid) 7 days Voucher processor
paid

1.8 Certify budget and Funds Budget Officer/Accounting

None None 8 days
available/account codes proper Chief

1.9 If for return to member, review

None None (If RTH/Denied) 12 days Adjudicator
and prepare transmittal for mailing

1.10 Prepare Check under Member's

None None 3 days Cashier
Name

None 1.11 Mail/Send Check to Member None 3 days Cashier

TOTAL: None 60 days

1. Processing of Application for Accreditation of Health Care Institution
The Accreditation Section of the regional offices shall process the application for Accreditation of Health Care Institution
Office/Division: Health Care Delivery Management Division - Accreditation Section
Classification: Highly Technical
Type of Transaction: G2C - Government to Citizen
Who may avail: Hospital, Primary Care Facility/Infirmary, Ambulatory Surgical Clinic, Free Standing Dialysis Clinic, Maternity Package Provider, TB DOTS
Package Provider, Out Patient Malaria Package Provider, Animal Bite Package Provider, Free Standing Family Planning Clinic, OHAT Package
Provider, SARS COV 2 Testing Facility using RT PCR, COVID 19 Community Isolation Benefit Package Provider
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Hospitals/PCF General Requirements: (Renewal/Reaccreditation)
1. Provider Data Record PhilHealth Website/Offices
2. Performance Commitment (Rev.3) PhilHealth Website/Offices
3. Updated DOH License (Photocopy) Provided by the Applicant
4. Application Fee Provided by the Applicant
5. Accredited Medical Director Proof of Accreditation may be provided by the applicant/verified in the
Accreditation database (IPAS)
6. Audited Financial Statement Provided by the Applicant
Specific Requirements (Initial) in addition to the above
7. JPEG Photo of the facility (also for reaccreditation for change in location) Provided by the Applicant
8. Proof of 3 years in Operation or Qualifier for exemption per PhilHealth Circular 11 s.2013 Provided by the Applicant
9. Copy of SEC Certificate/General Information Sheet Provided by the Applicant
10. Statement of Intent (if applying during the last quarter of the year)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submission of Application to LHIO/PRO 1. Receive and screen initially the application None 5 -10 Mins/Application LHIO/PRO Receiving Officer
2. Wait result of Screening of Application 2. Provide Order of Payment None 5 -10 Mins/Application LHIO/PRO Receiving Officer
If incomplete application, get the Return the application to applicant together with copy of None 5 -10 Mins/Application LHIO/PRO Receiving Officer
application together with attached checklist the checklist of requirements and list of deficiency/ies
of requirements with list of deficiency/ies
If application is complete Encode in the IPAS Receiving Module None 5 -10 Mins/Application LHIO/PRO Receiving Officer
3. Applicant gets Order of Payment 3. Prepares Order of Payment None 5 -10 Mins/Application LHIO/PRO Receiving Officer
4. Pays Applicable Fee/s 4. Process payment, issues Official Receipt PCF/Infirmary 10 -15 Mins/Application Cashier
- P3,000, Level
1 - P5,000, Level
2 - P8,000, Level 3 -
P10,000
None 5. Transmit application to PRO if application was filed at None Transmits within 5 LHIO Receiving Officer
the LHIO working days from
receipt of application
None 6. Determines the process of accreditation if for None Within the day SIO-AQAS
automatice accreditation encodes details in the Data
Entry Module of IPAS
None NOTE: Automatic Accreditation: is an accreditation given None
to any institutional health care provider that is licensed
or certified by DOH or other certifying body duly
recognized by Philhealth and has the opportunity to be
engaged with the national health Insurance Program.
These IHCPs do not require pre accreditation survey and
deliberation by the PRO Accreditation Subcommittee
None Non Automatic Accreditation: IHCPs shall be subjected None
to Pre accreditation survey , result of PAS shall be part
of the agenda for deliberation by the PRO Accreditation
SubCommittee
5. Wait for Notice of Survey If for Non Automatic Accreditation, schedule None 5-10 Mins/Application SIO-AQAS
notice of survey
generated and emailed
to facility
None Conduct Pre Accreditation Survey None Conducts survey within AQAS (MS III, MS I, SIO III, SIO I)
30 days from receipt of
application
6. Submit Compliance/s within the Note: During the pandemic, facility visit/conduct of Pre- None Compliance period 60
prescribed compliance period Accreditation Survey is waived, Health Care Institutions calendar days
are instructed to submit proof of compliance to
accreditation requirements within 60 calendar days
None Encoding in the Data Entry Module of the IPAS None 5-10 Mins/Application SIO-AQAS
None Evaluation of HCI Performance None
None • Inquire if with pending case from Legal Sector and None Inquiry/request can be AQAS
Arbitration Office emailed within the day
NOTE: reply from Legal
Sector/Arbitration
Office may take 1-2
weeks (but there
are times reply takes
longer period)
None • Evaluation of NBB Compliance for government None Inquire from BMU AQAS
hospitals within the day NOTE:
reply may take 1-2 days
None • Inquire from PRO Legal office if with pending case/ None Inquiry/request can be AQAS
validated findings transmitted
None • Request for profiling report from BMU None Inquiry/request can be AQAS
done within a day
NOTE: Reply may
take 7 working days
( longer depends on
ITU compliance on
extraction)
None Generate agenda recommended for Subcom None Within the day AQAS
None Conduct Pre SubCommittee Meeting None Within the day HCDMD/AQAS
None Conduct of SubCommittee Meeting None Conduct of meeting HCDMD/AQAS
Once or twice a month Accreditation Subcommittee
(15-30 days)
None Perform Post Subcommittee Meeting None
None • Generate IPAS agenda list for approved/denied None Within the day AQAS
applications
None • Recommend VP for affirmation of recommendation None Within the day AQAS
None • Prepares Minutes of Subcommittee Meeting None 7 working days AQAS
None • Posting/tagging of decision in the IPAS None 2 days from receipt of AQAS
signed agenda
None • Printing of certificate of Accreditation None 5 Mins/Document AQAS
None • Preparation of approval and denial letters None 5 Mins/Document AQAS
None • Mailing/messengerial request for denial letter None 15 Mins HCDMD Clerk
None Notify provider for the availability of the Approval Letter None 5 -10 Mins/Application AQAS
and certificate of Accreditation
7. Claims certificate of accreditation and Provides Certificate of Accreditation and Approval None 5 -10 Mins/Application HCDMD Clerk
approval letter at the PRO Letters, Files receiving copy

Signs receiving copy

TOTAL: None Highly Technical
Transaction
Automatic Accreditation 53 days (if SubCom
Meeting conducted
once a month)
Non-Automatic Accreditation 143 days (if SubCom
Meeting conducted
once a month)
Note: Processing time is under non-pandemic condition and non-skeletal schedule of staff
1. Enrollment/Registration of Members
The Local Health Health insurance Offices shall register all Filipinos to the NHIP.
Office/Division: Local Health Insurance Offices - Membership
Classification: Simple
Type of Transaction: G2G - Government to Government; G2B - Government to Business; G2C- Government to Citizen
Who may avail: All Members
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Government/Private (Employed)
If No PIN:
PhilHealth Member Registration Form (PMRF) (properly accomplished 1 original copy) Any PhilHealth Office/LHIO/PhilHealth Website
Properly accomplished ER2 (1 original copy)
If with PIN:
Properly accomplished ER2 (1 original copy)
Houshold Helpers/Employees
If No PIN:
For Kasambahay: Properly accomplished Household Employment Unified Report (HEUR2) and Any PhilHealth Office/LHIO/PhilHealth Website
Kasambahay Unified Registration Form (KURF) 1 original copy
For Family Driver: Properly accomplished Household Employment Unified Report (HEUR2) and Any PhilHealth Office/LHIO/PhilHealth Website
PhilHealth Member Registration Form (PMRF) 1 original copy
If with PIN:
Properly accomplished Household Employment Unified Report (HEUR2) 1 original copy
SSS Retirees/Pensioners
Printout of Death, Disability and Retirement (DDR) indicating that the type of claim is retirement in Social Security System
nature and the effectivity date of pension; or 1 original copy
Printout of contributions indicating the latest contributions (if they retired after March 4,1995) 1 Social Security System
original copy
GSIS Retirees
Any of the following: (1 original copy)
1. Certification/Letter of Approval of Retirement from GSIS;
2. Service Record issued by employer/s indicating date of retirement and total number of service not
less than 120 months
3. Certification/Retirement Gratuity from employer indicating not less than 120 months of service.
Government Service Insurance System
Uniformed Members of the AFP, PNP and BFP Retirees/ Pensioners (those who are inactive military
service until they retire at age 56 and those separated by retirement or other reasons prior to the said
age but have reached the age of 60)
Any of the following: (1 original copy)
Statement of Services from previous employer indicating not less than 120 months of service
Certification/Letter of Approval of Retirement from GSIS not less than 120 months of service
General, Bureau or Special Order indicating effectivity of retirement.
Receiving of the documents for retiring employees whose application for the Lifetime Member
Program (LMP) will be facilitated by the employer three (3) months prior to the date of retirement
Photocopy of the following documents, duly certified by the employer: Approved retirement
application and proof of contributions or Service Record 1 original copy
Senior Citizens
Properly accomplished PhilHealth Member Registration Form (PMRF) 1 original copy Any PhilHealth Office/LHIO/PhilHealth Website
1 x 1 photo taken within the last six (6) months
Senior Citizens’ Identification Card issued by the OSCA in the city or municipality where the elderly issued by the OSCA in the city or municipality where the elderly resides or ANY of
resides 1 original copy or the following as proof of status as senior citizen:
ANY of the following as proof of status as senior citizen: 1 original copy
o Philippine passport;
o Birth certificate;
o Baptismal Certificate;
o Valid Driver’s license;
o Voter’s ID;
o SSS/GSIS ID;
o Valid Professional Regulatory Commission (PRC) ID;
o Postal ID;
o National Bureau of Investigation (NBI) Clearance; National Bureau of Investigation
o Overseas Filipino Worker’s ID; Overseas Workers Welfare Administration
o Valid identification cards issued by recognized government institutions/ agencies/corporations that
specify the full name, sex, date of birth, address and signature of owner; or
o In the absence of the abovementioned documents, the following may be accepted, subject to
PhilHealth validation: 1 original copy
- Certificate from the National Council for the Welfare of Disabled Persons (NCWDP);
- DSWD or Local DSWD certification
- Barangay Certification; and
Affidavit from two (2) disinterested persons certifying the age and identity of the elderly person.
Receiving of the documents for OSCA or other Senior Citizen Group enrollment application for the
Lifetime Member Program (LMP) will be facilitated by the employer three (3) months prior to the date
of retirement: Office of Senior Citizen Affairs
Electronic text file of Senior Citizens with the following: 1 original copy
o Full name (family, first, middle, including name extension if applicable)
o Birth date
o Sex
o Full name (family, first, middle, including name extension if applicable) of legal spouse and/or
qualified dependents; and
o Address with the following breakdown:
- Unit/Room/Floor No.;
- Building Name;
- Lot/Block/House/Building No.;
- Street;
- Subdivision/Village;
- Barangay (required field);
- City/Municipality (required field); and
- Province (required field).
Endorsement letter: Preferably with filled-out PMRFs
i-Group (Organized Group)
PhilHealth Member Registration Form (PMRF) (properly accomplished 1 original copy) Any PhilHealth Office/LHIO/PhilHealth Website
Signed MOA 1 original copy Concerned LGU
Applicable Certification from BSP, COA, SEC, DTI or LGU (delete this), instead a Letter of Intent shall be
submitted 1 original copy

Migrant Workers
PhilHealth Member Registration Form (PMRF) (properly accomplished 1 original copy) Any PhilHealth Office/LHIO/PhilHealth Website
If warranted: 1 original copy Concerned offices as indicated
Any of the following as proof of being an active OFW:
Valid Overseas Employment Certificate (OEC) or E- receipt of current year or is valid for one (1) year
from date of transaction; or
Working Visa/Re-entry Permit; or
Valid Employment Contract; or
Valid Company ID issued by Employer abroad; or
Cash Remittance receipt from member abroad at least 2 months prior to the date of renewal/
payment; or
Valid workers’ Identification (ID) Card issued by the host country (i.e.Hongkong ID, Iqama of Saudi,
Permessod’ Soggiorno and Cartad’ Identita of Italy);or
Any other equivalent document that will prove that the member is an active OFW.

Foreign Nationals
Properly accomplished PhilHealth Member Registration Form (PMRF) Any PhilHealth Office/LHIO/PhilHealth Website
Alien Certificate Registration (ACR)this should be Alien Certificate of Registration Identity Card (ACR
I-Card)
PRA Identification Card or Special Resident Retiree’s Visa (SRRV)

Sponsored Members (e.g. LGUs, Private Institutions, Individuals, etc.)

Certified List/Properly accomplished PhilHealth Member Registration Form (PMRF) Concerned LGU

Indigent Members (NHTS-PR)

Certified List/Properly accomplished PhilHealth Member Registration Form (PMRF) Concerned LGU
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit required forms to any Receive the submitted documents None
Local Health Insurance Office
None check application based on attached documents None
None if incomplete, notify client None LHIO Head/LHIO Staff of the
5 mins per PMRF
None if complete, check for possible existing PIN None Membership Section
None if with existing PIN, notify client None
None if no existing PIN, assign a new PIN None
None Send electronic MDR to member None
TOTAL: None 5 mins
2. Enrollment/Registration of Employers
The Local Health Health insurance Offices shall register employers in the private/government sector.
Office/Division: Local Health Insurance Offices - Membership
Classification: Simple
Type of Transaction: G2G - Government to Government; G2B - Government to Business; G2C- Government to Citizen
Who may avail: All Private and Government Agencies
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Manual Registration
For Government Employers: Employer Data Record Form (1 properly accomplished original copy) Any PhilHealth Office/LHIO/PhilHealth Website
For Private employers: ER1 (1 properly accomplished original copy)
Business permit / license to operate and/or any of the following: 1 original copy
a. Department of Trade and Industry (DTI) Registration (Single proprietorship)
b. Securities and Exchange Commission (SEC) Registration (Partnerships, Corporations, Foundations,
& Non-Profit Organizations)
c. Cooperative Development Authority (CDA) Registration (Cooperatives)
d. Barangay Certification and/or Mayor’s Permit (Backyard Industries/Ventures and Micro-Business
Enterprises)

Electronic Registration
For private employers:
Registration through the Securities and Exchange Commission – Integrated Business Registration
System (SEC-IBRS)
Registration through the
Philippine Business Registry (PBR)
For Household Employers:
Household Employer Unified Registration Form (HEUR1) (1 properly accomplished original copy) Any PhilHealth Office/LHIO/PhilHealth Website
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit required forms to any Receive the submitted documents None 15 mins LHIO Head/LHIO Staff of the
Local Health Insurance Office Membership Section
None check application based on attached documents None
None if incomplete, notify client None
None if complete, check for possible existing PIN None
None if with existing PIN, notify client None
None if no existing PIN, assign a new PIN None
None Send electronic MDR to member None
TOTAL: None 15 mins
3. Updating of MDR through Online Methods (LHIO Emails)
The Field Operations Division - Local Health Insurance Offices shall provide convenience and protect the interest of all clients while aliagning our processes
to the mandate of contactless transactions.
Office/Division: Local Health Insurance Offices - Membership
Classification: Simple
Type of Transaction: G2G - Government to Government; G2B - Government to Business; G2C- Government to Citizen
Who may avail: All Members
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
PhilHealth Member Registration Form (PMRF) (1 original copy) Philhealth Office/website
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Send email requests to official check all emails None simple transaction - LHIO Head/LHIO Staff of the
email addresses of the regional 1-3 days Membership Section
offices
forward to respective unit for action None
check application based on attached documents None
if incomplete, notify client None

if complete, check for possible existing PIN None

if with existing PIN, notify client None
if no existing PIN, assign a new PIN None
Send electronic MDR to member None
TOTAL: None 3 days
4. Member Registration through Online Method
The Field Operations Division - Local Health Insurance Offices shall provide convenience and protect the interest of all clients while aliagning our processes
to the mandate of contactless transactions, expedite processing of registration and generation of PIN
Office/Division: Local Health Insurance Offices - Membership
Classification: Simple
Type of Transaction: G2G - Government to Government; G2B - Government to Business; G2C- Government to Citizen
Who may avail: All Members
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
1. Duly Filled out PMRFs accredited HCPs
2. Photocopy of documentary Requirements from patients
(e.g birth certificate/marriage contract)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit duly accomplished None None None
PMRFs to the PhilHealth Section
of HCPs
2. HCP representative conducts None None None
initial evaluation of documents
3. HCP representative shall scan Check email and review completeness of submitted documents; None 5 minutes LHIO Head/Staff
and email to LHIO print and stamp received
TOTAL: None 5 mins
5. Processing of Inquiry of walk in clients
The Field Operations Division - Local Health Insurance Offices shall provide services to walk-in clients.
Office/Division: Local Health Insurance Offices - Membership
Classification: Simple
Type of Transaction: G2G - Government to Government; G2B - Government to Business; G2C- Government to Citizen
Who may avail: All Walk-In Clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
1. PhilHealth Identification Card/PIN or 2 Valid IDs Clients must be present.
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit duly accomplished None None None
PMRFs to the PhilHealth Section
of HCPs
2. HCP representative conducts None None None
initial evaluation of documents

3. HCP representative shall scan Check email and review completeness of submitted documents; None 5 minutes LHIO Head/Staff
and email to LHIO print and stamp received

TOTAL: None 5 mins

1. Inquiry on PhilHealth Collection
Shall provide general information about PhilHealth Collection
Office/Division: Local Health Insurance Offices - Collection
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All members
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit request on PhilHealth 1. Check all e-mails for the day. None 1 Day Electronic (via email)
Collection via email
None 2. Send a reply on the inquiry on Collection Section Staff
PhilHealth Collection
TOTAL: None 1 Day
2. Request for refund of Double Payment per CO No. 2020-0025
The Collection Section shall provide assistance in facilitating requesting for refund of double payment

Office/Division: Collection Section - Branch

Classification: Complex
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All members
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Original with ( 1 Photocopy)
1. Data Amendment Request Form (DARF) 1. Forms may be downloaded at the PhilHealth website
2. Request Letter 2. Requesting Member
3. PhilHealth Official Receipt (POR)/PHilHealth Agent’s Receipy(PAR) 3. Receipt from Member
4. Statement of Premium Account(SPA)/Transaction Monitoring History 4. Generated by the employers through their own accounts using the Electronic Premium Remittance System
(EPRS).
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit request on PhilHealth 1. Check all e-mails None 1 Day Electronic (via email)
Collection via email
None 2. Prepare the DATA AMENDMENT 3 Days Collection Section Staff
REQUEST FORM (DARF) based
on the information provided for
approval of the Branch Manager/
Vice President-(of Area)
None 3. Send transmittal memo signed 2 Days
by the Branch Manager with
pertinent documents to the Vice
President-(of Area)
None 4. Submit the signed DARF and 1 Day
other pertinent documents to
the Area Vice President who will
endorse to the Fund Management
Sector for appropriate action
TOTAL: None 7 Days
3. Collection of Premium Payment
The Local Health Health insurance Offices shall accept premium payment to all members of the NHIP.
Office/Division: Local Health Insurance Offices - Collection
Classification: Simple
Type of Transaction: G2G - Government to Government; G2B - Government to Business; G2C- Government to Citizen
Who May Avail: All members
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Individual Payment:
1. PMRF and proof of income (1 properly accomplished and original copy) Any PhilHealth Office/LHIO/PhilHealth Website
2. PhilHealth Premium Payment Slip (PPPS) (1 properly accomplished and original copy) Local Health Insurance Offices

For Employers EPRS Users with 10 and below employees:

EPRS-generated Statement of Premium Accounts (1 original copy) EPRS (concerned employer)

For non-EPRS Users located in GIDAS or in Areas where there are ACAs but no available Internet
Service Provider (ISP):
3. PhilHealth Premium Payment Slip (PPPS) (1 properly accomplished and original copy) Local Health Insurance Offices

For i-Group
4. PhilHealth Premium Payment Slip (PPPS) (1 properly accomplished and original copy) Local Health Insurance Offices
5. Billing Statement: Statement of Premium Accounts (SPA) (1 properly accomplished and original
copy)

For Migrant Workers (Land-Based)

6. PhilHealth Premium Payment Slip (PPPS) (1 properly accomplished and original copy) Local Health Insurance Offices

For Foreign Nationals

7. PhilHealth Premium Payment Slip (PPPS) (1 properly accomplished and original copy) Local Health Insurance Offices
For Sponsored Members (e.g. LGUs, Legislators, Private Institutions, Individuals, etc.)
8. PhilHealth Premium Payment Slip (PPPS) (1 properly accomplished and original copy) Local Health Insurance Offices
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Comply with COVID-19 protocols: 1. Ensure compliance of client to the minimum health None 1 minute Guard
foot bath, temperature check, hand standards 2. Check if member’s/employer’s last digit of LHIO
sanitation and contact tracing PIN/PEN is catered for the day according to the assigned
number coding
2. Secure PMRF and payment slip 3. Direct clients to the appropriate procedures in filling up None 1 minute Guard
from LHIO frontline counter the PMRF and payment slip LHIO
3. Submit duly accomplished PMRF 4. Receive and screen the PMRF and proof of income; None 5 minutes PACD Officer
with proof of income and payment validate the payment slip against the attached proof of LHIO
slip income
4. Proceed to Cashier for payment 5. Process the payment/encode in the OTCCS 6. Receive the None 5 minutes Cashier
of premium cash or check payment from the payor/member LHIO
5. Receive the printed PhilHealth 7. Release the PhilHealth Official Receipt (POR) to payor/ None 3 minutes Releasing Officer
Official Receipt (POR) member LHIO
if no existing PIN, assign a new PIN
Send electronic MDR to member
TOTAL: None 15 Minutes
1. Approval of Requests by the Regional Vice-Presidents concerning Membership and Collection
The Local Health Health insurance Offices shall accept premium payment to all members of the NHIP.
Office/Division: Local Health Insurance Offices - Support Services
Classification: Complex
Type of Transaction: G2G - Government to Government; G2B - Government to Business; G2C- Government to Citizen
Who May Avail: All members
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Letter of Request (1 original copy) Members
General information about the members’ membership/premium contribution (1 original copy of Members
fully accomplished applicable form)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit letter request to the LHIO 1.1 Receive and stamp the date of receipt on the letter None 5 minutes LHIO Head/Staff
Admin Designate request 2. Forward the letter request to the CSIO for
action/notation

1.2 Write appropriate action and notation on the letter None 5 minutes LHIO Head/Staff
request
1.3 Forward the letter request to FOD None 5 minutes LHIO Head/Staff
1.4 Receive the letter request and route to ORVP for None 3-7 days complex transaction FOD
approval
1.5 Route the letter request to concerned Unit None Planning Unit

1.6 Process/provide the data and prepare the transmittal None Concerned Unit
letter
1.7 Sign/Appove the transmittal letter None RVP
1.8 Release the requested data to the requesting party/ None Planning Unit
LHIO
1.9 If channeled through LHIO; receive and release the None LHIO Admin Designate
data to the requesting party
TOTAL: None 8 days
2. Approval of Requests for Orientation
The Local Health Health insurance Offices shall accept premium payment to all members of the NHIP.
Office/Division: Local Health Insurance Offices - Support Services
Classification: Complex
Type of Transaction: G2G - Government to Government; G2B - Government to Business; G2C- Government to Citizen
Who May Avail: All members
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Letter of Request (1 original copy) Members
General information about the members’ membership/premium contribution (1 original copy Members
of fully accomplished applicable form)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit letter request to the LHIO 1.1 Receive and stamp the date of receipt on the letter None 15 minutes LHIO Head/Staff
Admin Designate request
1.2 Forward the letter request to the CSIO for action/ None LHIO Head/Staff
notation
1.3 Write notation on letter request: if can be handled by None LHIO Head/Staff
LHIO, assign LHIO staff who will conduct the orientation;
if not, endorse to FOD for appropriate action
1.4 If can be handled by LHIO, endorse the request to None LHIO Head/Staff
the assigned LHIO staff
1.5 If cannot be handled by LHIO in cases of highly None 3-7 days (complex transaction) LHIO Head/Staff
technical transactions, forward the letter request to FOD
1.6 Route/Transmit the letter request to concerned Unit None FOD
1.7 Process/provide the data and prepare the transmittal None Concerned Unit
letter
1.8 Sign/Appove the transmittal letter None RVP
1.9 Release the requested data to the requesting party/ None Planning Unit
LHIO
1.10 If channeled through LHIO; receive and release the None LHIO Admin Designate
data to the requesting party
TOTAL: None
1. Public Assistance Services
Provision of initial assistance to all clients of the Local Health Insurance Office for the purpose of establishing order and direction to the transacting public
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who may avail: All walk-in clients of the Local Health Insurance Office
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.   Secure information and appropriate 1. Provide appropriate forms and information None maximum of 10 minutes Public Assistance Staff - LHIO
PhilHealth Forms, fill-out the forms and ask for per client
initial direction
2. Get a queuing number and wait for the 2. Give queuing number and direct the client to the
number to be called appropriate frontline counter or area in the LHIO

TOTAL: None 10 minutes

2. Member Registration through Online Method
The Field Operations Division - Local Health Insurance Offices shall provide convenience and protect the interest of all clients while aliagning our processes to
the mandate of contactless transactions, expedite processing of registration and generation of PIN
Office/Division: Local Health Insurance Offices - Membership
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who may avail: All Members
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
1. Duly Filled out PhilHealth Member Registration Form (PMRF) (1 orginal copy) accredited HCPs
2. 1 Photocopy of documentary Requirements from patients
(e.g birth certificate/marriage contract)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit duly accomplished PhilHealth Member None None None None
Registration Form (PMRF) to the PhilHealth
Section of Health Care Providers (HCPs)
2. Health Care Provider (HCP) representative None None None None
conducts initial evaluation of documents
3. Health Care Provider (HCP) representative 3.1 Check email and review completeness of None 5 minutes LHIO Head/Staff
shall scan and email to LHIO submitted documents; print and stamp received
TOTAL: None 5 minutes
3. Online Application and processing of Inquiry of walk in clients
The Field Operations Division - Local Health Insurance Offices shall provide services to walk-in clients.
Office/Division: Local Health Insurance Offices - Membership
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who may avail: All Walk-In Clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
1. PhilHealth Identification Card/PIN or 2 Valid IDs Clients must present.
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit duly accomplished PhilHealth Member None None None None
Registration Form (PMRF) to the PhilHealth
Section of Health Care Providers (HCPs)
2. Health Care Provider (HCP) representative None None None None
conducts initial evaluation of documents
3. Health Care Provider (HCP) representative 1. Check email and review completeness of None 5 minutes LHIO Head/Staff
shall scan and email to LHIO submitted documents; print and stamp received
TOTAL: None 5 minutes
4. Enrollment of Formal Sector Employees (5 employees and below)
Registration of Formal Sector employees, maximum of 5 individuals and below only and issuance of their PhilHealth identification Cards and Member Data
Records
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who may avail: All newly hired or existing employees in the government or private institutions, with or without PhilHealth Identification Number (PIN)
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Employer Report Form 2 (ER2) (original, 2 copies) downloadable at www.philhealth.gov.ph, LHIO
PhilHealth Membership Registration Form (PMRF) (original 2 copies) downloadable at www.philhealth.gov.ph, LHIO
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.   Submit duly accomplished PMRF together 1.1 Receive and screen duly accomplished PMRF, Er2 and None 5 minutes per record Frontline Officer - LHIO
with the Report of Employee-Members (Er2 supporting documents (25 minutes for 5
Form) and supporting documents once the employees)
number is called
None 1.2 Reconcile the name/s of the employees indicated in
the Er2 form against the attached PMRF

None 1.3 Return received copy of Er2 (if submitted PMRFs are
more than 5); or advise the client to wait for the release
of PhilHealth Identification Card (PIC) and Member Data
Record (MDR) if submitted PMRFs are 5 and below at the
Releasing Counter
2.   Receive advice and received copy of ER2 from 2.1 Endorse PMRFs to Support Officer for processing
the Frontline Officer if documents submitted
are to be mailed or proceed to the Releasing
Counter once the name of the company/
business is called.
 2.2 Process PMRFs (Detailed Processing)
2.3 Verify if name of employee already exists in the
system
2.4 Encode data indicated in the PMRF in the system
2.5 Print PhilHealth Identification Cards (PIC) and Member
Data Record (MDR)
2.6 Release the PhilHealth Identification Card/s (PIC) and
Member Data Record/s (MDR)
3.   Receive PIC and MDR at the Releasing None
Counter
TOTAL: None 25 minutes
5. Enrollment of Household Employees (5 employees and below)
Registration of individuals belonging to the Household category and issuance of their PhilHealth identification Cards (PIC) and Member Data Record
(MDR)
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who may avail: All individuals belonging to the Household Employees category such as Kasambahays and Drivers
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Household Employer Unified Registration Forms (HEUR1, HEUR2) and Kasambahay Unified Registration Form downloadable at www.philhealth.gov.ph, LHIO
(KUR) (original, 2 copies)
PhilHealth Membership Registration Form (PMRF) (original 2 copies) downloadable at www.philhealth.gov.ph, LHIO
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.   Secure and submit duly accomplished 1.1 Receive and screen submitted KURF/PMRF and None 5 minutes per PMRF Frontline Officer - LHIO
Kasambahay Unified Registration Form (KURF) supporting documents (25 minutes for 5
and/or PMRF (for Family Driver) together with individuals)
the Household Employment Unified Report
(HEUR2) form and supporting documents (if any)
to the frontline staff
1.2 Reconcile the name/s of the Kasambahay/Family
Driver indicated in the HEUR2 form against the attached
KURF/PMRF
1.3 Acceptance of submitted KURF/PMRF
1.3.a.   For 5 KURF/PMRF and below, advise client to wait
for the release of PIC, MDR and copy of processed HEUR2
1.3.b.  For more than 5 KURF/PMRF, receive the
documents and inform client to return after 3 days for the
release of PIC, MDR and copy of processed HEUR2.
2.   Sign the processed HEUR2 and KURS and 2.1 Process KURFs/PMRF (for Family Drivers)
hand them back to the front line officer.
2.1.a. Verify if name of household employee already
exists in the system.
2.1.b. Update / Encode data indicated in the KURF in the
system (via KURS).
 2.1.c.  Print PIC and MDR
2.1.d. Print and sign the processed HEUR2 and KURF in 3
copies.

2.1.e. Require the client to sign also the above-mentioned

3 copies.

2.1..f.  Hand-over 1 duly-signed copies of the processed

HEUR2 and KURF to the client, and keep the 2 other
originally-signed copies for endorsement to SSS and for
PhilHealth record.

3. Receive copy of processed HEUR2 with 3.1 Release the copy of processed HEUR2, PIC and MDR to
applicant’s signature, PIC and MDR from the household employee/ representative
frontline staff

TOTAL: None 25 minutes

6. Enrollment of Individuals - Lifetime Members
Registration of individuals belonging to the Lifetime Members category and issuance of their PhilHealth identification Cards (PIC) and Member Data Record
(MDR)
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who may avail: All individuals who have reached minimum retirement age required of their profession (in case of professionals) or otherwise, individuals
who have reached sixty years of age and have contributed at least 120 monthly premium contributions to the National Health Insurance
Program
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
PhilHealth Membership Registration Form (PMRF) (original 2 copies) downloadable at www.philhealth.gov.ph, LHIO
Proof of 120 months contribution to the NHIP or proof that the 120 months requirement is not required (see Previous employer
specific requirements per category of retiree); (clear photocopy, 1) or
PhilHealth Official Receipts showing at least 120 months contribution to the NHIP (clear photocopy, 1)
Not applicable
Latest 1 x 1 ID pictures (2 copies) Not applicable
Specimen signature of the member Not applicable
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.   Submit duly accomplished PMRF and 1.1 Receive and screen duly accomplished PMRF with None 30 minutes per PMRF Frontline Officer - LHIO
supporting document/s, if applicable, once the supporting documents
number is called. 1.2 Encode/clean-up detected multiplicity/assign/update
member data and scan signature of member.
1.3 Print the Member Data Record (MDR) and
Identification Card.
1.4 Laminate the printed Identification Card with the ID
picture of the Client/Member, if applicable
1.5 Release the laminated Identification Card to Client/
Member together with the Member Data Record (MDR)
and have the member sign/acknowledge receipt of
documents
2.   Receive the Identification Card and Member
Data Record (MDR) and acknowledge receipt
TOTAL: None 30 minutes per PMRF
x No. of PMRF
7. Enrollment of Individuals - Senior Citizens
Registration of individuals belonging to the Senior Citizens category and issuance of their PhilHealth identification Cards (PIC) and Member Data Record
(MDR)
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All Filipinos who have reached sixty years of age, even without contribution to the National Health Insurance Program for as long as the
subsidy of the National Government for the premium contribution of this category continues.
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
PhilHealth Membership Registration Form (PMRF) (original 2 copies) downloadable at www.philhealth.gov.ph, LHIO
1 x 1 photo taken within the last six (6) months; and (2 pcs) Not applicable
Senior Citizens’ Identification Card issued by the OSCA in the city or municipality where the elderly resides or Office of the Senior Citizens Affairs
ANY of the following as proof of status as senior citizen:
Philippine passport; (clear photocopy, 1 copy) Department of Foreign Affairs
Birth certificate; Philippine Statistics Authority
Baptismal Certificate; Church where the member was baptized
Valid Driver’s license; Land Transportation Office
Voter’s ID; Commission on Election
SSS/GSIS ID; Social Security System
Governement Services Insurance System
Valid Professional Regulatory Commission (PRC) Professional Regulations Commission
ID;
Postal ID; Nearest Post Office
National Bureau of Investigation (NBI) Clearance; National Bureau of Investigation
Overseas Filipino Worker’s ID; Overseas Workers Welfare Administration, Employer
Valid identification cards issued by recognized Any recognized Government Institution
government institutions/agencies/corporations
that specify the full name, sex, date of birth,
address and signature of owner; or
In the absence of the abovementioned (Original) Not applicable
documents, the following may be accepted,
subject to PhilHealth validation:
-          Certificate from the National Council for National Council for the Welfare of Disabled Person’s Offices
the Welfare of Disabled Persons (NCWDP);
-          DSWD or Local DSWD certification; Department of Social Welfare and Development Offices
-          Barangay Certification; and Barangay where the Senior Citizen resides
-          Affidavit from two (2) disinterested persons Any licensed Notary Public
certifying the age and identity of the elderly
person.
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit duly accomplished PMRF and 1.1 Receive and screen duly accomplished PMRF with None 10 minutes per PMRF Frontline Officer - LHIO
supporting documents after the number is supporting document/s.
called

1.2 Encode/clean-up detected multiplicity/update

member data if with existing record. If none, issue PIN.

1.3 Print Member Data Record (MDR) and PhilHealth

Identification Card
2. Sign name in the PhilHealth ID card 2.1 Release MDR and PhilHealth ID
3. Receive the Identification Card & Member
Data Record (MDR) and acknowledge receipt of
the documents
TOTAL: None 10 minutes per PMRF
x No. of PMRF
8. Enrollment of Individuals - Informal Sector
Registration of individuals belonging to the Informal Sector, payment of the premium contribution and issuance of their PhilHealth identification Cards (PIC)

Office/Division: Local Health Insurance Office

Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who may avail: All individuals belonging to the Informal Sector category
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
PhilHealth Membership Registration Form (PMRF) (original, 2 copies) downloadable at www.philhealth.gov.ph, LHIO
Payment of premium contribution Not applicable
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.   Submit duly accomplished PMRF and 1.1 Receive and screen duly accomplished PMRF with None 10 minutes per PMRF Frontline Officer - LHIO
supporting documents and payment slip once supporting documents
the number is called. 1.2 Evaluate the completeness of data in the PMRF

1.3 Encode/assign/update in the MCIS

1.4 Print the Member Data Record (MDR) and PhilHealth

Identification Card (PIC) of the Client/Member

1.5 Endorse payment slip to the assigned payment

processor and advise to proceed to the Payment
Processor window and return after payment has been
made
2.   Proceed to the Cashier’s window once 2.1 Encode payment slip and assign number 300/month, 3600/ 5 minutes Payment Processor - LHIO
number is called, tender payment (premium annum
contribution) and receive Official Receipt 2.3 Advise member to proceed to Cashier’s Window once
the number is called (no. of months to be
paid depends on the
2.4 Receive payment from client, print Official Receipt assessment of the 5 minutes Collecting Officer - LHIO
(OR) and issue OR payment processor)

3.   Proceed to Frontline Officer and receive PIC None 5 minutes Frontline Officer - LHIO
and MDR
TOTAL: 25 minutes
9. Enrollment of Individuals - Foreign Nationals
Registration of Foreign Nationals, payment of the premium contribution and issuance of their PhilHealth identification Cards (PIC) and Member Data Record
(MDR)
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who may avail: All Foreign Nationals willing and qualified to become a member of the National Health Insurance Program
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
PhilHealth Membership Registration Form (PMRF) (original, 2 copies) downloadable at www.philhealth.gov.ph, LHIO
Alien Certificate Registration (ACR)this should be Alien Certificate of Registration Identity Card (ACR I-Card), Department of Foreign Affairs (DFA)
(clear photocopy, 1 copy), or
PRA Identification Card or Special Resident Retiree’s Visa (SRRV) (clear photocopy, 1 copy) Philippine Retirement Authority
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.       Submit duly accomplished PMRF, PRA 1.1 Receive and screens duly accomplished PMRF and None 10 minutes per PMRF Frontline Officer - LHIO
Identification Card or Special Resident Retiree’s verify authenticity of supporting documents.
Visa (SRRV) , Alien Certificate of Registration 1.2 Evaluate the completeness of data in the PMRF
Identity Card (ACR I-Card) and supporting
documents after the number is called 1.3 Encode/assign/update member’s data in the MCIS
1.4 Advise Client /Member to pay to the Cashier and
return after the payment has been made and submit
copy of Official Receipt (OR)
1.5 Print Member Data Record (MDR) and PhilHealth
Identification Card (PIC) of the Client/Member
2.       Proceed to the Cashier’s window once 2.1 Encode payment slip and assign number 5 minutes Payment Processor - LHIO
number is called, tender payment (premium 2.2 Advise member to proceed to Cashier’s Window once
contribution) and receive Official Receipt the number is called
2.3 Receive payment from client, print Official Receipt 3% of the declared 5 minutes Collecting Officer - LHIO
(OR) and issue OR income
3.       Proceed to Frontline Officer and receive PIC 3.1 Release PIC and MDR to the Client/Member None 5 minutes Frontline Officer - LHIO
and MDR
TOTAL: None 25 minutes
10. Enrollment of Individuals - Landbased Migrant Workers
Registration of individuals belonging to the Migrant Worker category, payment of the premium contribution and issuance of their PhilHealth identification
Cards (PIC) and Member Data Record (MDR)
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All individuals belonging to the Landbased Migrant Worker category
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
PhilHealth Membership Registration Form (PMRF) (original, 2 copies) downloadable at www.philhealth.gov.ph, LHIO
Contract (photocopy, 1 copy) Not applicable
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.    Submit duly accomplished PMRF and 1.1 Receive and screen duly accomplished PMRF with None 10 minutes per PMRF Frontline Officer - LHIO
supporting documents and payment slip once supporting documents and payment slip
the number is called. 1.2 Encode/assign/update member’s data
1.3 Endorse payment slip to the assigned Payment
Processor/ Collecting Officer and advise client to proceed
to the Payment Processor window and return after
payment has been made
2.    Proceed to the Payment Processor desk and 2.1 Encode payment slip and assign number 5 minutes Payment Processor - LHIO
receive priority number 2.2 Advise member to proceed to Cashier’s Window once
the number is called
3.    Proceed to the Cashier’s window once 3.1 Receive payment, issue OR and advice client/ 3% of the monthly 5 minutes Collecting Officer - LHIO
number is called, tender payment (premium member to proceed to Frontline Officer to get PhilHealth income, subject to
contribution) and receive Official Receipt Identification Card (PIC) / Member Data Record (MDR) ceiling
4.   Receive PIC and MDR 4.1 Print and release MDR and PIC None 5 minutes Frontline Officer - LHIO
TOTAL: None 25 minutes
11. Declaration of Dependents
Editing of data records in the membership database for the purpose of declaring dependents during initial registration, declaring additional dependents not
previously declared, transferring legal and qualified dependents from another PhilHealth member who becomes inactive.
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All existing PhilHealth members and all individuals who wants to declare legal and qualified dependents during initial registration
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
PhilHealth Membership Registration Form (PMRF) (original, 2 copies) downloadable at www.philhealth.gov.ph, LHIO
None (during initial registration except when the surname of the declarant member and the dependent Not applicable
spouse, child or parent is different from the surname of the member)
Supporting documents for declaration of additional dependents or correction of previously existing
member data records (clear photocopy of the following documents, 1 copy)
DEPENDENT SPOUSE
(a) Spouse Marriage certificate/Contract with registry number Philippine Statistics Authority (PSA)
For marriage which took place abroad, marriage Philippine Embassy
certificate stamped “Received” by the Philippine Embassy
or consular office exercising jurisdiction over the place of
marriage Consular Office in the country where the marriage took place
(b) Muslim Spouse · Affidavit of Marriage issued by the Office of Muslim Office of Muslim Affairs
Affairs (OMA), which passed through the Shari’a Court
and must be registered/authenticated in the National
Statistics Office (NSO)
Philippine Statistics Authority
DEPENDENT CHILD
(a) Legitimate or illegitimate children below 21 years old Philippine Statistics Authority (PSA)
· Birth Certificate with registry number or Baptismal Certificate reflecting the name of the member as parent
· For births which took place abroad, Birth Certificate Stamped “received” by the Philippine embassy or Philippine Embassy
Consular office exercising jurisdiction over the place of birth Consular Office in the country where the child was born
(b) Adopted children below 21 years old Trial court who heard the adoption proceedings
· Court Decree/Resolution of Adoption or Birth Certificate of the adopted child/ren in which adoption is Philippine Statistics Authority (PSA)
annotated thereto
(c) Stepchildren below 21 years old Philippine Statistics Authority (PSA)
· Marriage Certificate (with registry number) between biological parents and step father/stepmother and
Birth Certificate/s (with registry number) of the stepchildren
(d) Mentally or physically disabled children who are 21 years old and above Philippine Statistics Authority (PSA)
· Birth Certificate and original Medical Certificate issued by the attending physician within the past 6 months Any licensed physician in the Philippines
stating and describing the extent of disability
(e) Foster Child Department of Social Welfare and Development Offices
. Foster Placement Authority from DSWD
DEPENDENT PARENT
(a) Parent/s 60 years old and above Philippine Statistics Authority (PSA)
. Birth Certificate with registry number of both registrant and parent (in the absence of Birth Certificate of
parent, any proof attesting to the date of birth of parent/s)
(b) Step parents 60 years old and above
. Marriage Certificate/Contract with registry number between biological parent of the member-child and the Philippine Statistics Authority (PSA)
stepparent;
· Birth Certificate of the stepparent (in its absence, a notarized affidavit of 2 disinterested persons attesting to Philippine Statistics Authority (PSA)
the date of birth); Any licensed Notary Public
· Birth Certificate of the member-child indicating the name of his/her biological parent; and Philippine Statistics Authority (PSA)
· Death Certificate of member’s deceased biological parent Philippine Statistics Authority (PSA)
(c) Adoptive parents 60 years old and above
· Court Decree/Resolution of Adoption or photocopy of Birth Certificate of the child in which the adoption is Trial court who heard the adoption proceedings
annotated thereto; and
· Birth Certificate/s of adoptive parents or in its absence, a notarized affidavit of 2 disinterested persons Philippine Statistics Authority (PSA)
attesting to the date of birth Any licensed Notary Public
(d) Parents with permanent disability totally dependent with member
· Original Medical Certificate issued by the attending physician within the past 6 months stating and Any licensed physician in the Philippines
describing the extent of disability
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.    Submit duly accomplished PMRF and 1.1 Receive and screen duly accomplished PMRF with None 10 minutes per PMRF Frontline Officer - LHIO
supporting documents supporting documents
1.2 Update member’s data
2. Receive updated MDR 2.1 Print and release Member Data Record (MDR)
TOTAL: None 10 minutes per PMRF
12. Updating of Membership Records
Editing of membership records of the Member and/or the Employer in PhilHealth membership database for the purpose of updating and/or correcting
previously existing information/data

Office/Division: Local Health Insurance Office

Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All PhilHealth members and Employers with existing
records in the membership database
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
PhilHealth Membership Registration Form (PMRF) (original, 2 copies) downloadable at www.philhealth.gov.ph, LHIO
Supporting documents for declaration of additional dependents in case of existing employees and/or for Philippine Statistics Authority
correction of previously existing member data records (clear photocopy, 1)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.    Submit duly accomplished PhilHealth 1.1 Receive and screen duly accomplished PMRF and/or None 15 minutes per MDR/ Frontline Officer - LHIO
Member Registration Form (PMRF)/ER3 and ER3 and the supporting documents EDR
supporting documents once number is called 1.2 Update membership records
1.3 Print amended Member and/or Employer Data Record
(MDR/EDR) and PhilHealth Identification Card (PIC) - if
applicable
1.4 Release amended MDR/PIC (if applicable) to the
member or Employer Data Record (EDR) to the Employer
2.    Receive updated MDR/PIC and/or EDR
TOTAL: None 15 minutes x no. of MDR/EDR
13.a Request for Records (Client is the owner of the requested record)
Request of Stakeholders for PhilHealth records
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All stakeholders subject to compliance of the applicable and existing laws, rules and regulations on releasing of records.
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Request Slip for ID and/or MDR, Request letter for other type of documents Request Slip - Public Assistance Desk, LHIO
Request Letter - (Not applicable)
Any valid Identification Card of the client Government Institutions, Current Employer
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.   Submit duly accomplished request for 1.1 Receive properly filled-out request form with None 15 minutes per Frontline Officer - LHIO
documents form(with supporting documents if supporting documents requested document
applicable) to the frontline officer once number
is called 1.2 Process request of the client
1.3 Release requested documents and require client to
acknowledge receipt of documents
2.   Receive and acknowledge receipt of the
requested document
TOTAL: None 15 minutes x the no. of requested documents
13.b Request for Records (Client is the owner of the requested record)
Request of Stakeholders for PhilHealth records
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All stakeholders subject to compliance of the applicable and existing laws, rules and regulations on releasing of records.
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Request Slip for ID and/or MDR, Request letter for other type of documents Request Slip - Public Assistance Desk, LHIO
Request Letter - (Not applicable)
Any valid Identification Card of the client Government Institutions, Current Employer
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.   Submit duly accomplished request for 1.1 Receive properly filled-out request form with None 5 minutes Frontline Officer - LHIO
documents form(with supporting documents if supporting documents
applicable) to the frontline officer once number
is called
1.2 Inform client of the reason/s why the requested within 7 days for
document cannot be released immediately and advise complex transactions
him/her of the timeline when the document is to be
picked-up or delivered within 20 days for
highly technical
transactions
2.   Request for a receiving copy with indicated
agreed picked-up or delivery date
TOTAL: None within 7 days for complex transactions
within 20 days for highly technical transactions
14. Request for Records (Requested through a representative)
Request of Stakeholders for PhilHealth records
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All stakeholders subject to compliance of the applicable and existing laws, rules and regulations on releasing of records.
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Request Slip for ID and/or MDR Public Assistance Desk - LHIO
Request letter for other type of documents (original, 1 pc) Not applicable
Authorization Letter from the member (1 original copy) Not applicable
Any valid Identification Card of the client and of the requesting party Government Institutions, Current Employer
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.   Submit duly accomplished request for 1.1 Receive properly filled-out request form with None 15 minutes per Frontline Officer - LHIO
documents form(with supporting documents if supporting documents requested document
applicable) to the frontline officer once number
is called 1.2 Process request of the client
1.3 Release requested documents and require client to
acknowledge receipt of documents
2.   Receive and acknowledge receipt of the
requested document
TOTAL: None 15 minutes x the
no. of requested
documents
14.b Request for Records (Requested through a representative)
Request of Stakeholders for PhilHealth records
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All stakeholders subject to compliance of the applicable and existing laws, rules and regulations on releasing of records.
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Request Slip for ID and/or MDR, Request letter for other type of documents Request Slip - Public Assistance Desk, LHIO
Request Letter - (Not applicable)
Authorization Letter from the member (original, 1 pc) Not applicable
Any valid Identification Card of the client and of the requesting member Government Institutions, Current Employer
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.   Submit duly accomplished request for 1.1 Receive properly filled-out request form with None 5 minutes Frontline Officer - LHIO
documents form(with supporting documents if supporting documents
applicable) to the frontline officer once number
is called
1.2 Inform client of the reason/s why the requested within 7 days for
document cannot be released immediately and advise complex transactions
him/her of the timeline when the document is to be
picked-up or delivered within 20 days for
highly technical
transactions
2.   Request for a receiving copy with indicated
agreed picked-up or delivery date
TOTAL: None within 7 days
for complex
transactions

within 20 days for

highly technical
transactions
15. Registration of Employers
Encoding of Employer Data in the Membership database, generation of PEN, as applicable, issuance of Employer Data Record
and Certificate of Registration.
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All employers whether government or private institutions
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Employer Data Record (ER1) (original, 2 copies)
No additional documentary requirement for government employers Not applicable
For Private Employers MANUAL REGISTRATION
A.   Direct to PhilHealth (Non-PBR)
Business permit / license to operate and/or any of the Barangay Hall / City Hall
following:
Department of Trade and Industry (DTI) Registration Department of Trade and Industry
(Single proprietorship)
Securities and Exchange Commission (SEC) Securities and Exchange Commission
Registration (Partnerships, Corporations,
Foundations, & Non-Profit Organizations)
Cooperative Development Authority (CDA) Cooperative Development Authority
Registration (Cooperatives)
Barangay Certification and/or Mayor’s Permit Barangay Hall / City Hall
(Backyard Industries/Ventures and Micro-Business
Enterprises)
ELECTRONIC REGISTRATION
A. Registration through the Securities and Exchange Not applicable, c/o Securities and Exhange Commission
Commission – Integrated Business Registration
System (SEC-IBRS)

No documentary Requirement
 B. Registration through the Philippine Business Not applicable, c/o Department of Trade and Industry
Registry (PBR)

No documentary requirement
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit duly accomplished 1.1 Receive and screen duly accomplished ER1 Form None 15 minutes per ER1 Frontline Officer - LHIO
Employer Data Record (ER1 Form) together with supporting documents(e.g., URR or Info
and supporting documents (e.g., Sheet; or business permit)
Unified Registration Record (URR) 1.2 Search in MCIS the issued PEN found in the URR or
issued by the Securities and Info Sheet; or Encode to MCIS (applicants which have
Exchange Commission (SEC) or not passed thru the SEC-IBRS or PBR)
Info Sheet issued by DTI containing
their SEC or DTI Registration 1.3 Print the Employer Data Record and Certificate of
Certificate Number, PEN, TIN, and Registration
employer numbers issued by SSS 1.4 Release the Employer Data Record and Certificate
and Pag-IBIG Fund; ; or business of Registration
permit for those who have not
passed thru the SEC-IBRS or PBR)
once the number is called
2.   Receive the Employer
Data Record and Certificate of
Registration
TOTAL: None 15 minutes x the
number of ER1
16. Registration of Household Employers
Encoding of Household Employer Data in the Membership database, generation of PEN, as applicable, issuance of Employer Data Record and Certificate of
Registration.
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All household employers
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Household Employer Registration Form (HEUR1), or downloadable in philhealth.gov.ph
Kasambahay Unified Registration Form (KUR) (1 original coy) downloadable in philhealth.gov.ph
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.   Submit duly accomplished 1.1 Receive and screen duly accomplished HEUR1 and None 15 minutes per HEUR1 Frontline Officer - LHIO
Household Employer Unified supporting documents
Registration (HEUR1) form and 1.2 Process HEUR1 in the KURS
supporting documents to the
frontline staff 1.2.a. Encode in the KURS’ Household employer
module.
1.2.b. Print and sign the processed HEUR1 in 3 copies.
1.2.c. Require the client to sign also the said 3 copies.
2.   Sign the processed HEUR1 and 2.1. Hand‐over one (1) duly‐signed copies of the
hand them back to the front line processed HEUR1 to the client, and KEEP the two (2)
officer other originally‐signed copies for endorsement to SSS
and for PhilHealth record.
2.2 Print the Employer Data Record (EDR).
2.3 Release the Employer Data Record and COR to
household employer/representative
3.       Receive the EDR and copy of
processed HEUR1 with applicant’s
signature.
TOTAL: None 15 minutes x the
number of HEUR1
17. Collection of Premium Contribution (Formal economy, Informal economy and Landbased Migrant Workers)
Collection of Premium Contribution from Formal and Informal Economy and Landbased Migrant Workers and issuance of official receipts
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All direct contributors belonging to the Formal and Informal economy, and Landbased Migrant Worker category
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
PhilHealth Premium Payment Slip (PPPS) (original, 1 copy) Cashier’s window - LHIO
FORMAL ECONOMY
Employed Segment
For EPRS Users with 10 and below employees: EPRS generatd Not applicable
Statement of Premium Account (SPA)
For non-EPRS Users located in GIDAS or in Areas PPPS Cashier’s window - LHIO
where there are ACAs but no available Internet
Service Provider (ISP)
Kasambahays PPPS Cashier’s window - LHIO
INFORMAL ECONOMY
Informal Sector - formerly known as Individually PPPS Cashier’s window - LHIO
Paying Members
i-Group Billing statement Collection Section - PhilHealth Regional Office/Branch
SPA Not applicable
Migrant Workers Clear copy of contract for basis of income Not applicable
Foreign Nationals PPPS Cashier’s window - LHIO
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.    Submit duly accomplished PhilHealth 1.1 Receive payment slip and encode payment Refer to appropriate 10 minutes per Collecting Officer - LHIO
Premium Payment Slip to Cashier’s window and 1.2 Receive money from the Client/Member and print Official schedule of premium transaction
tender payment once priority number is called Receipt(OR) contributions
1.3 Release/ Issue PhilHealth Official Receipt
2. Receive PhilHealth Official Receipt
TOTAL: 10 minutes x
the number of
transactions
18. Submission of Remittance Report (RF1) for employers in Geographically Isolated and Depressed Areas (GIDA) only
Receiving of remittance report from the employers in GIDA areas only.
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All employers who are non Electronic Premium Remittance System (EPRS) users and located in Geographically Isolated and Depressed
Areas only.
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
PhilHealth Premium Payment Slip (PPPS) (original, 1 copy) Cashier’s window - LHIO
Employer Remittance Report (RF1) downloadable in www.philhealth.gov.ph, LHIO
USB Flash Drive containing the report Not applicable
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.    Submit emplopyer remittance report (RF- 1.1 Receive and screen remittance report/flash drive (as to None 30 minutes per Frontline Officer - LHIO
1) and flash drive to the frontline officer once number and/or data stored in the diskette/flash drive). transaction
number is called
1.2 Stamp “received” on the remittance report
1.3 Return received copy of remittance report/flash drive to
client.
2.    Receive copy of acknowledged remittance
report
TOTAL: None 30 minutes x no.
of transactions
19. Receiving of directly filed claims
Receiving of claims directly filed by the members or their representative because they were not able to avail of the automatic benefit deduction at the facility
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: All PhilHealth members who were not able to avail of the automatic benefit deduction during confinement
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Acknowledgement Receipt Form LHIO
PhilHealth Claim Form 1, 2, 3, & 4 and Claims Signature Form (CF1, CF2, CF3, CF4, CSF) as applicable, depending on the downloadable at www.philhealth.gov.ph, LHIO
nature of the claims (original)
Hospital and doctor’s waiver and official receipts of full payment (original) Facility where the patient is manage
Original official receipts or photocopies of the same authenticated by PHIC staff (with original copies seen) for For medicines: Pharmacy where it is bought
medicines bought outside the hospital or laboratory tests performed outside the hospital during confinement For laboratory test: Facility where it is done
“The authenticated photocopies is applicable in cases where original ORs are required by and submitted to HMOs
Anesthesia, Surgical or Operative Record (if surgery was performed)(photocopy) Facility where the patient is manage
Hospital Statement of Account duly signed by the hospital clerk or representative of the patient (photocopy)
Printed PhilHealth Benefit Eligibity Form (PBEF) (for facilities with portal) (original)
If confined abroad, Medical Certificate or Clinical Abstract indicating final diagnosis of patient, confinement period
and services rendered written in English (photocopy)
Additional requirements for confinements in non-accredited health care institutions: 1) Health Care Institutions DOH
License and 2) Clinical Abstract of CF3 indicating case was emergency and justification for impossibility of transferring
patient to accredited health care institution (photocopy)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.    Submit duly accomplished acknowledgement 1.1 Receive and screen claims as to completeness of documentary None 10 minutes per Frontline Officer - LHIO
receipt form and PhilHealth claims with requirements (non-medical). claim
supporting documents to the frontline officer 1.2 Stamp “received” the acknowledgement receipt form and
once priority number is called return copy to client/member or return acknowledgement
receipt and PhilHealth claim if with deficiency for client/member’s
compliance
2.    Receive acknowledgement receipt or claim 1.3 Advise Client/Member to expect notice/Benefit Payment
with deficiency Notice (BPN) (within the 60-day period) or to comply with the
required/deficient documents/information.
TOTAL: None 10 minutes per
claim x the no. of
claims
20. Receiving of application for accreditation by Health Care Institutions
Receiving of application for accreditation filed by Health Care Institutions (HCPs) in the Philippines
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business
Who May Avail: All Health Care Institutions willing and qualified to participate in the National Health Insurance Program
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Application for Accreditation (Original) Applicant/Concerned Health Care Institution
Other supporting documents for application for accreditation (Original)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.    Submit duly accomplished application forms 1.1 Receive Provider Data Record (PDR), other accreditation None 15 minutes Frontline Officer - LHIO
for accreditation and supporting documents documentary requirements and payment slip (order of payment)
together with the properly-filled -out payment 1.2 Screen application and other documentary requirements as to
slip once priority number is called completeness of requirements
1.3 Write down the HCI data in the receiving logbook
2.    If the application is not complete, get 2.1 If the application is not complete, return the application
the receiving copy of the application, receive to the HCI, furnish a Deficiency Letter, explain the content of
deficiency letter and explanation on the content the deficiency letter and ask HCI representative to sign under
of the letter and sign under “disposition” column “disposition” column in the receiving logbook
in the receiving logbook 2.2 If the application is complete, stamp complete the file copy
and the receiving copy (PDR and the 1st page of the other
requirements)
2.3 Endorse payment slip (order of payment) to client and advice
to proceed to the Payment Processor window and return after
payment has been made.
3.    Proceed to Cashier for payment 3.1 Receive payment for accreditation of the HCI, print and release Based on 5 minutes Collecting Officer - LHIO
Official Receipt applicable
charges
4. Proceed to frontline service counter and 4.1 Release the receiving copy of the PDR and other requirements None 10 minutes Frontline Officer - LHIO
get receiving copy of the PDR and other to the HCI representative
requirements.
4.2 If LHIO has an Integrated PhilHealth Accreditation System
(iPAS) , they will encode the following HCI data in the receiving
module of IPAS:
 4.2.a.       Name of HCI
4.2.b.      Address
4.2.c.       Date of submission
4.2.d.      OR number
4.2.e.      Amount of payment
4.2.f.        Date of Payment
4.2.g.       Manner of submission
4.2.h.      Documents submitted
TOTAL: None 30 minutes
21. Receiving of application for accreditation by Health Care Professionals
Receiving of application for accreditation filed by Health Care Professionals (HCPs) in the Philippines
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business
Who May Avail: All Health Care Professionals willing and qualified to participate in the National Health Insurance Program
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Application for Accreditation (Original) Applicant/Concerned Health Care Professionals
Other supporting documents for application for accreditation (Original)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.    Submit duly accomplished application form 1.1 Receive application for accreditation, and other supporting None 30 minutes Frontline Officer - LHIO
for accreditation and supporting documents to documents
the frontline officer once the number is called 1.2 Screen as to completeness of requirements
1.3 Write down the Health Care Professional data in the receiving
logbook
2.    If the application is not complete, get the 2.1 If the application is not complete, return the application to the
application and all other requirements, receive HCI, furnish Deficiency Letter, explain content of deficiency letter
the deficiency letter and sign under “disposition” and ask HCI representative to sign under “disposition” column in
column in the receiving logbook the receiving logbook
3.    If the application is complete, get the 3.1 If the application is complete, stamp complete the file copy
receiving copy of all the requirements and receipt and receiving copy of the application and the 1st page of the
of payment. other requirements.
3.2 Release receiving copy of the application to the HCI applicant
3.3 If LHIO has iPAS, encode the following HCI data in the
receiving module of IPAS
3.3.a.      Name of HC Professional
3.3.b.     Address
3.3.c.      Date of submission
3.3.d.     Manner of submission
3.3.e.     Documents submitted
TOTAL: None 30 minutes
22. Check Releasing (Member)
Releasing of benefit payment check to members
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business
Who May Avail: All stakeholders
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Valid IDs (1 photocopy) Claimant
Authorization Letter (if if representative) (original 1 copy) Claimant
Official Receipt (for Health Care Institutions and other Establishments)(original 1 copy) Claimant
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.    Present valid IDs (present authorization letter 1.1 Verify if claim check is available, if not, advice client/member of None 15 minutes Frontline Officer at the
if warranted) once number is called at the Check status of the check (if not yet available, etc.) Check Releasing Counter/
Releasing Counter/Cashier’s window 1.2 Validate IDs presented if check is available and release to Cashier’s Window - LHIO
client/member.
1.3 Require member to acknowledge receipt of the check by
signing the logbook.
2.    Acknowledge receipt of check.
TOTAL: None 15 minutes
23. Check Releasing (picked-up by stakeholders)
Releasing of check to the stakeholders
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business
Who May Avail: All stakeholders
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Valid IDs (1 photocopy) Claimant
Authorization Letter (if if representative) (original 1 copy) Claimant
Official Receipt (for Health Care Institutions and other Establishments)(original 1 copy) Claimant
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.    Present valid company IDs once priority 1.1 Receive and validate company ID None 30 minutes Frontline Officer at the
number is called at the Check Releasing Counter/ 1.2 Verify if check is available, if not, advice client of status of the Check Releasing Counter/
Cashier’s window check, if check is available release check to client. Cashier’s Window - LHIO
2.    Countercheck/validate cheques received then 2.1 Require client to acknowledge receipt of the check by signing
acknowledge receipt of check, affix signature in the logbook and disbursement voucher.
the logbook and disbursement voucher
3. Acknowledge receipt of check and issue official 3.1 Receive the official receipt and file
receipt
TOTAL: None 30 minutes
24. Request for Other Services
Processing of request for Other Services which includes; (Replacement of Check, Adjustment of Benefit Payment, Adjustment of Premium Contribution, Filing
of complaints)
Office/Division: Local Health Insurance Office
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business
Who May Avail: All stakeholders of the National Health Insurance Program
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Filled-out Request Form LHIO
Request letter from the stakeholder Not applicable
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.    Submit duly accomplished request forms 1.1 Receive request form/applicable forms None within 7 days from LHIO personnel or PRO
and supporting documents (if applicable) once 1.2 Check/Evaluate documents received. the receipt of the personnel
priority number is called request
1.3 Provide feedback on requested service; advise member/ (varies depending on the
stakeholder appropriately nature of the request)
1.4 Ask member/stakeholder to affix signature in logbook to
acknowledge filing of request
2. Request for a receiving copy of the request and
asked for the definite timeline when the request
is expected to be acted upon by the concerned
office
TOTAL: None 7 days
1. Member Registration and Issuance of Member Data Record and PhilHealth Identification Card
Frontline Service such as registration for new members, updating of member’s accounts and generation of IDs and MDRs
Office: PhilHealth Regional Offices - PhilHealth Expresses
Classification: Simple
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: Corporate Accounting Section
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Principal Member
PhilHealth Member Registration Form (PMRF) (1 original copy) Philhealth Counter
Birth Certificate (1 photocopy) or 2 Valid IDs (1
photocopy of each ID)
Barangay Certificate for First Time Job Seekers concerned Barangay

Declared Dependent/s of Principal Member

PhilHealth Member Registration Form (PMRF) (1 original copy) Philhealth Counter
Birth Certificate of child (1 photocopy)
Marriage Contract (1 photocopy) for
dependent spouse

Senior Citizen
PhilHealth Member Registration Form (PMRF) (1 original copy) Philhealth Counter
OSCA - Senior Citizen ID or 2 Valid IDs with birthdate or Birth Certificate (1 photocopy)

Representative
Authorization Letter from Member (1 original
copy)
Valid ID of Member (1 photocopy)
Valid ID of Representative (1 photocopy)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Membership Registration
1. Fill up the PhilHealth Member Registration 1.1 Give queuing number and PMRF to client None 5 minutes Philhealth Frontliner assigned
Form (PMRF) at Philhealth Express
2. Submit the filled-up PMRF and the 2.1 Receive the documents and check its None
supporting documents to the Frontline completeness
Counter when number is called
3. Wait for the frontliner while processing the 3.1 Start processing the request None
request
4. Check the details of the information in the ID 4.1 Hand over the requested ID or MDR to None
or Member Data Record (MDR) client
Request for ID/Member Data Record
1. Fill-up Request Form 1.1 Give queuing number and the Request None 5 minutes Philhealth Frontliner assigned
Form to client at Philhealth Express
2. Submit the filled-up Request Form and 2.1 Receive the documents and check its None
supporting documents to the Frontline completeness
Counter when number is called
3. Wait for the frontliner while processing the 3.1 Start processing the request None
request
4. Check the details of the information in the ID 4.1 Hand over the requested ID or MDR to None
or MDR client
TOTAL: None 5 minutes
1. Member Registration and Issuance of Member Data Record and PhilHealth Identification Card
To facilitate the enrolment or renewal of membership coverage of members under the Overseas Workers Program (OWP)
Member Data Record (MDR) - a computer print-out issued to a member as reference of his/her personal information as recorded in the Membership
Database.
PhilHealth Identification Number - is the PhilHealth Identification Card containing the PIN issued by the Corporation to the Members
Office: POEA-OFP Operations Satellite Office
Classification: Simple
Type of Transaction: G2C - Government to Citizen
Who May Avail: Overseas Filipino Workers and Migrant, Beneficiaries of Legal age able to read and write and not suffering from any legal disability
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
1. Migrant Workers (Land-based) PhilHealth Office
- Properly accomplished PMRF
Attach any of the following as proof of being an active OFW:
- Valid Overseas Employment Certificate (OEC) or E-receipt of current year or is valid for one (1) Phipilline Overseas Officemplyment Agency (POEA)
year from date of transaction; or
- Working Visa/Re-entry Permit; or Employer of the host country
- Valid Job Employment Contract; or Employer
- Certificate of Employment for applicable period
from Employer abroad; or
- Valid Company ID issued by Employer abroad; or Employer of the host country
- Cash Remittance receipt from member abroad
atleast 2 months prior to the date of renewal/payment;
or
- Valid workers’ Identification (ID) Card issued by Embassy, Consulate Office of the host country
the host country (i.e. Hongkong ID, Iqama of Saudi,
Permessod’ Soggiorno and Cartad’Identita of Italy); or
- Any other equivalent document that will prove that
the member is an active OFW.
2. Dependent
Spouse
- Marriage Certificate/Contract with registry number Philippine Statistics Authority (PSA)
 - For marriage which took place abroad, marriage Embassy, Consulate Office of the host country
certificate stamped “Received” by the Philippine
Embassy or consular office exercising jurisdiction over
the place of marriage
Muslim Spouse
- Affidavit of Marriage issued by the Office of Muslim Philippine Statistics Authority (PSA)
Affairs (OMA), which passed through the Shari’a
Courtland must be registered/authenticated in the
Philippine Statistics Authority (PSA)
Legitimate or illegitimate children below 21 years old
- Birth Certificate with registry number or Baptismal Philippine Statistics Authority (PSA)
Certificate reflecting the name of the member as
parent
- For births which took place abroad, Birth Certificate Embassy, Consulate Office of the host country
Stamped “Received” by the Philippine Embassy or
Consular office exercising jurisdiction over the place of
birth
Adopted children below 21 years old
- Court Decree/Resolution of Adoption or Birth Department of Social Welfare and Development (DSWD)
Certificate of the adopted child/ren in which adoption
is annotated thereto
Parents with permanent disability totally dependent
with member
- Original Medical Certificate issued by the attending
physician within the past 6 months stating and
describing the extent of disability
3. Foreign Nationals
- Properly accomplished PMRF
- Valid Alien Certificate Registration (ACR) I-Card Bureau of Immigration
issued by the Bureau of Immigration
4. PRA Foreign Retirees
- Properly accomplished PMRF Bureau of Immigration
- Valid SRRV or PRA issued ID Card
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Proceed to PhilHealth Information Desk for FOR MEMBERSHIP None 5 minutes Frontliner
temperature check and fill-out of Covid exposure ADMENDMENT/UPDATING POEA-OFP Operations
disclosure form, PhilHealth Membership Registration 1. Receive Satellite Office
Form (PMRF) and PhilHealth Premium Payment Slip and review the accomplished PMRF
(PPPS) and attach documentary requirements
2. Submit the properly accomplished PMRF with
attach documentary requirements to counter for initial 2 Promptly and correctly encode
assessment and verification the information on the PMRF
into the PhilHealth database
3. Pay the required fee to Cashier counter (Make sure
to secure Official Receipt that will be issued upon 3. Generate Member Data Record and
payment) PhilHealth ID
4. Return to counter for issuance of Member Data
Record (MDR)
MIGRANT WORKER The premium of Overseas 5 minutes Frontliner / Cashier
Filipinos shall be computed POEA-OFP Operations
1. Receive and review the based on their monthly Satellite Office
accomplished PMRF and attach basic income
documentary requirements

2 Promptly and correctly encode

the information on the PMRF
into the PhilHealth database

3. Generate Member Data

Record and PhilHealth ID

4. Generate Statement of Initial

Payment (if client avail Initial payment)
and proceed to Cashier for payment
 FOREIGN NATIONALS None 5 minutes Frontliner / Cashier
POEA-OFP Operations
1. Receive and review the Satellite Office
accomplished PMRF and attach Seventeen Thousand
documentary requirements Pesos (17,000) for Annual
Premium Contribution
2 Promptly and correctly encode Rate
the information on the PMRF
into the PhilHealth database

3. Generate Member Data

Record and PhilHealth ID

PRA FOREIGN RETIREES None 5 minutes Frontliner / Cashier

POEA-OFP Operations
1. Receive and review the Satellite Office
accomplished PMRF and attach Fifteen Thousand Pesos
documentary requirements (15,000) for Annual
Premium Contribution
2 Promptly and correctly encode Rate
the information on the PMRF
into the PhilHealth database

3. Generate Member Data

TOTAL: 20 Minutes
1. Manage Release of Funds through Interim Reimbursement Mechanism (IRM)
A special provision of substantial aid to eligible Health Care Institution directly hit by furtuitous event with clear and apparent intent to continuosly operate
and/or rebuild the Health Care Institution in order to provide continuous health care services to adversely affected Filipinos.
Office/Division: Office of the Area Vice-President/Office of the Regional Vice-President - Health Care Delivery Management Division (HCDMC)/Field
Operations Division (FOD)/Management Services Division (MSD)
Classification: Highly Technical
Type of Transaction: G2G - Government to Government ; G2B - Government to Business
Who May Avail: Eligible Health Care Institutions (HCIs)
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Letter of Intent (1 original copy) Health Care Institutions
Memorandum of Agreement (fully accomplished 6 original copies) Health Care Institutions
Official Receipt once IRM Fund payment is received (1 original copy) Health Care Institutions
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Eligible Health Care Institution to prepare 1.1 Facilitate the application of HCIs to the None 20 days HCDMD Staff/Local Health Insurance
Letter of Intent and secure proforma MOA IRM Fund Office Staff/Eligible Health Care
Institution
1.2 Check eligibility of applicant HCDMD Staff/Local Health Insurance
requesting for IRM funds Office Staff
1.3 Facilitate the proper accomplishment HCDMD Staff/Local Health Insurance
of Letter of Intent/Request (LOI/R) and Office Staff/Eligible Health Care
Contract/MOA with the eligible HCIs. Institution
2. Submit Letter of Intent/Request to the 2.1 Check for completeness of signature Local Health Insurance Office Receiving
nearest Local Health Insurance Office (LHIO) of the Memorandum of Agreement on Clerk
the Health Care Institution side.
2.2 Endorse the Letter of Intent/Request Local Health Insurance Office Head/Staff
to the PhilHealth Regional Office - Health
Care Delivery Management Division
2.3 If approved, the Regional Vice- Regional Vice-President/HCDMD Staff
President signs the MOA and
memorandum of recommendation
addressed to the Area Vice-President and
the President and Chief Executive Officer
 2.4 Transmit to the Central Office via PRO Office of the Regional Vice-President
official email of the Area Vice-President
concerned copy furnished the Fund
management Sector and the Office of the
President and Chief Executive Officer
2.5 Process IRM Fund application at the Office of the Area Vice-President/Office of
Central Office the Health Finance Management Sector/
Fund Management Sector/Office of the
Chief Operating Officer
If approved, the President and Chief President and Chief Executive Officer
Executive Officer signs the MOA
3. Receive payment and issue corresponding 3.1 Notify the Health Care Institution of Office of the Area Vice-President/
Official Receipt and copy of approved MOA the approval. PhilHealth Regional Offices concerned
3.2 Notify the Health Care Institution of PhilHealth Regional Office concerned
the crediting of payment from PhilHealth
through the Auto-Credit Payment Notice
3.3 Monitoring of compliance of health PhilHealth Regional Office concerned
care institution’s submission of official
receipts in acknowledgement of
payment received from PhilHealth for
benefit claims expense

Total: None 20 days

EXTERNAL SERVICES
CORPORATE AFFAIRS GROUP
1. Handling of Simple Client Queries and Feedback thru Calls
Simple queries or feedback from external clients via hotline (02) 8-441-7442.
Office: Corporate Action Center (CAC)
Classification: Simple
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Corporate Action Center channel: hotline (02) 8-441-7442
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Call hotline (02) 8-441-7442 1.  Respond with standard opening spiel None 8 minutes Call, SMS, FB agent
2. Give consent on use of personal 2. Secure consent on use of personal data in the transaction and for quality
data in order to proceed with assurannce purposes
query
3. Provide requested information 3. Ask /clarify client’s concern as necessary and request for name and PIN and
other required information.
None 4. View client’’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
4. Answer security questions 5. Perform information security protocol, if involving sensitve personal
information
5. Receive response 6. Provide response to the query or feedback including other relevant
information using spiels
None 7. Provide contact details and transaction reference number for follow-up
None 8. Encode transaction in CSMS/Tallysheet and close directly resolved
transaction.
TOTAL: None 8 minutes
2. Handling of Complex Client Queries and Feedback thru Calls
Complex Queries or feedback from external clients via hotline (02) 8-441-7442.
Office: Corporate Action Center (CAC)
Classification: Complex
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Corporate Action Center channels: hotline (02) 8-441-7442
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Call hotline (02) 8-441-7442 1.  Respond with standard opening spiel None 8 minutes Call Channel agent
2. Give consent on use of personal 2. Secure consent on use of personal data in the transaction and for quality
data in order to proceed with assurannce purposes
query
3. Provide requested information 3. Ask /clarify client’s concern as necessary and request for name and PIN and
other required information.
None 4. View client’’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
4. Answer security questions 5. Perform information security protocol, if involving sensitve personal
information
5. Receive initial response 6. Provide initial response to the query or feedback including other relevant
information using spiels
7. Provide contact details and transaction reference number for follow-up
None 8. Encode transaction in CSMS/Tallysheet.
9. Escalate complex transaction to Team Leader for level 2 resolution of other
office.
None 10. Coordinate and endorse transaction to responsible office thru CSMS, and 2.9 working days Call Channel Team
record in CAC Logsheet Leader
5. Provide requested information 11. Request client for additional information/documents required for processing, 4 working days Other office
if lacking

Note: Includes at least 3 correct information validated against client’s database

records for information security purposes, if applicable.
6. Receive services and/or final 12. Provide services as may be related to the client’s concern, in accordance with
response existing corporate policies and procedures.

Note: This may include appropriate redress for non-conforming services i.e.
re-work, correction of errors, giving of apology to the client, correction of other
affected processes or services.
13. Communicate final response to client

Note: For services that have long processing time (i.e. claims, employer billing,
claim appeal, etc.), current status may just be provided as final response,
provided that contact information for follow-up is duly communicated.
TOTAL: None 7 Working Days
Note: TAT of Activity 10 is 2.9 working days due to required coordination with other office and volume of escalated calls. As allowed under EODB Law, TAT extension of additional 20
working days may be applied for technical transactions, provided that, client is informed prior to deadline.
3.Handling of Technical Client Queries and Feedback thru Calls
Technical queries or feedback from external clients via hotline (02) 8-441-7442.
Office: Corporate Action Center (CAC)
Classification: Highly Technical
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Corporate Action Center channels: hotline (02) 8-441-7442
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Call hotline (02) 8-441-7442 1.  Respond with standard opening spiel None 8 minutes Call Channel Agent
2. Give consent on use of personal 2. Secure consent on use of personal data in the transaction and for quality
data in order to proceed with assurannce purposes
query
3. Provide requested information 3. Ask /clarify client’s concern as necessary and request for name and PIN and
other required information.
None 4. View client’’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
4. Answer security questions 5. Perform information security protocol, if involving sensitve personal
information
5. Receive initial response 6. Provide initial response to the query or feedback including other relevant
information using spiels
7. Provide contact details and transaction reference number for follow-up
None 8. Encode transaction in CSMS/Tallysheet.
None 9. Escalate technical transaction to Team Leader for resolution of other office.
None 10. Coordinate and endorse to responsible office thru CSMS, and record in CAC 2.9 working days Call Channel Team
Logsheet Leader
6. Provide requested information, 11. Request client for additional information/documents required for processing, 17 working days Other office
if required if lacking

Note: Includes at least 3 correct information validated against client’s database

records for information security purposes, if applicable.
7. Receive services and/or final 12. Provide services as may be related to the client’s concern, in accordance with
response existing corporate policies and procedures.

Note: These may also include appropriate redress for non-conforming services
i.e. re-work, correction of errors, correction of other affected processes or
services, and giving of apology to the client.
13. Communicate final response to client

Note: For services that have long processing time (i.e. claims, employer billing,
claim appeal, etc.), current status may just be provided as final response,
provided that contact information for follow-up is duly communicated.
TOTAL: None 20 Working Days
Note: TAT of Activity 10 is 2.9 working days due to required coordination with other office and volume of escalated calls. As allowed under EODB Law, TAT extension of additional 20
working days may be applied for technical transactions, provided that, client is informed prior to deadline.
4. Handling of Client Queries and Feedback thru Email (Level 1- for direct resolution)
Simple queries or feedback from external clients via [email protected].
Office: Corporate Action Center (CAC)
Classification: Simple
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Corporate Action Center channel:
[email protected]
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send simple email to 1. Sort and distribute 80 valid emails to agents None 3 working days CAC Team Leader
[email protected]
None 2. Read email and check available information for database look-up CAC Agent
None 3. View client’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
2. Receive final response 4. Respond to email using spiel based on available information.
Note:
Response may be as follows:
- Final response (if information/document provided is sufficient to make a
response)
- Request for client to provide additional information/documents

Contact information of CAC for follow-up is provided.

None 5. Encode transaction in CSMS/Tallysheet and close directly resolved
transaction.
TOTAL: None 3 Working Days
Note: TAT of 3 days includes cycle time. It is based on current capacity to manage regular volume of emails, with quota set at 80 per agent per day. As allowed under EODB Law, TAT
extension of additional 3 working days may be applied for simple transactions, provided that, client is informed prior to deadline.
5. Handling of Client Queries and Feedback thru Email (Level 2- for endorsement to other office)
Complex queries or feedback from external clients received by Corproate Action Center via email ([email protected].). These transactions are
for endorsement by CAC to another office for Level 2 resolution.
Office: Corporate Action Center (CAC)
Classification: Complex
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Corporate Action Center channel:
[email protected]
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send email to actioncenter@ 1. Sort and distribute 80 valid emails to agents None 3 working days CAC Team Leader
philhealth.gov.ph
None 2. Read email and check available information for database look-up CAC Agent
None 3. View client’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
2. Receive acknowledgement and 5. Respond with acknowledgement and initial response using spiel based on
initial response available information and database

Contact information of CAC for follow-up are provided.

None 5. Encode transaction in CSMS/Tallysheet.

None 6. Escalate complex transaction to Team Leader for resolution of other office.
None 7. Coordinate and endorse to responsible office thru CSMS, and record in CAC CAC Team Leader
Logsheet
3. Provide requested information 8. Request client for additional information/documents required for processing, 4 working days Other office
if applicable.

Note: Includes at least 3 correct information validated against client’s database

records for information security purposes, if applicable.
4. Receive services and/or final 9. Provide services as may be related to the client’s concern, in accordance with
response existing corporate policies and procedures.

Note: These may also include appropriate redress for non-conforming services
i.e. re-work, correction of errors, correction of other affected processes or
services, and giving of apology to the client.
10. Communicate final response to client

Note: For services that have long processing time (i.e. claims, employer billing,
claim appeal, etc.), current status may just be provided as final response,
provided that contact information for follow-up is duly communicated.
TOTAL: None 7 working days
Note: TAT of 3 days for endorsements includes cycle time. It is based on current capacity to manage regular volume of emails, with quota set at 80 per agent per day. As allowed under
EODB Law, TAT extension of additional 7 working days may be applied for complex transactions, provided that, client is informed prior to deadline.
6.  Handling of Client Queries and Feedback via Email
Queries or feedback from external clients received by Corproate Action Center via email ([email protected].). These transactions are for
endorsement by CAC and for Level 2 resolution of another office involving provision of core services (i.e. membership,collection, claims, accreditation, etc)
and/or review and management approval process.
Office: Corporate Action Center (CAC)
Classification: Highly Technical
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Corporate Action Center channel: [email protected]
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send email to actioncenter@ 1. Sort and distribute 80 valid emails to agents None 3 working days CAC Team Leader
philhealth.gov.ph
None 2. Read email and check available information for database look-up CAC Agent
None 3. View client’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
2. Receive acknowledgement and 5. Respond with acknowledgement and initial response using spiel based on
initial response available information and database

Contact information of CAC for follow-up are provided.

None 5. Encode transaction in CSMS/Tallysheet.

None 6. Escalate technical transacction to Team Leader for resolution of other office.
None 7. Coordinate and endorse to responsible office thru CSMS, and record in CAC CAC Team Leader
Logsheet
3. Provide requested information 8. Request client for additional information/documents required for processing, 8 working days Other office
if applicable.

Note: Includes at least 3 correct information validated against client’s database

records for information security purposes, if applicable.
5. Receive services, if applicable 9. Provide services as may be related to the client’s concern, in accordance with
existing corporate policies and procedures.

Note: These may also include appropriate redress for non-conforming services
i.e. re-work, correction of errors, correction of other affected processes or
services, and giving of apology to the client.
None 10. Prepare final response letter to client using spiel and based on available 3 working days
information.

Note: For services that have long processing time (i.e. claims, employer billing,
claim appeal, etc.), current status may just be provided as final response,
provided that contact information for follow-up is duly communicated.
None 11. Review draft response letter 3 working days
None 12. Revise draft response letter as necessary
None 13. Sign final response
6. Receive final response letter 14. Release response letter to client
TOTAL: None 20 working days
Note: TAT of 3 days for enodrsement of CAC includes cycle time. It is based on current capacity to manage regular volume of emails, with quota set at 80 per agent per day. As allowed
under EODB Law, TAT extension of additional 20 working days may be applied for technical transactions, provided that, client is informed prior to deadline.
7. Handling of Client Queries and Feedback via Social Media and SMS (Level 1- for direct resolution)
Simple queries or feedback from external clients via “PhilHealthofficial” Facebook page and textline 0917-898-7442.
Office: Corporate Action Center (CAC)
Classification: Simple
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Corporate Action Center channels: “PhilHealthofficial” Facebook
page Textline 0917-898-7442.
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send message to 1.  Respond with standard opening spiel None 3 working days CAC Agent
PhilHealth FB page, or textline
0917-898-7442.
2. Give consent on use of personal 2. Message client to secure consent on use of personal data in the transaction
data in order to proceed with and for quality assurannce purposes
query

3. Provide requested information 3. Ask /clarify client’s concern as necessary and request for name and PIN and
other required information.
None 4. View client’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
4. Answer security questions 5. Perform information security protocol, if involving sensitve personal
information
5. Receive final response 6. Provide response to the query or feedback including other relevant
information using spiels
7. Provide contact details and transaction reference number for follow-up
None 8. Provide closing spiel.
None 9. Encode transaction in CSMS/Tallysheet and close directly resolved
transaction.
TOTAL: None 3 working days
Note: TAT of 3 days processing by CAC includes cycle time. It is based on current capacity to manage regular volume of emails, with quota set at 80 per agent per day. As allowed under
EODB Law, TAT extension of additional 3 working days may be applied for simple transactions, provided that, client is informed prior to deadline.
8.  Handling of Client Queries and Feedback via Social Media and SMS (Level 2- for endorsement to other office)
Queries or feedback from external clients received by Corproate Action Center via “PhilHealthofficial” Facebook page and Textline
0917-898-7442. These transactions are for endorsement by CAC and for Level 2 resolution of another office involving provision of
core services (i.e. membership,collection, claims, accreditation, etc) with review process.
Office: Corporate Action Center (CAC)
Classification: Complex
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Corporate Action Center channels: “PhilHealthofficial” Facebook
page Textline 0917-898-7442.
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send message to 1.  Respond with standard opening spiel None 3 working days CAC Agent
PhilHealth FB page, or textline
0917-898-7442.
2. Give consent on use of personal 2. Message client to secure consent on use of personal data in the transaction
data in order to proceed with and for quality assurannce purposes
query
3. Provide requested information 3. Ask /clarify client’s concern as necessary and request for name and PIN and
other required information.
None 4. View client’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
4. Answer security questions 5. Perform information security protocol, if involving sensitve personal
information
5. Receive acknowedgement and 6. Provide acknowledgement and initial response to the query or feedback
initial response including other relevant information using spiels
7. Provide contact details and transaction reference number for follow-up
8. Provide closing spiel.
None 9. Escalate complex transaction to Team Leader for resolution of other office.
None 10. Coordinate and endorse to responsible office thru CSMS, and record in CAC CAC Team Leader
Logsheet
5. Provide requested information 11. Request client for additional information/documents required for processing, 4 working days Other office
if applicable.

Note: Includes at least 3 correct information validated against client’s database

records for information security purposes, if applicable.
6. Receive services and/or final 12. Provide services as may be related to the client’s concern, in accordance with
response existing corporate policies and procedures.

Note: These may also include appropriate redress for non-conforming services
i.e. re-work, correction of errors, correction of other affected processes or
services, and giving of apology to the client.
13. Communicate final response to client

Note: For services that have long processing time (i.e. claims, employer billing,
claim appeal, etc.), current status may just be provided as final response,
provided that contact information for follow-up is duly communicated.
TOTAL: None 7 working days
Note: TAT of working 3 days processing by CAC includes cycle time. It is based on current capacity to manage regular volume of sms and FB messages, with quota set at 80 per agent per
day. As allowed under EODB Law, TAT extension of additional 3 working days may be applied for simple transactions, provided that, client is informed prior to deadline.
9.  Handling of Technical Client Queries and Feedback via Social Media and SMS
Queries or feedback from external clients via “PhilHealthofficial” Facebook page and textline 0917-898-7442. These transactions are for endorsement by CAC
and for Level 2 resolution of another office involving provision of core services (i.e. membership,collection, claims, accreditation, etc) with review and
Office: Corporate Action Center (CAC)
Classification: Highly Technical
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Corporate Action Center channels: “PhilHealthofficial” Facebook
page Textline 0917-898-7442.
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send message to PhilHealth FB 1.  Respond with standard opening spiel None 3 working days CAC Agent
page, or textline 0917-898-7442.
2. Give consent on use of personal 2. Message client to secure consent on use of personal data in the transaction
data in order to proceed with and for quality assurannce purposes
query
3. Provide requested information 3. Ask /clarify client’s concern as necessary and request for name and PIN and
other required information.
None 4. View client’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
4. Answer security questions 5. Perform information security protocol, if involving sensitve personal
information
5. Receive acknowledgement and 6. Provide acknowledgemnt and initial response to the query or feedback
initial response including other relevant information using spiels
7. Provide contact details and transaction reference number for follow-up
8. Provide closing spiel
None 9. Escalate technical transaction to Team Leader for resolution of other office.
None 10. Coordinate and endorse to responsible office thru CSMS, and record in CAC CAC Team Leader
Logsheet
5. Provide requested information 11. Request client for additional information/documents required for 8 working days Other office
processing, if applicable.

Note: Includes at least 3 correct information validated against client’s database

records for information security purposes, if applicable.
5. Receive services, if applicable 12. Provide services as may be related to the client’s concern, in accordance with
existing corporate policies and procedures.

Note: These may also include appropriate redress for non-conforming services
i.e. re-work, correction of errors, correction of other affected processes or
services, and giving of apology to the client.
None 14. Prepare final response letter to client using spiel and based on available 3 working days
information.

Note: For services that have long processing time (i.e. claims, employer billing,
claim appeal, etc.), current status may just be provided as final response,
provided that contact information for follow-up is duly communicated.
None 15. Review draft response letter 3 working days
None 16. Revise draft response letter as necessary
None 17. Sign final response
6. Receive final response letter 18. Release response letter to client
TOTAL: None 20 working days
Note: TAT of 3 working days processing by CAC includes cycle time. It is based on current capacity to manage regular volume of sms and FB messages, with quota set at 80 per agent per
day. As allowed under EODB Law, TAT extension of additional 3 working days may be applied for simple transactions, provided that, client is informed prior to deadline.
10.  Handling of Complex Client Queries and Feedback via letter
Queries or feedback from external clients via letter (including letters from Presidential Complaint Center which are ffor Level 1 resolution by CAC with
review and approval process.
Office: Corporate Action Center (CAC)
Classification: Complex
Type of Transaction: G2C- Government to Citizen ,G2G-Government to Government
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Thru letter sent to: Philippine Health Insurance Corporation Head Office CityState Center, 709 Shaw Boulevard, Oranbo,
Pasig City Presidential Complaint Center [email protected] (letter)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send query/feedback via letter 1. Sort and distribute letters to agents 4 working days Letter Channel Team
to PhilHealth Head Office Leader
None 2. Read letter and check available contact information. Letter Channel Agent
2. Provide requested information 3. Contact client thru phone, text or email (if available), ask /clarify concern and
request for name and PIN and other required information as necessary.
None 4. View client’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
3. Receive initial response 5. Resolve concern through phone, text or email, if possible.
None 6. Prepare response letter using spiel and based on available information. 3 working days
Note:
Response may be as follows:
- Documentation of the resolution (if outrightly resolved via phone)
- Final response (if information/document provided is sufficient to make a
response)
- Request for client to provide additional information/documents (if client was
not able to provide requested information or was not contacted in Step 3).

Contact information of CAC for follow-up is provided.

None 7. Review draft response letter and provide comments, if any CAC Head
None 8. Finalize reply letter, if wth comments Letter Channel Agent
None 9. Sign finalized response letter CAC Head
4. Receive final response letter 10. Release response letter to client via email (if available) or thru PhilHealth Releasing Staff
Mailing Section
TOTAL: None 7 working days
Note: TAT of 7 working days processing by CAC includes cycle time. It is based on current capacity to manage regular volume of Letters. As allowed under EODB Law, TAT extension of
additional 7 working days may be applied for complex transactions, provided that, client is informed prior to deadline.
11. Handling of Client Queries and Feedback via letter (Level 2 - for initial response of CAC and resolution of other office)
Technical queries or feedback from external clients via letter (including letters from Presidential Complaint Center). These transactions are
for endorsement by CAC and for Level 2 resolution of another office involving provision of core services (i.e. membership,collection, claims,
accreditation, etc) with review and management approval process.
Office: Corporate Action Center (CAC)
Classification: Highly Technical
Type of Transaction: G2C- Government to Citizen ,G2G-Government to Government
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Thru letter sent to: Philippine Health Insurance Corporation Head Office CityState Center, 709 Shaw Boulevard
Oranbo, Pasig City Presidential Complaint Center [email protected] (letter)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send query/feedback via letter 1. Assign letters to agents 3 working days Letter Channel Team
to PhilHealth Head Office Leader
Letter Channel Agent
None 2. Read letter and check available contact information.
2. Provide requested information 3. Contact client thru phone or text (if available), ask /clarify concern and
request for name and PIN and other information/document, if lacking.
None 4. View client’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
None 5. Coordinate technical transaction with concerned office, as necessary, and
provide advance copy of letter and attachments
None 6. Encode transaction in CSMS and Logsheet
None 7. Prepare acknowledgement letter to client and endorsement memorandum to 3 working days
responsible office, using spiel and based on available information.

Contact information of CAC for follow-up is provided.

None 8. Review draft response letter and endorsement CAC Head

None 9. Revise draft response and endorsement as necessary Letter Channel Agent
None 10. Sign finalized response and endorsement letter CAC Head
3. Receive acknowledgeement and 11. Release acknowledgement and initial response letter to client via email (if Email Team or Releasing
initial response letter available) or thru PhilHealth Mailing Section and endorsement Staff
None 12. Release endorsement memo to responsible office via official email and via 8 working days Email Channel TL and
CSMS; oncode in Logsheet Letter Channel Agent
Other office
4. Provide requested information 13. Request client for additional information/documents required for
processing, if applicable.

Note: Includes at least 3 correct information validated against client’s database

records for information security purposes, if applicable.
5. Receive services, if applicable 14. Provide services as may be related to the client’s concern, in accordance with
existing corporate policies and procedures.

Note: These may also include appropriate redress for non-conforming services
i.e. re-work, correction of errors, correction of other affected processes or
services, and giving of apology to the client.
None 15. Prepare final response letter to client using spiel and based on available 3 workiing days Action Officer Designate
information. 3 working days (AOD) of Other Office

Note: For services that have long processing time (i.e. claims, employer billing,
claim appeal, etc.), current status may just be provided as final response,
provided that contact information for follow-up is duly communicated.
None 16. Review draft response letter Head of Other Office
None 17. Revise draft response letter as necessary Action Officer Designate
(AOD) of Other Office
None 18. Sign final response Head of Other Office
6. Receive final response letter 19. Release response letter to client via email (if available) Releasing Staff
TOTAL: None 20 working days
Note: As allowed under EODB Law, TAT extension of additional 20 working days may be applied for technical transactions, provided that, client is informed prior to deadline.
12.  Handling of Simple Client Queries and Feedback lodged to Government Channels (Level 1 - for direct resolution of CAC)
Smple queries or feedback from external clients lodged to Government Channels i.e. 8888, CSC-CCB and ARTA (with online system). These transactions are
for direct resolution by CAC using pre-approved spiels and not requiring review and approval process. .
Office: Corporate Action Center (CAC)
Classification: Simple
Type of Transaction: G2C- Government to Citizen,G2G Government to Government
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Anti-Red Tape Authority (ARTA): [email protected] 8-478-5093 Presidential Complaint Center (PCC):
8888 Contact Center ng Bayan (CCB): [email protected] 0908-881-6565
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Client sends query/feedback thru 1. Receive endorsement from Government Channel None 3 working days CAC Technical Point
Government Channel Person
(Initial action must
Government Channel endorses be within 72 hours)
feedback/ transaction to CAC
None 2. Read client’s concern and check available contact information.
2. Provide requested information 3. Contact client thru phone or text (if available), ask /clarify concern and
request for name and PIN and other required information as necessary.
None 4. Record initial actios in Government Channel’s online system and upload
documentation.

Contact information of CAC for follow-up is provided.

None 5. View client’s profile using Customer Service Management System (CSMS)
and assess information needs of client (including other aspects of participation
in the National Health Insurance Program.)
3. Receive final response 6. Immediately resolve simple concern through text or email for
documentation.
None 7. Record resolution of transaction in Government Channel’s online system and
upload documentation.

Contact information of CAC for follow-up is provided.

None 8. Record transaction in CSMS and close directly resolved transaction.
TOTAL: None 3 working days
Note: Initial contact with client must be with concrete and specifc action within 72 hours from receipt, as mandated by EO 6, 2016. As allowed under EODB Law, TAT extension of additional
3 working days may be applied for simple transactions, provided that, client is informed prior to deadline.
13. Handling of Complex Client Queries and Feedback lodged to Government Channels
(Level 1 - direct resolution, Complex - with no available spiel)
Queries or feedback from external clients lodged to Government Channels i.e. 8888, CSC-CCB and ARTA (with online system). These transactions are for
direct resolution by CAC without pre-approved spiels and requiring review and approval process.
Office: Corporate Action Center (CAC)
Classification: Complex
Type of Transaction: G2C- Government to Citizen,G2G Government to Government
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Anti-Red Tape Authority (ARTA): [email protected] 8-478-5093 Presidential Complaint Center (PCC): 8888
Contact Center ng Bayan (CCB): [email protected] 0908-881-6565
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Client sends query/feedback 1. Receive endorsement from Government Channel None 3 working days
thru Government Channel
Government Channel endorses (Initial action must
feedback/ transaction to CAC be within 72 hours)
None 2. Read client’s concern and check available contact information.
2. Provide requested 3. Contact client thru phone, text or email (if available), ask /clarify concern and
information request for name and PIN and other required information as necessary.
None 4. Encode initial actions in Government Channel’s online system.
None 5. View client’s profile using Customer Service Management System (CSMS) and 4 working days
assess information needs of client (including other aspects of participation in the
National Health Insurance Program.)
None 6. Prepare response based on available information.
Note: Response may be as follows:
Contact information of CAC for follow-up is provided.
None 7. Review draft response CAC Head
None 8. Finalize response as necessary CAC Technical Point Person
None 9. Approve finalized response CAC Head
4. Receive final response letter 10. Release response to client via email (if available) CAC Technical Point Person
None 11. Record resolution of transaction and upload documentation in Government CAC Technical Point Person
Channel’s online system.
None 12. Close the transaction ticket in CSMS
TOTAL: None 7 working days
Note: As allowed under EODB Law, TAT extension of additional 7 working days may be applied for complex transactions, provided that, client is informed prior to deadline.
14. Handling of Client Queries and Feedback lodged to Government Channels
(Level 2 - for endorsement to other office)
Simple queries or feedback from external clients lodged to Government Channels i.e. 8888, CSC-CCB and ARTA (with online system). These transactions are
for direct resolution by CAC without pre-approved spiels and requiring review and approval process.
Office: Corporate Action Center (CAC)
Classification: Complex
Type of Transaction: G2C- Government to Citizen,G2G Government to Government
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Anti-Red Tape Authority (ARTA): [email protected] 8-478-5093 Presidential Complaint Center (PCC): 8888
Contact Center ng Bayan (CCB): [email protected] 0908-881-6565
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Client sends query/feedback 1. Receive endorsement from Government Channel None 2 working days CAC Technical Point Person
thru Government Channel

Government Channel endorses (Initial action must

feedback/ transaction to CAC be within 72 hours)
None 2. Read client’s concern and check available contact information.
2. Provide requested 3. Contact client thru phone, text or email (if available), ask /clarify concern and
information request for name and PIN and other required information as necessary.
None 4. Encode initial actions in Government Channel’s online system.
None 5. View client’s profile using Customer Service Management System (CSMS) and
assess information needs of client (including other aspects of participation in the
National Health Insurance Program.)
None 6. Coordinate and endorse complex transaction with concerned office via email
for docmentation.
None 7. Encode transaction and initial actions in Government Channel’s online system 5 working days Other office
and in CSMS and Logsheet.
3. Provide requested 8. Request client for additional information/documents required for processing,
information if applicable.
4. Receive services and/or final
response Note: Includes at least 3 correct information validated against client’s database
records for information security purposes, if applicable.
 9. Provide services as may be related to the client’s concern, in accordance with
existing corporate policies and procedures.

Note: These may also include appropriate redress for non-conforming services
i.e. re-work, correction of errors, correction of other affected processes or
services, and giving of apology to the client.
10. Communicate final response to client

Note: For services that have long processing time (i.e. claims, employer billing,
claim appeal, etc.), current status may just be provided as final response,
provided that contact information for follow-up is duly communicated.
None 11. Record status of transaction in CSMS and endorse to CAC Technical Point Action Officer Designate
Person for closure (AOD) of Other Office
None 12. Record resolution of transaction and upload documentation in Government CAC Technical Point Person
Channel’s online system.

Contact information of CAC for follow-up is provided.

None 13. Close the transaction ticket in CSMS
TOTAL: None 7 working days
Note: As allowed under EODB Law, TAT extension of additional 7 working days may be applied for complex transactions, provided that, client is informed prior to deadline.
15. Handling of Client Queries and Feedback lodged to Government Channels
Queries or feedback from external clients via letter (including letters from Presidential Complaint Center) whic are for endorsement by CAC and for Level 2
resolution of another office involving provision of core services (i.e. membership,collection, claims, accreditation, etc) with review and management approval
process.
Office: Corporate Action Center (CAC)
Classification: Highly Technical
Type of Transaction: G2C- Government to Citizen,G2G Government to Government
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None Anti-Red Tape Authority (ARTA): [email protected] 8-478-5093 Presidential Complaint Center (PCC): 8888
Contact Center ng Bayan (CCB): [email protected] 0908-881-6565
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Client sends query/feedback 1. Receive endorsement from Government Channel None 3 working days CAC Technical Point Person
thru Government Channel

Government Channel endorses (Initial action must

feedback/ transaction to CAC be within 72 hours)
None 2. Read client’s concern and check available contact information.
2. Provide requested 3. Contact client thru phone, text or email (if available), ask /clarify concern and
information request for name and PIN and other required information as necessary.
None 4. Encode initial actions in Government Channel’s online system.
None 5. View client’s profile using Customer Service Management System (CSMS) and
assess information needs of client (including other aspects of participation in the
National Health Insurance Program.)
None 6. Coordinate and endorse complex transaction with concerned office via email
for docmentation.
None 7. Encode transaction and initial actions in Government Channel’s online system 8 working days
and in CSMS and Logsheet.
3. Provide requested 8. Request client for additional information/documents required for processing, Other office
information if applicable.

Note: Includes at least 3 correct information validated against client’s database

records for information security purposes, if applicable.
4. Receive services, if 9. Provide services as may be related to the client’s concern, in accordance with
applicable existing corporate policies and procedures.

Note: These may also include appropriate redress for non-conforming services
i.e. re-work, correction of errors, correction of other affected processes or
services, and giving of apology to the client.
None 10. Prepare final response letter to client using spiel and based on available 3 workiing days Action Officer Designate
information. 3 working days (AOD) of Other Office

ote: For services that have long processing time (i.e. claims, employer billing,
claim appeal, etc.), current status may just be provided as final response,
provided that contact information for follow-up is duly communicated.
None 11. Review draft response letter Head of Other Office
None 12. Revise draft response letter as necessary Action Officer Designate
(AOD) of Other Office
None 13. Sign final response Head of Other Office
6. Receive final response letter 14. Release response letter to client via email (if available) or thru PhilHealth 3 working days Releasing Staff
Mailing Section.
None 15. Record status of transaction in CSMS and endorse to CAC Technical Point Action Officer Designate
Person for closure (AOD) of Other Office
None 16. Record resolution of transaction and upload documentation in Government CAC Technical Point Person
Channel’s online system.

Contact information of CAC for follow-up is provided.

None 17. Close the transaction ticket in CSMS
TOTAL: None 20 working days
Note: As allowed under EODB Law, TAT extension of additional 20 working days may be applied for technical transactions, provided that, client is informed prior to deadline.
16. Handling of Simple Client Queries and Feedback via CAC Walk-In Counter
Simple queries or feedback from external clients via CAC Walk-In Counter.
Office: Corporate Action Center (CAC)
Classification: Simple
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
For complaints against non-remitting employers: CAC Walk-In Counter
- “Salaysay” or affidavit (available at CAC) Room 706, CityState Center,
- Payslip and proof of non-payment 709 Shaw Boulevard,
Oranbo, Pasig City
For all other complaints and queries: NONE
Core processes on membership, collection, benefit availment and accreditation are not available at CAC.
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit simple query/ 1.  Respond with standard opening spiel None 8 minutes CAC Walk-In Agent
feedback at CAC Walk-In
Counter
2. Give consent on use of 2. Secure consent on use of personal data in the transaction and for quality
personal data in order to assurannce purposes
proceed with query

3. Provide requested 3. Ask /clarify client’s concern as necessary and request for name and PIN and
information other required information.
None 4. View client’’s profile using Customer Service Management System (CSMS) and
assess information needs of client (including other aspects of participation in the
National Health Insurance Program.)
4. Answer security questions 5. Perform information security protocol, if involving sensitve personal
5. Receive final response and information
information materials 6. Provide response to the query or feedback including other relevant
information using spiels
7. Provide contact details and transaction reference number for follow-up
None 8. Encode transaction in CSMS and Logsheet and close directly resolved
transaction.
TOTAL: None 8 minutes
17.  Handling of Complex Client Queries and Feedback via CAC Walk-In Counter
Complex queries or feedback from external clients via CAC Walk-In Counter.
Office: Corporate Action Center (CAC)
Classification: Complex
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
For complaints against non-remitting employers: CAC Walk-In Counter
- “Salaysay” or affidavit (available at CAC) Room 706, CityState Center,
- Payslip and proof of non-payment 709 Shaw Boulevard,
Oranbo, Pasig City
For all other complaints and queries: NONE
Core processes on membership, collection, benefit availment and accreditation are not available at CAC
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit complex query/ 1.  Respond with standard opening spiel None 8 minutes CAC Walk-In Agent
feedback at CAC Walk-In
Counter
2. Give consent on use of 2. Secure consent on use of personal data in the transaction and for quality
personal data in order to assurannce purposes
proceed with query

3. Provide requested 3. Ask /clarify client’s concern as necessary and request for name and PIN and
information other required information.
None 4. View client’’s profile using Customer Service Management System (CSMS) and
assess information needs of client (including other aspects of participation in the
National Health Insurance Program.)
4. Answer security questions 5. Perform information security protocol, if involving sensitve personal
information
5. Accomplish forms and 6. Require to accomplish forms and submit supporting documents as applicable
attach supporting documents (based on requirements per process as posted in www.philhealth.gov.ph)
5. Receive acknowledgment 7. Provide response to the query or feedback including other relevant
and initial response information using spiels
8. Provide contact details and transaction reference number for follow-up
None 10. Encode transaction in CSMS and Logsheet. 2.9 working days CAC Walk-In Agent
None 11. Coordinate complex transaction with concerned office, as necessary, and
provide advance copy of letter and attachments
None 12. Prepare endorsement memorandum to responsible office, using spiel and
based on available information.

None 13. Review draft endorsement CAC Head

None 14. Revise draft endorsement as necessary CAC Walk-In Agent
None 15. Sign finalized endorsement letter CAC Head
None 16. Release endorsement memo to responsible office via official email and via 4 working days CAC Walk-In agent
CSMS Other office
7. Provide requested 17. Request client for additional information/documents required for processing,
information if applicable.
8. Receive services and/or final
response Note: Includes at least 3 correct information validated against client’s database
records for information security purposes, if applicable.
18. Provide services as may be related to the client’s concern, in accordance with
existing corporate policies and procedures.

Note: These may also include appropriate redress for non-conforming services
i.e. re-work, correction of errors, correction of other affected processes or
services, and giving of apology to the client.
19. Communicate final response to client

Note: For services that have long processing time (i.e. claims, employer billing,
claim appeal, etc.), current status may just be provided as final response,
provided that contact information for follow-up is duly communicated.
TOTAL: None 7 working days
Note: As allowed under EODB Law, TAT extension of additional 7 working days may be applied for compllex transactions, provided that, client is informed prior to deadline.
18. Handling of Technical Client Queries and Feedback via CAC Walk-In Counter
Technical queries or feedback from external clients via CAC Walk-In Counter.
Office: Corporate Action Center (CAC)
Classification: Highly Technical
Type of Transaction: G2C- Government to Citizen
Who may avail: All external clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
For complaints against non-remitting employers: CAC Walk-In Counter
- “Salaysay” or affidavit (available at CAC) Room 706, CityState Center,
- Payslip and proof of non-payment 709 Shaw Boulevard,
Oranbo, Pasig City
For all other complaints and queries: NONE
Core processes on membership, collection, benefit availment and accreditation are not available at CA
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit technical query/ 1.  Respond with standard opening spiel None 8 minutes CAC Walk-In agent
feedback at CAC Walk-In
Counter
2. Give consent on use of 2. Secure consent on use of personal data in the transaction and for quality
personal data in order to assurannce purposes
proceed with query

3. Provide requested 3. Ask /clarify client’s concern as necessary and request for name and PIN and
information other required information.
None 4. View client’s profile using Customer Service Management System (CSMS) and
assess information needs of client (including other aspects of participation in the
National Health Insurance Program.)
4. Answer security questions 5. Perform information security protocol, if involving sensitve personal
information
5. Accomplish forms and 6. Require to accomplish forms and submit supporting documents as applicable
attach supporting documents (based on requirements per process as posted in www.philhealth.gov.ph)
6. Receive acknowledement 7. Provide acknowledgement and initial response to the query or feedback
and initial response including other relevant information using spiels
8. Provide contact details and transaction reference number for follow-up None 2.9 working days CAC Walk-In agent
None 9. Encode transaction in CSMS
None 10. Coordinate technical transaction with concerned office, as necessary, and
provide advance copy of letter and attachments
None 11. Prepare endorsement memorandum to responsible office, using spiel and
based on available information.

None 12. Review draft endorsement CAC Head

None 13. Revise draft endorsement as necessary CAC Walk-In agent
None 14. Sign finalized endorsement letter CAC Head
None 15. Release endorsement memo to responsible office via official email and via None 8 working days CAC Walk-In agent
CSMS Other office
7. Provide requested 16. Request client for additional information/documents required for processing,
information if applicable.

Note: Includes at least 3 correct information validated against client’s database

records for information security purposes, if applicable.
8. Receive services and/or final 17. Provide services as may be related to the client’s concern, in accordance with
response existing corporate policies and procedures.

Note: These may also include appropriate redress for non-conforming services
i.e. re-work, correction of errors, correction of other affected processes or
services, and giving of apology to the client.
None 18. Prepare final response letter to client using spiel and based on available 5 workiing days Action Officer Designate
information. 4 working days (AOD) of Other Office

Note: For services that have long processing time (i.e. claims, employer billing,
claim appeal, etc.), current status may just be provided as final response,
provided that contact information for follow-up is duly communicated.
None 19. Review draft response letter Head of Other Office
None 20. Revise draft response letter as necessary Action Officer Designate
(AOD) of Other Office
None 21. Sign final response Head of Other Office
6. Receive final response letter 22. Release response letter to client via email (if available) or thru PhilHealth Releasing Staff
Mailing Section.
TOTAL: None 20 working days
Note: As allowed under EODB Law, TAT extension of additional 20 working days may be applied for technical transactions, provided that, client is informed prior to deadline.
EXTERNAL SERVICES
FUND MANAGEMENT SECTOR
1. Securing Order of Payment
Information for Cashier as to type of transaction being paid as well as the account code to be encoded

Office: Corporate Accounting Section

Classification: Simple
Type of Transaction: G2B,G2G
Who May Avail: Bidders, Philhealth Employees, Business Entities
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Bid documents - 1 Original Copy SBAC
Notice of Appeal - 1 Original Copy Arbitration Departmentw
Service Decision - 1 Original Copy Arbitration Department
Certificate of Finality - 1 Original Copy Arbitration Department
Accreditation Document - 1 Original Copy Treasury Department
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Present the required Document 1) Fill out the Order of Payment Document None 5 minutes 1 Fiscal Controller III - General
to be paid indicating the amount to be paid (listed on the bid Accounting Unit
docs, Notice of appeal, service Decision, Certificate
of Finality and Accreditation Documents)
2) Direct the client to the Cashier Section at Room none
1612 for payment
TOTAL: None 5 minutes
2. Preparation of Financial Statements
Consolidation of PROs and Head Office Trial Balance to come up with Financial Statements for management’s decision making and for Public Information of
the Financial Condition, Performance and other relevant information regarding the corporation

Office: Corporate Accounting Section

Classification: Highly Technical
Type of Transaction: G2G (Internal and External)
Who May Avail: All PhilHealth Cost Centers
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
PROs Consolidated Trial Balance - 1 original Copy Branch Accounting Section
General Journal - 1 original Copy Corporate Accounting Section
Journal of Collection and Deposit - 1 original copy Cash Division/Treasury Department
Voucher Register -1 Original Copy Disbursement Administration Section
Check Register - 1 Original Copy Cash Division and Corporate Accounting
Trial Balance - Head Office - 1 General Accounting Unit
original Copy
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
The Branch Accounting Unit, Cash Corporate Accounting Section shall analyze and none 20 days after the 1Fiscal Controller IV - Corporate Accounting
Division, Disbursement Section process to come with the Consolidated Trial ensuing month Section
shall submit respective reports to balance and classifly the accounts to come up with 2 Fiscal Controller III - General Accounting
the Corporate Accounting Section the Financial Statements 4 Fiscal Controller II - General Accounting Unit
2 Fiscal Examiner A - General Accounting Unit
2 Fiscal Controller 1 -General Accounting Unit

TOTAL: None 20 days after the

ensuing month
1. Processing of Disbursement Vouchers
Pre-audit disbursement vouchers in order to have a check prepared to pay an individual or an organization for goods sold or services rendered.
Office: Disbusement Administration Section (DAS)(
Classification: Complex
Type of Transaction: G2G
Who May Avail: External and Internal Clients
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Budget Utilization Request (BUR) Form (3 original copies) Financial Accounting Reporting Utility (FARU)
Disbursement Vouchers (DV) (4 original copies) Financial Accounting Reporting Utility (FARU)
Documentary requirements as stated in CO 2020-0118 Various sources
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Log in to FARU 1. DAS will receive the documents from NONE 1.5 wdays for simple transactions; 1. Receiving Clerk – Disbursement
the Budget Administration Section and 3 wdays for complex transactions Administration Section (DAS)
pre- audit the transaction.
2. Enter all the details for DV 2. Prepare the necessary accounting 2. Processor – DAS
preparation entries.
3. Print DV and BUR 3. Certify the completeness of the 3. Fiscal Controller III / Authorized Box B
documentary requirements. signatory (DAS) in accordance with the
Corporate Order on the Delegation and
Signing Authority
4. Attach documentary 4. Approve the payment of the 4. Head, Das / Authorized Box C signatory
requirements for the particular transaction. (DAS) in accordance with the Corporate Order
transaction on the Delegation and Signing Authority
5. Sign Box A 5. Transmit the documents (manually and 5. Receiving/releasing clerk (DAS)
electronically) to the Cash Division for
check preparation.
6. Transmit the documents to the
Budget Administration Section –
Comptrollership Dept. manually
and electronically using the FARU
TOTAL: 1.5 wdays for simple transactions; 3 wdays for complex transactions
Budget Proposal for the National Government Subsidy (NG) - Sponsored Members
This covers the preparation and submission of the budget proposal for the NG subsidy for the Indigent Program to the Department of Budget and
Management (DBM).
Office: Fiscal Management Division (FMD), Comptrollership Department
Classification: Highly Technical
Type of Transaction: G2G,
Who May Avail: Sponsored Members of PhilHealth
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
1. Original Budget Proposal for the Indigent Program (1 copy) Member Management Group
2. Original Approved PhilHealth Board Resolution (PBR) (1 copy)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Translate PhilHealth Board approved a. Collate all DBM Forms and other required documents for 5 days MMG, CorPaln And FMD-
budget to DBM Forms consolidation Comptrollership Staff
b. Prepare transmittal letter to DBM
5 days
c. Forward documents to the Offices of the Senior Vice
President for Fund Management Sector and President and 2 days
Chief Executive Officer for signature (2 copies including
receiving copy) 1 day
d. Photocopy and submit documents to DBM
e. Provide receipt copies to the Office of the President (OP),
MMG and CorPlan (2 copies including receiving copy)
a. Revision of DBM Forms based on Revision of DBM Forms based on adjustments 5 days MMG and FMD-Comptrollership
adjustments Staff
b. Forward documents to OP for signture Facilitate the approval FMD-Comptrollership Staff
and submit to DBM
c. Submission of Budget Execution Submission of Budget Execution Documents (BED) based 2 days MMG and FMD-Comptrollership
Documents (BED) based on the NEP/GAA on the NEP/GAA (2 copies including receiving copy) Staff
TOTAL: 20 days
1. Issuance of Financial Reports
Provides Financial Reports for information and reference of requesting parties, other than those mandatory monthly/quarterly/annual reports
Office: Managerial Finance Section
Classification: Complex
Type of Transaction: G2G - Government to Government
Who May Avail: Other Government/Oversight Agencies/Congress, All PhilHealth Cost Center
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Letter or Email Request: 1 Original/Soft Copies Requesting Office
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Send letter or email request 1. Evaluate the request None 15 minutes FC IV, Managerial Finance Section
2. Prepare the reports 1 - 3 working days *depends FC IV, Managerial Finance Section
*If the source of the requested report is on the complexity of the
not in the custody of the MFS, secure first requested report
fromComptrollership or Treasury Department **depends also if requested
report needs data from other
offices outside FMS
3. Review and approve the reports 40 minutes SVP, FMS
4. Once report is cleared for submission, 5 minutes Social Insurance Assistant I, Man-
forward the same to the requesting office agerial Finance Section
TOTAL: None 1 - 3 working days
1. Accreditation of Collecting Agents
Processing of PhilHealth Accredited Collecting Agents Application
Office AGENTS RELATION UNIT ACCREDITATION TEAM,TREASURY DEPARTMENT
Classification Simple
Type of Transaction G2G - Government to Government; G2B - Government to Business
Who May Avail Banks and Non-banks; Government and Private Entities
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No.1. Letter of Intent ( 1 copy, original copy) Applicant Collecting Agent
Document No 2. Audited AFS for the past 3 yrs, including Notes to FS ( 1 copy , scanned copy/
photocopy)
Document No. 3. Cert. of Registration issued by BSP, SEC, NTC ( 1 copy, scanned/photocopy)
Document No 4. Art. Of Incorporation and By-Laws; Art. Of Partnership duly authenticated by
SEC ( scanned/photocopy, 1 copy)
Document No.5. Electronic Banking Authority from BSP ( 1 copy, scanned/photocopy)
Document No. 6. List of Members of BOD/Partners and Key Officers ( 1 copy , scanned/
photocopy)
Document No. 7. Copy f Business License/permit from City of Municipality( scanned/photovopy,
1 copy)
Document No. 8. Sworn Statement by the applicant in compliance to Labor Laws (1 copy ,
scanned/photocopy)
Document No 9. Cert. of Good Standing w/Existing Industry/Association( scanned/photocopy, 1
copy)
Document No. 10. List of Branches/Tie-ups (1 copy, scanned/photocopy)
Document No. 11. PhilHealth Online Application Form ( scanned copy/photocopy, 1 copy)
Document No. 12. Bond (Cash, surety, fidelity) - for non-banks ( 1 copy, scanned/photocopy)
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Inquire about the requirements Acknowledge phone queries and/or letter of applicants NONE 5 minutes Fiscal Controller II Fiscal Examiner A Social
through phone/letter/email Assistant I, AGRU, Accreditation Team
Submit accreditation Provide checklist of documentary requirements thru email 5 minutes Fiscal Controller II Fiscal Examiner A Social
requirements or attachment to letter to applicant Assistant I, AGRU, Accreditation Team
comply remaining accreditation Upon receipt of the documents, record it in the logbook or 5 minutes Fiscal Controller II Fiscal Examiner A Social
requirements if incomplete in the monitoring sheet Assistant I, AGRU, Accreditation Team
Upon receipt of the documentary requirements, 5 minutes Fiscal Controller II Fiscal Examiner A Social
check completeness thereof (tick mark the checklist of Assistant I, AGRU, Accreditation Team
documentary reqts.)
If complete, proceed with the safekeeping of documents 5 minutes Fiscal Controller II Fiscal Examiner A Social
in the individual folder for the new applicant and prepare Assistant I, AGRU, Accreditation Team
the FS for evaluation.
If not complete, inform applicant through phone or email 5 minutes Fiscal Controller II Fiscal Examiner A Social
to comply with the deficient document/s Assistant I, AGRU, Accreditation Team
TOTAL 30 minutes
2. Accreditation of Collecting Agents
Evaluation of the Audited FS of the Applicant
Office AGENTS RELATION UNIT ACCREDITATION TEAM,TREASURY DEPARTMENT
Classification Simple
Type of Transaction G2G - Government to Government
Who May Avail Banks and Non-banks; Government and Private Entities
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No. 1 Audited AFS for the past 3 yrs, including Notes to FS ( 1 copy, scanned /photocopy) Applicant
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Note: The FS evaluation template varies on the category of bank/applicant. NONE
(Universal, Commercial, Thrift, Rural and non-bank)
Based on the BSP Performance indicator, evaluate the applicant’s FS to 10 minutes Fiscal Controller II Fiscal Examiner A,
determine the liquidity, solvency, capital adequacy and profitability. AGRU, Accreditation Team
Input the data in a proforma template for a specific bank/non-bank category. 10 minutes Fiscal Controller II Fiscal Examiner A,
AGRU, Accreditation Team
Identify the equivalent points correponding the variance as a result of the 20 minutes Fiscal Controller II Fiscal Examiner A,
applicant’s Financial Performance versus the BSP Performance Indicator. Once AGRU, Accreditation Team
the equivalent points are identified, we can now determine whether the
applicant passed or failed based on the benchmark set forth in the Manual of
Accreditation for Collecting Agents.
Print the template of evaluation and initial on it prior to submission to the Team 10 minutes Fiscal Controller II Fiscal Examiner A,
Head for review/initial. AGRU, Accreditation Team
Endorse the result of the FS evaluation to Team Head for review/counter- 5 minutes Fiscal Controller II Fiscal Examiner A,
checking/initial on the report. AGRU, Accreditation Team
Review the financial evaluation 10 minutes Fiscal Controller II, AGRU / Fiscal
If with error, return to the one who evaluated the FS for revision. Controller III, Accreditation Team

If none, affix initial/signature and endorse to Comptrollership Department for

signature of the TWG member
Log and endorse FS evaluation template to Comptrollership Department and 5 minutes Fiscal Clerk III,AGRU, Accreditation
TWG Head, for signature. Team
Receive and log signed document from Comptrollership Department 5 minutes Fiscal Clerk III,AGRU, Accreditation
Team
Endorse FS Evaluation template to Senior Manager, Treasury Department 5 minutes Clerk III, Accreditation Team
Affixes signature in the template 5 minutes SM, Treasury Department
Receive and log signed document from OM, Treasury Department 5 minutes Clerk III,Accreditation Team
Inform applicant on the deferment/denial of accreditation via email and transmit 10 minutes Fiscal Controller II Fiscal Examiner A,
the original letter thereafter. AGRU, Accreditation Team
Once signed, receive and log again in the monitoring sheet and file documents 5 minutes Clerk III, Accreditation Team
for reference
TOTAL 1 hour and 30 minutes
3. Accreditation of Collecting Agents
Conduct of Meetings
Office AGENTS RELATION UNIT ACCREDITATION TEAM,TREASURY DEPARTMENT
Classification Simple
Type of Transaction G2G - Government to Government; G2B - Government to Business
Who May Avail Banks and Non-banks; Government and Private Entities
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No. 1 PowerPoint Presentation (1 copy, photocopy only) Accreditation Team
Document No. 2 Necessary documents, if any (1 copy, photocopy onlly)
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Check availability of the attendees (PCA AccreCom members, TWGs and NONE 60 minutes Social Insurance Assistant I, AGRU,
officers concerned) Clerk III, Accreditation Team
Check availabilty of Venue 30 minutes
Confirm the date and venue of the activity thru the Eas/person-in-charge of 60 minutes
the PCA AccreCom members, COO/EVP, PCEO and the new ACA.
Prepare the Notice of PCA AccreCom meeting 15 minutes
Affix initial/signature on the documents 16 hours Fiscal Controller I, AGRU I Fiscal
Controller III, Accreditation Team
/ Senior Manager , Treasury
Department /SVP, FMS
Log all outcoming documents in the Monitoring Sheet 5 minutes Clerk III, Accreditation Team
Endorse/distribute documents for the meeting 60 minutes
File the remaining copy of the documents for reference 5 minutes
TOTAL 19 hrs and 55 minutes
4. Accreditation of Collecting Agents
Processing of the Non-Disclosure Agreement of the Applicant
Office AGENTS RELATION UNIT ACCREDITATION TEAM,TREASURY DEPARTMENT
Classification Highly Technical
Type of Transaction G2G - Government to Government; G2B - Government to Business
Who May Avail Banks and Non-banks; Government and Private Entities
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No. 1 Non-Disclosure Agreement ( original copy, 5 copies) Accreditation Team
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Initial review of the Upon confirmation that the applicant passed the financial evaluation, NONE 5 minutes Fiscal Examiner A Social Insurance
NDA personnel in-charge shall provide a copy of the the Proforma NDA and Assistant I, AGGRU, Accreditation Team
POAF
Send comments on Receive comments from applicant regarding NDA 5 minutes Fiscal Examiner A Social Insurance
the NDA thru email Assistant I, AGGRU, Accreditation Team
Analyze comments/summarize and prepare memo to be endorsed to Legal 180 minutes Fiscal Examiner A Social Insurance
Sector Assistant I, AGGRU, Accreditation Team
initial/sign the memo 60 minutes Fiscal Controller II, AGRU/Fiscal
Controller III, Accreditation Team
Endorse the memo and copy of the NDA with comments from the applicant 15 minutes Clerk III, Accreditation Team
together with the proforma NDA for reference of Legal.
Receive and log the documents received from the Legal Sector 5 minutes
Inform the applicant of the legal opinion for conformity thru email 5 minutes Fiscal Examiner A Social Insurance
Assistant I, AGRU, Accreditation Team
Review NDA If not acceptable ,endorse to Legal Sector for review and comments. 5 minutes Clerk III, Accreditation Team
If comments are acceptable to PhilHealth, Legal Sector will issue a
certification ( TAT depends on Legal Sector’s processing time)
acknowledge receipt of the comments and or conformity of the applicant 5 minutes Fiscal Examiner A Social Insurance
collecting agent on the NDA. Assistant I, AGRU, Accreditation Team
Final print the NDA in 6 sets 30 minutes
 Prepare endorsement memo to the applicant 15 minutes
initial/sign the memo 60 minutes Fiscal Controller II , AGRU/Fiscal
Controller III , Accreditation Team/Senior
Manager, Treasury Department
Receive and sign NDA Send documents through courier 15 minutes Clerk III, Accreditation Team
Send signed NDA to Receive signed documents from the applicant 5 minutes
PhilHealth
Prepare endorment memo to PhilHealth signatories 15 minutes Fiscal Examiner A Social Insurance
Assistant I, AGRU, Accreditation Team
initial/sign the memo 60 minutes Fiscal Controller II, AGRU/ Fiscal
Controller III, Accreditation Team/ Senior
Manager, Treasury Department
Record outgoing documents and endorse it to PhilHealth signing officers’ 5 minutes Clerk III, Accreditation Team
office.
Received signed documents from OP 5 minutes
Prepare documents for notarization 15 minutes Social Insurance Assistant I , Clerk III,
AGRU, Accreditation Team
Provide ITMD a copy of the NDA as reference for them to provide the 15 minutes
techncal specifications of the technical requirements to the applicant.
Prepare endorsement letter for the transmittal of NDA to the applicant. 15 minutes Fiscal Examiner A Social Insurance
Assistant I, AGRU, Accreditation Team
initial/sign the memo 15 minutes Fiscal Controller II, AGRU/ Fiscal
Controller III, Accreditation Team/ Senior
Manager, Treasury Department
Send the documents via courier or request the collecting agent to send 15 minutes Clerk III, Accreditation Team
their messenger to get the NDA,
File the extra copy of the documents 5 minutes
TOTAL 9 days and 55 minutes
5. Accreditation of Collecting Agents
Conduct of User Acceptance Test of Applicant’s System
Office AGENTS RELATION UNIT ACCREDITATION TEAM,TREASURY DEPARTMENT
Classification Simple
Type of Transaction G2G - Government to Government; G2B - Government to Business
Who May Avail Banks and Non-banks; Government and Private Entities
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No. 1. PhilHealth’s Technical Requirements (1 copy, soft copy via google sheet) ITMD
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
UAT within PhilHealth Premises
Proceed to the office/room where Coordinate with the concerned officers of ACAs and NONE 2 hours Fiscal Controller II Fiscal Examiner A Social
the UAT will be conducted PhilHealth and get the availability and quorum Assistant I, AGRU, Accreditation Team
If both are available on a certain date, set the date and Fiscal Controller II Fiscal Examiner A Social
venue for the UAT Assistant I, AGRU, Accreditation Team
Coordinate with ITMD, MMG, OSVP-FMS, PRID for the 2 hours Fiscal Controller II Fiscal Examiner A Social
needed equpments Assistant I, AGRU, Accreditation Team
Fill-out necessary forms as a requisite to borrow 15 minutes Fiscal Controller II Fiscal Examiner A Social
certain equpments from other offices Assistant I, AGRU, Accreditation Team
A day before or on the day of the UAT, secure the Fiscal Controller II Fiscal Examiner A Social
needed equipments Assistant I, AGRU, Accreditation Team
Set-up equipments such as projector, projector screen, 15 minutes Fiscal Controller II Fiscal Examiner A Social
laptops and connectivity with the internet Assistant I, AGRU, Accreditation Team
Participate in the UAT Assist in the conduct of the UAT between PhilHealth 3 hours Fiscal Controller II Fiscal Examiner A Social
and ACA Assistant I, AGRU, Accreditation Team
After the activity, return all borrowed equipments to Fiscal Controller II Fiscal Examiner A Social
the custodian. Assistant I, AGRU, Accreditation Team
Prepare an after-UAT report for documentation 1 hour Fiscal Controller II Fiscal Examiner A Social
purposes Assistant I, AGRU, Accreditation Team
Review/initial/sign reports 3 hours Fiscal Controller II Fiscal Examiner A Social
Assistant I, AGRU, Fiscal Controller III,
Accreditation Team
Log and file documents 5 minutes Clerk III, Accreditation Team
TOTAL 11 hours and 35 minutes
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
UAT outside PhilHealth Premises
Accommodate PhilHealth team Coordinate with concerned officers of ACAs and NONE 2 hours Fiscal Controller II Fiscal Examiner A Social
PhilHealth and get the availability and quorum Assistant I,AGRU, Accreditation Team
If both are available on a certain date, set the date and Fiscal Controller II Fiscal Examiner A Social
venue for the UAT Assistant I,AGRU, Accreditation Team
Request for a vehicle to transport the attendees of the Fiscal Controller II Fiscal Examiner A Social
UAT to the venue Assistant I,AGRU, Accreditation Team
Coordinate with ITMD, MMG, OSVP-FMS, PRID for the Fiscal Controller II Fiscal Examiner A Social
needed equipments Assistant I,AGRU, Accreditation Team
Fill-out necessary forms as a requisite to borrow 15 minutes Fiscal Controller II Fiscal Examiner A Social
certain equpments from other offices Assistant I, AGRU, Accreditation Team
A day before or on the day of the UAT, secure the Fiscal Controller II Fiscal Examiner A Social
needed equipments Assistant I, AGRU, Accreditation Team
Particiapte in the UAT Assist in the conduct of the UAT between PhilHealth 3 hours Fiscal Controller II Fiscal Examiner A Social
and ACA Assistant I, AGRU, Accreditation Team
After the activity, return all borrowed equipments to Fiscal Controller II Fiscal Examiner A Social
the custodian. Assistant I, AGRU, Accreditation Team
Prepare an after-UAT report for documentation 1 hour Fiscal Controller II Fiscal Examiner A Social
purposesj Assistant I, AGRU, Accreditation Team
Review/initial/sign reports 3 hours Fiscal Controller II Fiscal Examiner A Social
Assistant I, AGRU, Fiscal Controller III,
Accreditation Team
Log and file documents 5 minutes Clerk III, AGRU, Accreditation Team
TOTAL 9 hours and 20 minutes
6. Accreditation of Collecting Agents
Preparation of the PCA AccreCom Resolution
Office AGENTS RELATION UNIT ACCREDITATION TEAM,TREASURY DEPARTMENT
Classification Simple
Type of Transaction Government to Government
Who May Avail Banks and Non-banks; Government and Private Entities
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No. 1 Matrix of Documents Submitted (1 copy, original copy) Accreditation Team
Document No. 2 Signed Financial Evaluation ( 1 copy, photocopy) Accreditation Team
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Draft PCA AccreCom Resolution for review of the Unit NONE 2 hours Fiscal Controller II Fiscal Examiner A Social
or Team Head. Insurance Assstant I. AGRU, Accreditation Team
* using the proforma Resolution
* new (cases such as termination, receivership, etc.)
Unit/ Team Head reviews the resolution. If with errors, 15 minutes Fiscal Controller II, AGRU/ Fiscal Controller III,
return to the personnel who drafted the resolution for Accreditation Team
revision
log documents and endorse to OM-TD 5 minutes Clerk III, Accreditation Team
* If with errors, return to the personnel who drafted 5 minutes Fiscal Controller II Fiscal Examiner A Social
the resolution for revision * If none, endorse to the Insurance Assstant I, AGRU, Accreditation Team
next signatory. There are 10 signatories for the PCA
AccreCom Resolution and everytime the document
is signed and returned to AgRS, it is being logged/
recorded for tracking purposes.
Received signed resolution from the last signatory, the 5 minutes Clerk III, Accreditation Team
PCEO. Log it in the monitoring sheet and thereafter
file it for safekeeping.
Indicate the number of the approved PCA AccreCom 5 minutes Fiscal Controller II Fiscal Examiner A Social
resolution and the date to when it was approved. Insurance Assstant I, AGRU, Accreditation Team
File the approved PC AccreCom Resolution 5 minutes Clerk III, Accreditation Team
TOTAL 2 days and 40 minutes
Note: Same process applies to renewal of accreditation
Finalization of CRA is dependent on Philhealth and applicant’s conformity on the provisions of the CRA.
7. Accreditation of Collecting Agents
Processing of the Collection and Remittance Agreement
Office AGENTS RELATION UNIT ACCREDITATION TEAM,TREASURY DEPARTMENT
Classification Highly technical
Type of Transaction G2G - Government to Government; G2B - Government to Business
Who May Avail Banks and Non-banks; Government and Private Entities
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No. 1 Collection and Remittance Agreement ( 5 copies, original copy) Accreditation Team
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Draft CRA based on the proforma CRA with ILD Certification NONE 2 days Fiscal Controller II Fiscal Examiner A Social
with the assumption that all data needed were already Insurance Assistant I, AGRU, Accreditation Team
gathered from the applicant collecting agent and the
PhilHealth Office concerned.
Once drafted, endorse the drafted CRA and Annexes to the 5 minutes Fiscal Controller II Fiscal Examiner A Social
Team Head for review and clearance. Insurance Assistant I, AGRU, Accreditation Team
Review the draft CRA and Annexes 2 days Fiscal Controller III, Accreditation Team
If with error, revise the CRA 2 days Fiscal Controller II Fiscal Examiner A Social
Insurance Assistant I, AGRU, Accreditation Team
Initial review of the CRA If none, endorse to applicant collecting agent for their review 5 minutes Fiscal Controller II Fiscal Examiner A Social
and conformity via email Insurance Assistant I, AGRU, Accreditation Team
To fast track the accreditation process, follow up or get the 10 minutes Fiscal Controller II Fiscal Examiner A Social
comments/conformity of the applicant through phone or Insurance Assistant I, AGRU, Accreditation Team
email.
Send comments to Treasury Once the comments of the applicant collecting agent was sent 10 minutes Fiscal Controller II Fiscal Examiner A Social
Department through mail, log said document for montoring purposes and Insurance Assistant I, AGRU, Accreditation Team
provide the copy to the personnel incharge of the applicant.
If through email, it will directly be received by the personnel 5 minutes Fiscal Controller II Fiscal Examiner A Social
incharge of the applicant Insurance Assistant I, AGRU, Accreditation Team
acknowledge receipt of the comments and or conformity of 5 minutes Fiscal Controller II Fiscal Examiner A Social
the applicant collecting agent on the CRA. Insurance Assistant I, AGRU, Accreditation Team
Analyze and classify which comments shall be endorsed to 3 days Fiscal Controller II Fiscal Examiner A Social
Legal Sector (legal matters); SERU, MMG (Operational matters) Insurance Assistant I, AGRU, Accreditation Team/
or comments that can be dealth with immedialtely within the Fiscal Controller III, Accreditation Team
authority of the Division/Department.
 Summarize, encode and print memo containing the 1 day Fiscal Controller II Fiscal Examiner A Social
summarized comments of ACAs to be endorsed to Legal Insurance Assistant I, AGRU, Accreditation Team
Sector
Print CRAs (original and with comments from ACA) as 20 minutes Fiscal Controller II Fiscal Examiner A Social
attachment and reference for concerned office/s Insurance Assistant I, AGRU, Accreditation Team
Submit memo for review and initial of Unit/Team Head 10 minutes Fiscal Controller II Fiscal Examiner A Social
Insurance Assistant I, AGRU, Accreditation Team
Review documents submitted and affix initials/signature. 1 day Fiscal Controller II, AGRU, Fiscal Controller III,
Accreditation Team
If there are corrections, return to the initiator for revisions 15 minutes Fiscal Controller II Fiscal Examiner A Social
Insurance Assistant I
If none, affix initial/signature on the memo 10 minutes Fiscal Controller II Fiscal Examiner A Social
Insurance Assistant I
Log and endorse documents to Accreditation Team Head for 5 minutes Clerk III, Accreditation Team
review and initials
Review and initial the documents 60 minutes Fiscal Controller III, Accreditation Team
Repeat steps F1.5 Review and signed the document 60 minutes Senior Manager, Treasury Department
Receive signed memo for the OSM-Treasury Dept. 5 minutes Clerk III, Accreditation Team
Log outgoing documents and endorse to Legal Sector 15 minutes Clerk III, Accreditation Team
File the extra copy of the memo 5 minutes Clerk III, Accreditation Team
Receive and log the legal certification. An LS certification shall 5 minutes Clerk III, Accreditation Team
be sought everytime there is a comment on the CRA from the
applicant.
Through email/call, inform applicant collecting agent of the 10 minutes Fiscal Controller II Fiscal Examiner A Social
comments/aceptance of theLS on their suggestions on the Insurance Assistant I, AGRU, Accreditation Team
CRA
Conform with the provisions If applicant conformed, finalize and prepare CRA in five sets, if 1 day Fiscal Controller II Fiscal Examiner A Social
of the CRA not, go back to the first step. Insurance Assistant I, AGRU, Accreditation Team
Prepare a letter to the newly approved collecting agent 10 minutes Fiscal Controller II Fiscal Examiner A Social
endorsing the CRA for their signature Insurance Assistant I
Unit /Team Head review and initial in the letter 15 minutes Fiscal Controller II, AGRU/ Fiscal Controller III,
Accreditation Team
Endorse documents to OM-TD signing 5 minutes Clerk III, Accreditation Team
 Same process as steps F1.5 to F1.10 Dependent on Fiscal Controller II Fiscal Examiner A Social
the exchanges Insurance Assistant I, AGRU, Accreditation Team
and acceptance of
comments in the
CRA by PhilHealth
and applicant
Receive signed letter 5 minutes Clerk III, Accreditation Team
Receive and sign the CRA Send the documents via courier or request the collecting 15 minutes
agent to send their messenger to get the CRA.
File the extra copy of the transmittal letter 5 minutes
Receive signed documents from the new ACA 5 minutes Clerk III, Accreditation Team
Endorse to PhilHealth authorized signatories 15 minutes
Receive signed CRA from OPCEO 5 minutes
Notarize CRA 120 minutes Social Insurance Assistant I, Clerk III, AGRU,
Accreditation Team
Safekeep the notarized CRA Provide ACA and PhilHealth Offices a copy of the CRA 20 minutes Social Insurance Assistant I Clerk III, AGRU,
Accreditation Team
TOTAL 20 days
8. Accreditation of Collecting Agents
Processing of the Accreditation Fee Payment of ACAs
Office AGENTS RELATION UNIT ACCREDITATION TEAM,TREASURY DEPARTMENT
Classification Simple
Type of Transaction G2G - Government to Government; G2B - Government to Business
Who May Avail Banks and Non-banks; Government and Private Entities
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No.1 Manager’s Check ( 1 copy, original copy) Accredited Collecting Agent
Document No.2 Bank Validated deposit Slip ( 1 copy, scanned/photocopy Accredited Collecting Agent
Document No. 3 PhilHealth Official Receipt ( 1 copy, original copy PhilHealth Cashier
Document No.4 ACA Official Receipt ( 1 copy, original copy) ACA

CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
THRU: Manager’s Check
Prepare Check Receive Check from ACA representative 5 minutes Fiscal Controller II Fiscal Examiner A Social
Insurance Assistant I, AGRU, Accreditation
Team
Provide Check Request for an Order Payment Slip from Original Accreditation: 20 minutes
to personnel in Comptrollership
Accreditation Team
Universal Bank - P50,000.00
Endorse the Order of Payment Slip and the Check to the Commercial Bank - P40,000.00 5 minutes
Cashier for issuance of PhilHealth Official Receipt (POR)
Thrift Bank - P30,000.00
Receive the original copy of the POR for TD Cashier. Rural Bank -P20,000.00 5 minutes
Photocopy the POR for TD copy and file/serves as proof Remittance Center - P50,000.00 2 minutes
of receipt from ACA representative
Telecom - P50,000.00
Receive copy of the POR Provide the original copy of the POR to the ACA Bills Payment Center - P40,000.00 2 minutes
representative
Pawnshop - P30,000.00
File Organized Groups -P10,000.00 1 minute
TOTAL 40 minutes
THRU: Deposit to *For the renewal of accreditation, there is an
PhilHealth AGDBs additional amount of P10,000.00 for each category.
Deposit payment to Receive a copy of the Bank Validated Deposit Slip from Original Accreditation: 5 minutes Fiscal Controller II Fiscal Examiner A Social
AGDB of PhilHealth the ACA Insurance Assistant I, AGRU, Accreditation
Universal Bank - P50,000.00 Team
Acknowledge receipt of the email from ACA Commercial Bank - P40,000.00
Thrift Bank - P30,000.00
Prepare memo addressed to the Cash Division of Rural Bank -P20,000.00 15 minutes
Treasury Department and request for verification of the
amount deposited by the ACA.
Remittance Center - P50,000.00
Initial/sign the memo Telecom - P50,000.00 10 minutes Fiscal Controller II, AGRU/ Fiscal Controller
III, Accreditation Team
Bills Payment Center - P40,000.00
Log and endorse the memo to Cash Division Pawnshop - P30,000.00 5 minutes Clerk III, Accreditation Team
Organized Groups -P10,000.00
Receive Cash Division’s reply together with the original 5 minutes Clerk III, Accreditation Team
copy of the POR

Photocopy the POR for TD copy and file/serves as proof 5 minutes Fiscal Controller II Fiscal Examiner A Social
of receipt from ACA representative Insurance Assistant I, AGRU, Accreditation
Receive copy of the POR Send the oginal copy of the POR to the applicant. 5 minutes Team
File
TOTAL 55 minutes
9. Accreditation of Collecting Agents
Preparation of the Advisory
Office AGENTS RELATION UNIT ACCREDITATION TEAM,TREASURY DEPARTMENT
Classification Simple
Type of Transaction G2G - Government to Government
Who May Avail Banks and Non-banks; Government and Private Entities
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No. 1 Memo signed by the Senior Manager (1 copy, original copy) Accreditation Team
Document No. 2 Draft copy of the advisory (1 copy, original copy)
Document No. 3 Necessary attachments, if any (1 copy, photocopy copy)
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Upon confirmation with the Collecting agent and the NONE 15 minutes Fiscal Controller II Fiscal Examiner A Social
PRO concerned on the effectivity date, prepare and Insurance Assistant I, AGRU, Accreditation
submit the draft advisory and memo Team
Review and affix intials/signs in the memo 10 minutes Fiscal Controller II,AGRU , Fiscal Controller
III, Accreditation Team /Senior Manager,
Treasury Department
Log documents for monitoring purposes and endorse 15 minutes Clerk III, Accreditation Team
to CAGT for lay-out of the advisory
Receive the lay-out of advisory from CADT
Check contents if complete and initial on the draft lay- 5 minutes
out
Provide clearance on the content of the lay-out 30 minutes Fiscal Controller III, Accreditation Team/
Senior Manager, Treasury Department
Endorse back the lay-out to CorCom for signature and 15 minutes Clerk III, Accreditation Team
approval of the PCEO
File a copy of the documents endorsed to CorCom 5 minutes Clerk III, Accreditation Team
TOTAL 95 minutes
10. Transaction Fees Paid to Accredited Collecting Agents
Processing of the BUR for the Payment of Transaction Fees to ACAs
Office AGENTS RELATION UNIT ACCREDITATION TEAM,TREASURY DEPARTMENT
Classification Simple
Type of Transaction G2G - Government to Government; G2B - Government to Business
Who May Avail Banks and Non-banks; Government and Private Entities
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No. 1 Original Billing ( original copy, 1 copy) Accredited Collecting Agent
Document No. 2 Generated RF2 report ( scanned/photocopy, 1 copy) SERU-Treasury Dept.
Document No. 3 Budget Utilization Request ( original copy, 2 copies) AGRU
Document No. 4 Certification ( original copy, 2 copies)
Document No. 5 BIR Form 2306 (original copy, 2 copies
Document No. 6 BIR Form 2307 original copy, 2 copies
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Submit original billing to Receive orignal billing statement from SERU OTC ACAs : P 40.00 per 5 minutes Clerk III, AGRU, Accreditation Team
Treasury Department transaction /Online ACAs: P10.00
per transaction
Countercheck the total transactions from the billing vs. 10 minutes
the generated RF2A
Access FARU and prepare BUR 10 minutes
Prepare Certification 5 minutes
Prepare the BIR forms for the tax withheld from ACAs 5 minutes
Review BUR and supporting documents 15 minutes Fiscal Controller II, AGRU / Fiscal Controller
III, Accreditation Team
Initial/sign documents 15 minutes Fiscal Controller II, AGRU/ Fiscal Controller
III , Accreditation Team/Senior Manager,
Treasury Department
Endorse documents to Compt Dept 15 minutes Clerk III, Accreditation Team
File copies retained for reference. 10 minutes Clerk III, Accreditation Team
TOTAL 1 hour and 45 minutes
* total amount is dependent on the total transaction counts to be processed per month
1. Distribution of PhilHealth Agents Receipt (PAR)
Issuance of PAR to Accredited Collecting Agent (ACA)
Office Data Management and Systems Monitoring Unit (DMSMU), Accreditation Team, Treasury Department
Classification Simple
Type of Transaction G2B & G2G
Who May Avail Accredited Collecting Agent
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document 1 Requisition and Issue Slip(RIS) ( One (1) Original Copy) -DMSMU, Accreditation Team, Treasury Department
Document 2 Invoice and Receipt of Accountable Form (IRAF) (One (1) Original Copy) -DMSMU, Accreditation Team, Treasury Department
Documents 3 Authorization letter and valid (government or Company) ID for liaison officer ( One - Accredited Collecting Agent (ACA)
(1) Original Copy)
Document 4 Authority to Release and Gate Pass (3 Original Copies) -DMSMU, Accreditation Team, Treasury Department
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit the filled up and signed 1. Input in the PhilHealth Agents Receipt Management NONE 15 minutes Social Insurance Officer (alternate Fiscal
(RIS) to Treasury Department Module (PARMM) the recipient ACA and the quantity of Examiner A), DMSMU, Accreditation Team
PARs for distribution
2. Check and approve the accuracy of the details. 5 minutes Fiscal Controller II, DMSMU /Fiscal
Controller III, Accreditation Team
3. Generate IRAF from the PARMM for signature by the 5 minutes Social Insurance Officer (alternate Fiscal
authorized representative of the recipient ACA. Examiner A), DMSMU, Accreditation Team
2. Confirm of pick up. 4. Retrieve the boxes of PAR from the storage room as 60 minutes Social Insurance Officer (alternate Fiscal
specified in the IRAF and update the bin card and stock Examiner A), DMSMU, Accreditation Team
card.
5. Coordinate with the recipient ACA the schedule and 10 minutes Social Insurance Officer (alternate Fiscal
manner of distribution/pick up. Examiner A), DMSMU, Accreditation Team
3. Pick up the PARs 6. Distribute the PARs to the recipient ACAs. 60 minutes Social Insurance Officer (alternate Fiscal
Examiner A), DMSMU, Accreditation Team
7. Input in the PARMM the following details in the 10 minutes Social Insurance Officer (alternate Fiscal
distribution of PARs to ACA using the signed IRAF: a. Manner Examiner A), DMSMU, Accreditation Team
of release; b. Date the PARs are released/distributed to ACA.
TOTAL: 1 hour and 45 minutes
1. Monitoring of Accredited Collecting Agents’ (ACA) Remittances, Reports and Documents
Acknowledgement of Receipt of PhilHealth Accredited Collecting Agents (ACAs) RemittancesReconciliation of ACAs Remittances vs. Treasury Database
Office Standards, Enforcement and Reconciliation (SERU), Accreditation Team, Treasury Deaprtment
Classification Simple
Type of Transaction G2B & G2G
Who May Avail Accredited Collecting Agents
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No 1. Validated ACAs Remittance Report ( 1 copy, soft copy). Cash Division
Document No 2. Treasury Data Editing Module (TDEM) generated uploaded transactions SERU, Accreditation Team
( 1 copy, scanned/photocopy)
Document No 3. ACAs Summary of Remittance (RF2a) and Bank Abstract of Daily Collection ACAs
(1 copy, scanned/photocopy)
Document No 4. Data Amendment Request Form (DARF) ( 1 copy, scanned/photocopy) SERU, Accreditation Team
Document No 5. Cancelled PARs/ Dishonored Checks. ( 1 copy/scanned/photocopy) ACAs
Document No 6. Generated Bad files ( 1 copy, scanned/photocopy) ACAs
Document No. 7. Formal request letter to update the ACAs library in TDEM. ACAs
( 1 copy/ original or photocopy)
Document No.8. Statements of Accounts (SOA) for late remittances, late submission of SERU, Accreditation Team
documents and late uploading of textfiles in Electronic Collection Reporting System (ECRS). (
1 copy, original copy)
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Accredited Collecting Agents
1. Submit Proof of Remittance and 1.Prepare Summary of ACAs Remittances and forward NONE 30 minutes Fiscal Controller II, Fiscal Examiner A , Social
RF2a to SERU. to Cash Division Insurance Officer , SERU Account Officer, SERU,
Accreditation Team
2. Upon receipt of validation from Cash Division, 30 minutes Fiscal Examiner A, SERU, Accreditation Team
prepare final Summary of ACAs Remittances
3. Review and sign the report 15 minutes Fiscal Controller II, SERU/Fiscal Controller III,
Accreditation Team
2. Upload RF2 textfile in ECRS. 4.Check RF2a and RF2 textfile in TDEM generated 30 minutes Fiscal Controller II, Fiscal Examiner A , Social
report if tally with the Proof of Remittance submitted. Insurance Officer , SERU Account Officer, SERU,
Accreditation Team
3. Report Cancelled and 5. Prepare DARF. 15 minutes Fiscal Controller II, Fiscal Examiner A , Social
Dishonored check transactions to Insurance Officer , SERU Account Officer, SERU,
SERU. Accreditation Team
4. Submit Letter Request to update 6. Adjust/ Correct transaction in TDEM. 30 minutes Fiscal Examiner A, Data Management Systems
ACAs Library in TDEM. Monitoring Unit (DMSMU), Accreditation Team
5. Upload corrected bad files to 7. Update TDEM’s ACAs Library. 15 minutes
ECRS.
6. Submit Billings tally with the 8. Post ACAs Remittance, TDEM Uploaded transactions, 15 minutes Fiscal Controller II, Fiscal Examiner A , Social
Reconciled Remittances. Adjustments (DARF) to Monitoring Report of ACAs Insurance Officer / SERU Account Officer, SERU,
Collection and Remittance vs. Treasury Database Accreditation Team
(Status Report).
9.Prepare Statement of Account for late remittances, 15 minutes Fiscal Controller II, Fiscal Examiner A , Social
late submission of documents and late uploading of Insurance Officer / SERU Account Officer, SERU,
textfile to ECRS. Accreditation Team
10. Review and sign the SOA 15 minutes Fiscal Controller II, SERU/Fiscal Controller III,
Accreditation Team
11. Inform ACA to submit Billings providing the 5 minutes Fiscal Controller II, Fiscal Examiner A , Social
transaction count of reconciled remittances Insurance Officer / SERU Account Officer, SERU,
Accreditation Team
12. Stamp verified and forward to Agents Relations Unit 5 minutes Fiscal Controller II, Fiscal Examiner A , Social
(AgRU) for monitoring of transaction fees. Insurance Officer / SERU Account Officer, SERU,
Accreditation Team
TOTAL: 6 hours and 20 minutes
2. REFUND OF PREMIUM CONTRIBUTION
Refund of Employer’s Double Premium Payment
Office Standards Enforcement and Reconciliation Unit (SERU), Accreditation Team, Treasury Department
Classification Simple
Type of Transaction G2G
Who May Avail PhilHealth Regional Offices / Area Vice-President
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
“Per CO 2020-0025: 1. Employerj
Document No. 1. Formal request letter from employers to Regional Vice President (RVP) ( 1
copy, original or photocopy)
Document No. 2. Statement of Premium Account (SPA), PhilHealth Official Receipt 2. Employer
(POR) /PhilHealth Agents Receipt (PAR), proofs of double payments ( 1 copy, original or
photocopy)
Document No 3. RVP endorsement to Collection Section (Col. Sec.) ( 1 copy, original or 3. RVPs
photocopy)
Document No 4. Data Amendment Request Form (DARF) prepared by Col. Sec. signed by 4. Col. Sec.
RVP.( 1 copy, original or photocopy)
Document No 5. Endorsement of RVP to AVP for approval/denial.( 1 copy, original or 5. RVP
photocopy)
Document No 6. Treasury Data Editing Module (TDEM) print screen showing both 6. Standard Enforcement and Reconciliation Unit (SERU)-Treasury Department
transactions.( 1 copy, scanned/photocopy)
Document No. 7. TDEM print screen showing the transaction tagged refunded.( 1 copy, 7. SERU, Accreditation Team
scanned/ photocopy)
Document No. 8. Proofs of Accredited Collecting Agents’ (ACA) remittances such as POR, 8. SERU, Accreditation Team
ACAs Summary of Remittances (RF2a), Cash Report where the transaction was included.( 1
copy, scanned/photocopy)
Document No. 9. Endorsement to Cash Division for processing of fund transfer.( 1 copy, 9. SERU, Accreditation Team
original copy)”
CLIENT’S STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit complete requirements 1. Acknowledge receipt of documents via email or None 5 minutes Fiscal Controller II, SERU Head/Fiscal Controller III,
per CO 2020-0025 to SERU-Accre hard copy documents stamp received. Accreditation Team
Team via email or courier.
2. If received by the Head, Accreditation Team, 5 minutes Fiscal Controller III, Accreditation Team
endorse to SERU for processing.
2. Check completeness of requirements. 20 minutes Fiscal Controller II, SERU , Accreditation Team
3. Log to Monitoring Report for Refund. 5 minutes Fiscal Controller II, SERU , Accreditation Team
4. Access TDEM for verification and validation of 15 minutes Fiscal Controller II, Fiscal Examiner A, Social
double payment. Insurance Officer, Account Officers, SERU,
Accreditation Team
5. Tagging (zero amount) of duplicate payment to 10 minutes Fiscal Examiner A, Data Management System
TDEM. Monitoring Unit (DMSMU), Accreditation Team
6. Attach print screen of tagged transaction and Cash 10 minutes Fiscal Controller II, Fiscal Examiner A, Social
Report. Insurance Officer, Account Officers, SERU,
Accreditation Team
7. Endorse to Cash Division for processing of fund 10 minutes Fiscal Controller II ,SERU & Fiscal Controller III,
transfer to PROs. Accreditation Team
TOTAL: 1 hour and 20 minutes
1. Remittances
Acknowledgement of Receipt of PhilHealth Accredited Collecting Agents (ACAs) Remittances
Office: Treasury Department, Cash Division
Classification: Simple
Type of Transaction: Over-the-Counter Remittances of Accredited Collecting Agents (ACAs)
Who May Avail: G2B - Business Entity (ACAs which opted to pay OTC in PhilHealth Head Office)
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document No. 1 - 1 Managers Check Documents 1&2 from paying ACAs
Document No. 2 - 1 original copy of ACAs Remittance Report (RF2a)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Proceed to Cash Division and Check/ scrutinize the correctness of the details of None 10 minutes Collecting Officer of Cash Division,
present the Managers Check and Managers check as against Remittance Report (RF2a) Treasury Department
RF2A and process in the Over-the-Counter Collection System
(OTCCS) the remittance of ACAs.

1 Manager’s check
- duly signed and complete Print, check the correctness of details and sign the
details, correct amount in words PhilHealth Official Receipt and hand it over to the paying
and figures ACA.
1 Original copy of ACAs
Remittance Report (RF2a)

Present the PhilHealth Official Validate the amount which may be broken down as None 10 minutes Team Members of SERU, Accreditation
Receipt (POR) and ACAs follows: Regular remittance and penalty Team, Treasury Department
Remittance Report to Standards
and Enforcement Section (SERU)
of Accreditation Team in charge
of ACAs
TOTAL: 20 minutes
2. Payment of Approved Disbursement Vouchers
Check Releasing
Office: Treasury Department, Cash Division
Classification: Simple
Type of Transaction: Releasing of checks to payees of approved disbursement vouchers
Who May Avail: G2B – Business Entity for suppliers
G2G – Another Government Agency, PhilHealth Employees
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
1 original set of BIR authorized Official Receipt (OR) Provided by the Business Entity and Agency/ Payee
2 valid government issued IDs of claimant - present the original and 1 photocopy for Cash Division’s
file
1 original authorization letter of authorized personnel with attached photocopy of government
issued ID of authorizing personnel of business entity
For payee who is a PhilHealth employee/other government agencies/ former employee(s) of
PhilHealth - 1 original notarized Special Power of Attorney for authorized representative of
employee who is not an immediate family and with attached photocopy of 1 valid government
issued ID of payee
For family member of payee who is a PhilHealth employee /other government agencies/ former
employee(s) of PhilHealth - authorization letter of payee with attached photocopy of valid
government issued ID of payee and 2 valid government issued IDs of authorized representative
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
G2B - Suppliers
Present the applicable Validate the documents presented. Retrieve DV and check. None 2 minutes Check releasing personnel - Cash Division,
documentary requirements Treasury Department
enumerated above to Cash
Division upon claiming of check
Sign the original copy of approved Review the OR issued None 3 minutes Check releasing personnel - Cash Division,
disbursement voucher and issue Treasury Department
original Official Receipt (OR)
Sign the Check Register Release the check None 1min
Sign the Tax Certificate original and Release the supplier’s copy of tax certificates (Form 2306 and/ None 2mins
receiving copy or 2307)
G2G - Government Agency
Present the documentary Validate the documents presented. Retrieve DV and check. None 2mins Check releasing personnel - Cash Division,
requirements to Cash Division Treasury Department
upon claiming of check
Sign the disbursement voucher Review the OR issued None 3mins
and issue OR
Sign the Check Register Release the check None 1min
G2G - Government Employee
Present valid ID Validate ID presented. Retrieve DV and check. None 2mins Check releasing personnel - Cash Division,
Sign the disbursement voucher Release the check None 1min Treasury Department
and check register
G2G - Government Employee’s Representative
Present Authorization Letter/ Validate documents presented. Retrieve DV and check. None 2mins Check releasing personnel - Cash Division,
Special Power of Attorney (SPA), Treasury Department
whichever is applicable, and valid
IDs
Sign the disbursement voucher Release the check None 1min
and check register
TOTAL: 20 minutes
1. Accreditation of Government Securities Eligible Dealers (GSEDs)
Accreditation of Government Securities Eligible Dealers (GSEDs) on the sale of Government Securities (GS) in the secondary market via Non-Restricted
Trading Environment (NRTE) of the Bureau of the Treasury
Office: Treasury Department, Investments Division
Classification: Simple
Type of Transaction: Accreditation of Counterparty Bank/Institution for Government Securities Transactions in the Secondary Market
Who May Avail: G2B – Business Entity (Government Securities Eligible Dealers-Private Banks and Investment Houses)
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Document 1: Letter addressed to SVP Fund Management Sector requesting for Provided by the Government Securities Eligible Dealer (GSED)
accreditation as GSED counterparty bank of PhilHealth for Government Securities (GS)
Trading
Document 2: Certified True Copy (1) of latest PDEX Certification
Document 3: Certified True Copy (1) of renewal of SEC Registration as GSED together with
the list of authorized fixed income market salesman and associated person
Document 4: Certified True Copy (1) of GSED’s SEC Registration
Document 5: Certified True Copy (1) of latest Secretary’s Certificate together with the list of
authorized signatories
Document 6: Original copy (1) of Certificate of Good Standing from Three (3) Government
Agencies
Document 7: Photocopy (1) of Audited FS for the last three (3) years (including the interim
FS if available)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Submit the documentary Validate/ Check/ the completeness of documentary None 30 minutes Fiscal Controller II, Fixed Income Section,
requirements requirements Investment Division
Follow -up the completion of Documentary 2 working days Fiscal Controller II, Fixed Income Section,
Requirements Investment Division
Evaluation of the Request for Accreditation/Re- 7 working days Fiscal Controller II, Fiscal Controller IV
Accreditation upon completion of Documents of Fixed Income Section, and Chief of
Investment Division
Issuance of the Letter Confirming Accreditation/ 2 working days Fiscal Controller II, Fixed Income Section,
Renewal of Accreditation Investment Division
TOTAL: 11 days and 30 minutes
1. Processing of Software Certification/ Compliance Request
This service is used to ensure that the requester’s system complies with the standard data, transmission and integration requirements provided by the
Corporation.
Office/Division: IT Management Department - IS Management Division
Classification: Highly Technical
Type of Transaction: G2B - Government to Business and G2G - Government to Government
Who May Avail: Health Care Institutions, Government Agencies, Other external partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
One (1) Original Copy of Software Certification Application Form (SCAF) PhilHealth Website
One (1) Original Copy of Non-Disclosure Agreement (NDA) PhilHealth Website
One (1) Original Copy of Software Certification Agreement (SCA) PhilHealth Website
One (1) Original Copy of Software Certification Kit (SCK) Philhealth Regional Office IT
One (1) Original Copy of Software Valiation Test Form (SSVTF) Philhealth Regional Office IT
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit Application for Software 1.1 Receive fully accomplished NDA, SCAF and SCA None 3 working days Receiving Clerk
Certification with attached 1.2. Check completion of the supporting documents. PRO IT
documents using IT Ticketing 1.3. Set and coordinate schedule of the Software
System. Certification Test.
2. Conduct of the Scheduled 3.1. Prepare test data for the test. None 5 working days PRO IT
Software Certification Test 3.2. Conduct 3 cycles of testing to ensure compliance
of the system to the Software Validation Test Form
(SSVTF).
3.3. Prepare, finalize and sign-off in teh SSVTF.
3. System Software Certification 4.1 Receive PRO IT Endorsement with the attached None 12 working days PRO IT
Completion test documents as proof of system compliance UPECS-EMR Team
4.2 Prepare Software Certificate / Notice of System RVP
Compliance for signature of authorized signatories ITMD Heads
4.3 Route the Software Certificate / Notice of System CIO
Compliace to authorized signatories PCEO
4.4 Register HCI in the Database.
TOTAL: 20 working days
EXTERNAL SERVICES
HEALTH FINANCE POLICY SECTOR
1. Receiving & Processing of Appeal/Motion for Reconsideration of HCPs
Process to address the appeals/MRs of health care providers from receipt to issuance of letters of approval or denial
Office: Accreditation Compliance Review Division_Accreditation Department
Classification: Highly Technical
Type of Transaction: G2B
Who May Avail: Health Care Providers and other partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. HCP file an appeal/Motion 1. Prepares final agenda for deliberation by the Accreditation None 3 days prior to conduct of meeting ACRD-Technical personnel
for Reconsideration Committee
2. Distributes agenda folder to members of the Committee None 2 days prior to conduct of meeting AD- Admin personnel
3. Acts as the secretariat for the Accreditation Committee None 1 day ACRD-Division Chief/Section
Head/Technical staff
4. Deliberates on the appeals and motions for reconsideration None 1 day Accreditation Committee

External Members-
5.  Recommends policy review / revision None DOH, PMA, PHA, PNA

Internal Members- COO,

AVPs, QAG, Legal

Resource Person- DOH, SMD

AD Secretariat
6. Prepares Minutes of the Accreditation Committee Meeting None 6 days after the conduct of meeting ACRD-Technical personnel
7.  Prepares List of Approved/Denied Appeals and MRs None (for # 6,7,8,9, 10) ACRD-Technical personnel
Prepares List of Approved/Denied Appeals and MRs
8.  Prepares letters of approved/denied appeals and MRs for None ACRD-Technical personnel
HCPs
9.  Prepares Accreditation Committee Resolutions None ACRD-Technical personnel
10.  Routes the Minutes of the meeting, List of Approved / None AD-Receiving/Releasing Clerk
denied appeals/ MR, letters to providers, AC resolution for
approval
 11.    Posts in the Accreditation database (iPAS) the final None within 3 working days from ACRD-Database Technical
decision on the appeals and MRs of HCPs receipt of the PCEO- signed List of personnel
approved/denied
12.   Provides feedback to concerned health care providers None 2 days from posting in the database ACRD-Technical personnel
and concerned PROs on the decision of the Corporation on
the applications for accreditation of HCPs
TOTAL: 18 days

2. Receiving & Processing of Data Amendment Form (DAF) in the Integrated PhilHealth Accreditation System (iPAS)
Process in managing Accreditation database
Office: Accreditation Compliance Review Division_Accreditation Department
Classification: Simple
Type of Transaction: G2B
Who May Avail: Health Care Providers and other partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. The PRO send DAF with 1. Evaluate the received DAF and supporing documents if None 1 day ACRD-Database Technical
supporting documents compliant to existing policy personnel
to Accreditaion Dept (AD)
to post in the iPAS the
recommended amendment/
changes in the health care
providers records
2.  Post in the iPAS the requested amendment None 10 minutes ACRD-Database Technical
personnel
3.  The technical staff who execute the posting in the iPAS None 1 minute ACRD-Database Technical
signs the DAF personnel

4. The immediate supervisor reviews the correctness of the None 1 day ACRD-Database Section Head
iPAS posting executed by the technical staff
5. The immediate supervisor signs the DAF if correct. If not None 1 hour ACRD-Database Section Head
the technical staff will post necessary changes and signs for
correction.
 6.  Feedback the concerned PRO through email on the None 10 minutes ACRD-Database Technical
completion of request personnel
TOTAL 3 days

3. Processing of Data Amendment Form (DAF) in the Integrated PhilHealth Accreditation System (iPAS)
Process in managing Accreditation database
Office: Accreditation Compliance Review Division_Accreditation Department
Classification: simple
Type of Transaction: G2B
Who May Avail: Health Care Providers and other partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. The PRO Legal Unit sends 1. Evaluate the received documents and prepares DAF None 1 day ACRD-Database Technical
Return of Writ of Execution personnel
to AD, copy of letter wih
date receipt of health care
provider under Temporary
Suspension of Payment of
Claims (TSPC), DOH sends
to AD copy of letter to healh
care institutions with cease
and desist order , new health
care instiuions contracted
as providers of Z benefit
packages
2.  Post in the iPAS the amendment in te health care providers None 10 minutes ACRD-Database Technical
profile personnel
3.  The technical staff who execute the posting in the iPAS None 1 minute ACRD-Database Technical
signs the DAF personnel
4. The immediate supervisor reviews the correctness of the None 1 day ACRD-Database Section Head
iPAS posting executed by the technical staff
 5. The immediate supervisor signs the DAF if correct. If not None 1 hour ACRD-Database Section Head
the technical staff will post necessary changes and signs for
correction.
6.  Feedback the concerned PRO through email on the None 10 minutes ACRD-Database Technical
completion of posing personnel
TOTAL 3 days

4. Enhancement of Integrated PhilHealth Accreditation System (iPAS)

Process in managing Accreditation database
Office: Accreditation Compliance Review Division_Accreditation Department
Classification: Highly Technical
Type of Transaction: G2B
Who May Avail: Health Care Providers and other partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Feedback/ 1.  Identify the need for system enhancement based on new None 1 day ACRD-Database Technical
recommendation from issuance of policies or from PROs recommendation personnel
PROs re: enhancement of
iPAS, new policy that needs
enhancement of iPAS
2.  Draft System Request Form (SRF) and User Requirement None 2 days ACRD-Database Technical
Specification (URS). personnel
3. The supervisor and Dept Manager review and approve the None 1 day AD-Senior Manager/ACRD-
SRF and URS Division Chief
4.  Conduct of Daily Scrum Meeting (DSM) with the developer None 5 days ACRD-Division Chief/Section
upon their receipt of the signed SRF/URS. Head/Database Technical
personnel
4.  Signing of System Requirement Specification (SRF) once None 1 day ACRD-Database Technical
reviewed. personnel
5.  Conduct of initial testing. None 3 days ACRD-Database Technical
personnel
6.  Conduct of follow up testing until final testing. None 3 days ACRD-Database Technical
personnel
7.      Signing of User Acceptance Form (UAF) once reviewed. None 1 day ACRD-Database Technical
personnel
8.      Wait for feedback on the successful system deployment. None 3 days ACRD-Database Technical
personnel
TOTAL 20 days
1. Receiving and Processing of Contracts of HCIs as Z benefit package providers
Managing Contracts of HCIs as Z benefit package providers
Office: Accreditation Policy Research Development Division_Accreditation Department
Classification: highly technical
Type of Transaction: G2B
Who May Avail: Health Care Providers and other partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
1.     LOI from contracted HCI (1 copy of original Letter of Intent) 1.     From HCI
2.     Recommendation from PROs (1 copy of original Memo with Recommendation) 2.     From PRO
3.     NBB compliance certificate (1 copy of original Certification) 3.     From PRO
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Health Care Institution submit 1. AD reviews the recommendation of PRO, CSW and None 3 days APRDD-Contracting Technical
LOI for Initial /Renewal the detailed Co Payment proposal of the HCI personnel
2. AD prepares endorsement to BDRD, QAG and None 1 day APRDD-Contracting Technical
HFPS for approval of co pay personnel
3. AD drafts contract for Internal Legal Department None 2 days APRDD-Contracting Technical
clearance (as applicable) personnel
4. AD facilitates forwarding of the contract with None 1 day APRDD-Contracting Technical
clearance to concerned PRO for HCI signature personnel
5. AD receives the contracts with HCIs signature and None 1 day APRDD-Contracting Technical
forward to the office of OPCEO for signature and personnel
approval
6. AD tags the approved contracts on the None 1 day APRDD-Contracting Technical
accreditation database personnel
7. AD facilitates the notarization of the approved None 1 day APRDD-Contracting Technical
contract personnel
 8. AD prepare transmittal of notarized contract to None 1 day APRDD-Contracting Technical
the concerned HCI and appropriate office personnel

9. Contracts mailed to concerned PROs None 1 day APRDD-Contracting Technical

personnel
TOTAL: 12 days

2. Policy Development
Process on the development of new/enhanced policy
Office: Accreditation Policy Research Development Division_Accreditation Department
Classification: Highly technical
Type of Transaction: G2B
Who May Avail: Health Care Providers and other partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Feedback/recommendation 1. Development of Policy None 5 days APRDD-Division Chief/Section
from internal/external Chief/Technical Staff
stakeholders
2. Stakeholder’s Consultation None 1 day APRDD-Technical Staff
3. Drafting of Policy None 7 days APRDD-Division Chief/Section
Chief/Technical Staff
4. Writeshop/ Consultation with PROs None 1 day APRDD-Division Chief/Section
Chief/Technical Staff
5. Routing None 1 day APRDD-Clerk
6. Review and Approval None 1 day AD-SM/QAG-VP/HFPS-SVP to PCEO
7. Publication None c/o CAG APRDD-Technical Staff
8. Development of SOPs None 2 days APRDD-Division Chief/Section
Chief/Technical Staff
9. Routing None 1 day APRDD-Clerk
10. Review and Approval None 1 day AD-SM/QAG-VP/HFPS-SVP/CAG/
CORPLAN/5 SVPS/OCOO to OPCEO
TOTAL: 20 days
1. Inquiries from Internal/External Stakeholders thru Email/Mail
Action on Inquiries received by the office through email

Office: Office of the Manager_Accreditation Department

Classification: Simple
Type of Transaction: G2B, G2C, G2G
Who May Avail: Health Care Providers, Government Agencies, LGUs, Members and other partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send inquiry thru email/mail 1.  Receive inquiry thru email/mail None 10 minutes AD Office of the Manager-Receiving Clerk
2.  Assign to concerned staff None 5 minutes AD Office of the Manager-Senior Manager
3.  Route to concerned staff None 5 minutes AD Office of the Manager-Secretary
4.  Prepare the response to inquiry None 30 minutes APRDD/ACRD-Technical staff
5.  Draft routed for approval of the Division Chief None 30 minutes APRDD/ACRD-Division Chief/Clerk
6.  if with correction return to the concerned None 30 minutes APRDD/ACRD-Clerk/Technical Staff
personnel for revision, if approved proceed to next
step
7.  Route to OSM for approval None 5 minutes AD Office of the Manager-Secretary
8.  SM approved/signed response None 20 minutes AD Office of the Manager-Senior Manager
9.  Response shall be emailed/mailed to client None 10 minutes AD Office of the Manager-Releasing Clerk
2. Send acknowledgment receipt 10. Expect acknowledgement of receipt of client None upon receipt of the AD-Office of the Manager
client
TOTAL 2 hours and 2
minutes
2. Inquiries from Internal/External Stakeholders thru Email/Mail
Action on Inquiries received by the office through email
Office: Accreditation Department
Classification: Complex
Type of Transaction: G2B, G2C, G2G
Who May Avail: Health Care Providers, Government Agencies, LGUs, Members and other partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send inquiry thru email/mail 1. Receive inquiry thru email/mail None 10 minutes AD Office of the Manager-Receiving Clerk
2.      Assign to concerned staff None 5 minutes AD Office of the Manager-Senior Manager
3.      Route to concerned staff None 5 minutes AD Office of the Manager-Secretary
4. Coordinate with other offices/personnel in relation None 1 day APRDD/ACRD-Technical staff
to the inquiry
5. Prepare response to inquiry – takes max of 1 day None 1 day APRDD/ACRD-Technical staff
6. Draft routed for approval of the Division Chief None 1 hour APRDD/ACRD-Division Chief/Clerk
7. if with correction return to the Concerned None 1 hour APRDD/ACRD-Clerk/Technical Staff
personnel for revision, if approved proceed to next
step
8. Route to OSM for approval None 5 minutes AD Office of the Manager-Secretary
9. SM approved/signed response None 20 minutes AD Office of the Manager-Senior Manager
10. Response shall be emailed/mailed to client None 10 minutes AD Office of the Manager-Releasing Clerk
2. Send acknowledgment receipt 11. Expect acknowledgement of receipt of client None upon receipt of the AD-Office of the Manager
client
TOTAL: 2 days, 2 hours, 55
minutes
3. Inquiries from Internal/External Stakeholders thru Email/Mail
Action on Inquiries received by the office through email

Office: Accreditation Department

Classification: Highly Technical
Type of Transaction: G2B, G2C, G2G
Who May Avail: Health Care Providers, Government Agencies, LGUs, Members and other partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send inquiry thru email/mail 1. Receive inquiry thru email/mail None 10 minutes AD Office of the Manager-Receiving Clerk
2. Assign to concerned staff None 5 minutes AD Office of the Manager-Senior Manager
3.  Route to concerned staff None 5 minutes AD Office of the Manager-Secretary
4. Coordinate with other offices/personnel in relation None 2 days APRDD/ACRD-Technical personnel
to the inquiry
5. Conduct meetings in relation to the inquiry None 1 day AD-Senior Manager/APRDD or ACRD-Division
Chiefs/Technical staff
6. Prepare response to inquiry – takes max of 3 day None 3 days APRDD/ACRD-Technical personnel
7. Draft response routed for approval of the Division None 1 day APRDD/ACRD-Division Chief/Clerk
Chief
8. if with correction return to the Concerned None 1 day APRDD/ACRD-Clerk/Technical Staff
personnel for revision, if approved proceed to next
step
9. Revise draft routed to OSM for approval None 5 minutes AD Office of the Manager-Secretary
10. SM approved/signed response None 20 minutes AD Office of the Manager-Senior Manager
11. Response shall be emailed/mailed to client None 10 minutes AD Office of the Manager-Releasing Clerk
2. Send acknowledgment receipt 12. Expect acknowledgement of receipt of client None upon receipt of the AD-Office of the Manager
client
TOTAL: 8 days, 55 minutes
1. Inquiries from Internal/External Stakeholders thru Email/Mail
Action on Inquiries received by the office through email
Office: Office of the Senior Vice President
Classification: Complex
Type of Transaction: G2G
Who May Avail: All
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
None NONE
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Send inquiry thru email/mail Receive mail/email inquiry none 2 minutes CLERK III OSVP HFPS
Encoding of document to database none 30 minutes to 2 hours Clerk III osvp HFPS
Initial review of document none 1 day Social Insurance Assistant I or Exec-
utive Assistant IV osvp hfps
Document to be reviewed by the SVP none 1 day Senior Vice President osvp hfps
Route to concerned staff/office for action none 1 hour Clerk III osvp hfps
Prepare the response to inquiry none 3 days SIA I/EA IV/Office under HFPS
If with correction return to the concerned personnel none 1 hour clerk III osvp hfps
for revision, if approved proceed to next step
For approval and signature of the SVP none 1 day Senior Vice President osvp HFPS
Response shall be emailed/mailed to client none 1 day Clerk III osvp hfps
2. Send acknowledgment receipt Expect acknowledgement of receipt of client none
TOTAL 7 days
1. Customer Assistance
Customer Assistance (Check Member’s Eligibility, Issue pertinent forms)
Office: PhilHealth CARES
Classification: Simple
Type of Transaction: G2C-Government to Client
Who May Avail: Clients within the Hospital
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Client Identification/ information Client
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Sign in the Client Log sheet 1. Give the log sheet to the client None 1- 2 minutes P-CARES (PhilHealth Customer
Assistance, Relations and
Enpowerment Staff)/ SIA I
2 Verbalize the nature of inquiry. 2. Analyze the nature of client’s inquiry None 1-5 minutes P-CARES (PhilHealth Customer
Assistance, Relations and
Enpowerment Staff)/ SIA I
3. Provide necessary supporting 3. Answer the client or refer to responsible office . None 1 minute- 5 mins P-CARES (PhilHealth Customer
documents or information Assistance, Relations and
in relation to the inquiry Enpowerment Staff)/ SIA I
(Government Issued Valid ID, Birth
certificate, SOA, IEC Materials,
BPN, etc)

TOTAL: 3-12 minutes

2. Conduct of PhilHealth Patient Exit Survey
Conduct of PhilHealth Patient Exit Survey

Office: PhilHealth CARES

Classification: Simple
Type of Transaction: G2C-Government to Client
Who May Avail: Clients who availed PhilHealth Benefits
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Client Identification/ information Client
Statement of Account (1 original copy) None
Proof of Payment (1 Original copy ) None
PPES Tool (1 original copy) P-CARES/ SMD
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Client is for discharge. 1. P-CARES seeks permission to conduct PPES None 1- 2 minutes P-CARES (PhilHealth Customer
Assistance, Relations and
Enpowerment Staff)/ SIA I
2. Verbalize the willingness to 2. Ask client to sign informed consent and conduct None 5-10 minutes P-CARES (PhilHealth Customer
participate in the survey and signs the survey proper. Assistance, Relations and
the informed consent Enpowerment Staff)/ SIA I

TOTAL: 6-12 minutes

1. P- Malasakit Center Customer Assistance
Check Member’s Eligibility and Issue pertinent forms
Office: PhilHealth Malasakit Center
Classification: Simple
Type of Transaction: G2C- Government to Client
Who May Avail: Clients within the Malasakit Centers
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Client Identification/ information Client
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Sign in the Client Log sheet 1. Give the log sheet to the client None 1- 2 minutes P-Malasakit Personnel

2. Verbalize the nature of inquiry. 2. Analyze the nature of client’s None 1-5 minutes P-Malasakit Personnel
inquiry
3. Provide necessary supporting 3. Answer the client or refer to
documents or information in re- partner offices
lation to the inquiry (Government
Issued Valid ID, Birth certificate, None 1 minute- 5 mins P-Malasakit Personnel
SOA, IEC Materials, BPN, etc)

TOTAL: 3-12 minutes

EXTERNAL SERVICES
INFORMATION MANAGEMENT SECTOR
1. Processing of Software Certification/ Compliance Request
This service is used to ensure that the requester’s system complies with the standard data, transmission and integration requirements provided by the
Corporation.
Office/Division: IT Management Department - IS Management Division
Classification: Highly Technical
Type of Transaction: G2B - Government to Business and G2G - Government to Government
Who May Avail: Health Care Institutions, Government Agencies, Other external partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
One (1) Original Copy of Software Certification Application Form (SCAF) PhilHealth Website
One (1) Original Copy of Non-Disclosure Agreement (NDA) PhilHealth Website
One (1) Original Copy of Software Certification Agreement (SCA) PhilHealth Website
One (1) Original Copy of Software Certification Kit (SCK) Philhealth Regional Office IT
One (1) Original Copy of Software Valiation Test Form (SSVTF) Philhealth Regional Office IT
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit Application for Software 1.1 Receive fully accomplished NDA, SCAF and SCA None 3 working days Receiving Clerk
Certification with attached 1.2. Check completion of the supporting documents. PRO IT
documents using IT Ticketing 1.3. Set and coordinate schedule of the Software
System. Certification Test.
2. Conduct of the Scheduled 3.1. Prepare test data for the test. None 5 working days PRO IT
Software Certification Test 3.2. Conduct 3 cycles of testing to ensure compliance
of the system to the Software Validation Test Form
(SSVTF).
3.3. Prepare, finalize and sign-off in teh SSVTF.
3. System Software Certification 4.1 Receive PRO IT Endorsement with the attached None 12 working days PRO IT
Completion test documents as proof of system compliance UPECS-EMR Team
4.2 Prepare Software Certificate / Notice of System RVP
Compliance for signature of authorized signatories ITMD Heads
4.3 Route the Software Certificate / Notice of System CIO
Compliace to authorized signatories PCEO
4.4 Register HCI in the Database.
TOTAL: 20 working days
2. Registration to PhilHealth Systems and Integration Services
The purpose of this service is to register and enable access to specific PhilHealth systems and/or application programming interface (API) provided by the
Corporation.
Office/Division: IT Management Department - IS Management Division
Classification: Simple
Type of Transaction: G2B - Government to Business and G2G - Government to Government
Who May Avail: Any external partners with existing MOA/Contract facilitated by a Business Process or Program Office
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Service Request Form (1 original copy) IT Helpdesk
Business and User Requirements (1 original copy) OSM-ITMD
Memorandum of Agreement (1 original copy) Requesting Office
Data Sharing Agreement (1 original copy) Requesting Office
Non-Disclosure Agreement (1 original copy) Requesting Office
Application Integration Registration Form (1 original copy) OSM-ITMD
Service Terms of Use (1 original copy) OSM-ITMD
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Create a ticket request using the IT Ticketing 1.1. Receive and log the request with existing ticket None 3 working days Receiving Clerk
System and attach the scanned documents. request. Return hardcopy requests for non-existing Office of the Senior Manager, IT
Submit all hardcopy document requirements in tickets. Management Department
the Office of the Senior Manager reflecting the 1.2. Stamp, indicate the request number and return
ticket number in the Service Request Form. the receiving copy if any.
1.3. Endorse to the IS Management Division.

1.4. Endorse for IMS approval based on ISSP and None 5 working days Division Chief of the IS
Corporate Thrust. Management Division
1.5. Endorse to OSM-ITMD to present and report for
Management Approval/Prioritization.
1.6. Release Request Status Update to the requesting
office.
1.7. Assign a Scrum Team to handle approved request.
 1.8. Define and document the data formats, layout None 10 working days Scrum Team
and standards, transmission requirements, security to ISMD
be implemented and the input/output parameters.
1.9. Conduct items no. 2-5 under the #5. SOFTWARE None 23 working days Scrum Team
DEVELOPMENT SERVICES ISMD
1.10. Prepare the Interoperability Implementing None 10 working days Scrum Team
Guidelines and Specifications, Software Validation ISMD
Checklist
1.11. Release of the Interoperability Kit and None 3 working days Scrum Team
Confirmation Slip of the Orientation/Meeting ISMD
Schedule to the external partners and requesting
office.
2. Submit the Orientation Confirmation Slip to 2.1. Conduct the orientation to the external partner/s None 5 working day Scrum Team
the OSM-ITMD. in coordination to the requesting office. ISMD
2.2. Document the conduct of the orientation.
TOTAL: None 59 working days
3. Software Development Services
This service facilitates the request for automation of business processes and support to Corporate policies, programs and projects to be developed internally.
Activities will be based on the Scrum Methodology where the project deliverables will be subdivided into a 2 week period, hence process from 2-5 will be
repeating until completion of the Project.
Office/Division: IT Management Department - IS Management Division
Classification: Highly Technical
Type of Transaction: G2B - Government to Business and G2G - Government to Government
Who May Avail: Any PhilHealth Business Process Units or Program Offices.
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Service Request Form (#1 original copy) IT Helpdesk
Business User Requirements Document (#1 original copy) OSM-ITMD
PhilHealth Circular and Policy Issuances (#1 copy) Requesting Office
Corporate Orders and Implementing Guidelines (#1 copy) Requesting Office
Standard Operating Procedures (#1 copy) Requesting Office
Risk Assessment Certificate (#1 copy) Risk Management Department
Updated Prioritized Sector Project List (#1 signed original copy) Sector of the Requesting Office
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Create a ticket request using the 1.1. Receive and log the request with existing ticket None 3 working days Receiving Clerk
IT Ticketing System and attach the request. Return hardcopy requests for non-existing Office of the Senior Manager, IT
scanned documents. Submit all tickets. Management Department
hardcopy document requirements 1.2. Stamp, indicate the request number and return
in the Office of the Senior Manager the receiving copy if any.
reflecting the ticket number in the 1.3. Endorse to the IS Management Division.
Service Request Form.
1.4. Endorse for IMS approval based on ISSP and None 5 working days Division Chief of the IS Management
Corporate Thrust. Division
1.5. Endorse to OSM-ITMD to present and report for
Management Approval/Prioritization.
1.6. Release Request Status Update to the requesting
office.
1.7. Assign a Scrum Team to handle approved request.
2. Define all product backlog based 2.1. Group the defined product backlog into None 5 working days Scrum Team
on priority. actionable deliverables within the prescribed period.
2.2. Prepare the Project Releases Timeline.
2.3. Prepare the System Requirements Specification
for the applicable development period based on
sequence of the Project Timeline.
2.4. Release the Project Timeline and SRS to the
requesting office for approval.
3. Submit the approved the 3.1. Conduct Sprint Planning. None 3 working days Scrum Team
Project Timeline and the System 3.2. Prepare the Project Journal.
Requirements Specification (SRS)
for the initial sprint.
4. Participate in the Daily Scrum 4.1. Conduct the Daily Scrum. None 10 working days from Scrum Team
Meeting 4.2. Conduct the Sprint Review. project start date ISMD
4.3. Endorse the developed application for user
acceptance test and security assessment compliance.
4.4. Update the Project Journal.
5. Submit the completely signed 5.1. Prepare for the deployment documentations. None 5 working days Scrum Team
System Acceptance Form (SAF). 5.2. Submit deployment requirements to the IT ISMD
Resource Management Division - IT Management
Department.
5.3. Conduct Sprint Retrospective.
5.4. For publicly facing applications, endorse project
to Information Security Department to facilitate 3rd
Party Vulnerability Assessment Test
Repeat processes from 2-5 until all project deliverables has been completed.
TOTAL: 31 working days per project iteration
4. Support Management Services
The service involves the processing or resolution of incidents, complaints, inquiries and issues reported by internal and external users
of PhilHealth systems.
Office/Division: IT Management Department - IS Management Division
Classification: Highly Technical
Type of Transaction: G2C - Government to Citizen, G2B - Government to Business and G2G - Government to Government
Who May Avail: Internal or external users of PhilHealth Systems
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
A detailed description of incidents, complaints, inquiries and issues (#1 original copy) PhilHealth System Users
Screenshot of incidents, complaints, inquiries and issues (#1 original copy) PhilHealth System Users
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
External User: 1.1. Acknowledge receipt of the incidents, None 3 working days UPECS-EMR
1. Create a ticket indicating the detailed description complaints, inquiries and issues
and screenshots of incidents, complaints, inquiries 1.2 Endorse the incidents, complaints, inquiries and
and issues via the PhilHealth Ticketing System at issues to the concerned scrum team.
URL?
Internal User: 1.1. Acknowledge receipt of the incidents, IT Helpdesk
1. Email the detailed description and screenshots complaints, inquiries and issues
of incidents, complaints, inquiries and issues to IT 1.2 Endorse the incidents, complaints, inquiries and
Helpdesk Unit ([email protected]) issues to the concerned office/team.
1.3. Evaluate the incidents, complaints, inquiries and None 1-3 working days (simple) Concerned Scrum Team
issues 4-7 working days (moderate)
8-20 working days (complex)
1.4. Provide feedback or resolution to the UPECS- None 1 working day Concerned Scrum Team
EMR team or escalate issues to concerned office.
1.5. Provide feedback or resolution to the reporting None 1 working day UPECS-EMR
user
TOTAL: 6 working days (simple)
10 working days (moderate)
22 working days (complex)
5. System Integration and Data Sharing Services
This facilitates the request for system integration and/or data sharing requests received from other external partners.

Office/Division: IT Management Department - IS Management Division

Classification: Highly Technical
Type of Transaction: G2B - Government to Business and G2G - Government to Government
Who May Avail: Health Care Institutions, Government Agencies, Other external partners
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Service Request Form (#1 original copy) IT Helpdesk
Business User Requirements Document (#1 original copy) Requesting Office
PhilHealth Circular and Policy Issuances (#1 copy) Requesting Office
Corporate Orders and Implementing Guidelines (#1 copy) Requesting Office
Standard Operating Procedures (#1 copy) Requesting Office
Risk Assessment Certificate (#1 copy) Requesting Office
Updated Prioritized Sector Project List (#1 signed original copy) Sector of the Requesting Office
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit all document 1.1. Receive and log the request. None 3 working days Receiving Clerk
requirements in the Office of the 1.2. Stamp, indicate the request number and return the receiving Office of the Senior Manager, IT
Senior Manager, IT Management copy if any. Management Department
Department. 1.3. Endorse to the IS Management Division.
1.4. Endorse for IMS approval based on ISSP and Corporate Thrust. None 5 working days Division Chief of the IS Management
1.5. Endorse to OSM-ITMD to present and report for Management Division
Approval/Prioritization.
1.6. Release Request Status Update to the requesting office.
1.7. Assign a Scrum Team to handle approved request.
2. Define all product backlog based 2.1. Group the defined product backlog into actionable deliverables None 5 working days Scrum Team
on priority. within the prescribed period.
2.2. Prepare the Project Releases Timeline.
2.3. Prepare the System Requirements Specification for the
applicable development period based on sequence of the Project
Timeline.
2.4. Release the Project Timeline and SRS to the requesting office for
approval.
3. Submit the approved the 3.1. Conduct Sprint Planning. None 3 working days Scrum Team
Project Timeline and the System 3.2. Prepare the Project Journal.
Requirements Specification (SRS)
for the initial sprint.
4. Participate in the Daily Scrum 4.1. Conduct the Daily Scrum. None 10 working days Scrum Team
Meeting 4.2. Conduct the Sprint Review.
4.3. Endorse the developed application for user acceptance test and
security assessment compliance.
4.4. Update the Project Journal.
5. Submit the completely signed 5.1. Prepare for the deployment documentations. None 5 working days Scrum Team
System Acceptance Form (SAF). 5.2. Submit deployment requirements to the IT Resource
Management Division - IT Management Department.
5.3. Conduct Sprint Retrospective.
5.4. For publicly facing applications, endorse project to Information
Security Department to facilitate 3rd Party Vulnerability Assessment
Test
Repeat processes from 2-5 until all project deliverables has been completed.
TOTAL: 31 working days
1. External Collaboration
Collaborate with external agencies (Government and Non-government) the request received for Projects within the sector. Inter-organizational
collaboration such as to: mutually achieve goals, share information, resources, and responsibilities, as well as make joint decisions and solve problems.

Office: Project Management Office - PhilHealth Identity Management System (PMO-PIMS)

Classification: Complex
Type of Transaction: G2G - Government to Government, G2B - Government to Business
Who May Avail: External Agencies / External Offices
CHECKLIST OF REQUIREMENTS WHERE TO SECURE
Request Letter (1 Original copy or digital copy) Requesting Office
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit request letter 1.1 Receive and identify request None 10 mins SIA II
PMO-PIMS
1.2 Evaluate and process the request letter None 20 mins SIO II
PMO-PIMS
1.3 Provide further instructions None 1 day Senior Manager
PMO-PIMS
1.4 Coordinate with other PhilHealth offices involve None 3 days SIO II
PMO-PIMS
1.5 Prepare response letter None 1 day SIO II, Senior Manager
PMO-PIMS
2. Receive response letter None
TOTAL: None 5 days and 30 minutes
1. Conduct of Fact-Finding Investigation
Perform claims validation through domiciliary visits and health care provider inspection, to verify from members the authenticity (and quality) of benefits and
services provided by a health care provider.
Office/Division: Fact-Finding Investigation and Enforcement Department - Investigation and Enforcement Division
Classification: Highly Technical
Type of Transaction: G2G – Government to Government; G2C – Government to Citizen
Who May Avail: PRO Legal Offices, Other Government Agencies such as Presidential Anti-Corruption Commission, any Individual
CHECKLIST OF REQUIREMENT WHERE TO SECURE
Original Copy or CTC of the oiriginal documents, hard copy (1 copy) PhilHealth Regional Office – Legal Office
Original copy of the Salaysay (1 copy) Fact-Finding Investigation and Enforcement Department
Report or letter-recommending/requesting the conduct of investigation (emailed request PRO Legal Offices, Other Government Agencies such as Presidential Anti-Corruption
or transmitted hard copy) (1 copy) Commission, any Individual
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1.For walk-in clients: File a 1.1. Receive the complaint or report for investigation None 10 minutes Administrative personnel,
complaint at the Fact-Finding Fact-Finding Investigation And
Investigation and Enforcement Enforcement Department
Department or PhilHealth
Regional Office -Legal Office (refer
to Processing of Complaints Filed
by Walk-in Clients)
2. Endorse the report to the 2.1 Acknowledge receipt of emailed transaction. None 30 minutes Administrative personnel,
FFIED (through email or forward/ Fact-Finding Investigation And
transmit hard copy of the report) Enforcement Department
None 2.2. Coordinate with agency, acknowleding receipt None 1 hour and 30 minutes "Administrative personnel,
of hard copy of report. Fact-Finding Investigation And
Enforcement Department”
None 2.3 Record in transaction recording system or Legal None 30 minutes "Administrative personnel,
Case Management System Fact-Finding Investigation And
Enforcement Department”
None 2.4 Evaluate complaint/report None within 60  days Department Manager/Division
(RA 7875 as amended, Chief, Fact-Finding Investigation
Title VIII, Rule II, Section And Enforcement Department
84. Complaints filed
None 2.5 Assign complaint/report to an investigator None before FFIED, Item B. ) Department Manager/Division
Chief, Fact-Finding Investigation
And Enforcement Department
None 2.6  Prepare documents necessary in the conduct of None Investigator, Fact-Finding
fact-finding investigation Investigation And Enforcement
Department
None 2.7  Secure Official Business or Travel Order None Investigator, Fact-Finding
Investigation And Enforcement
Department
None 2.8 Prepare cash advance, if necessary None Investigator, Fact-Finding
Investigation And Enforcement
Department
None 2.9 Perform the investigation and validation of None Investigator, Fact-Finding
claims through domiciliary visitation to members or Investigation And Enforcement
health care provider inspection Department
None 2.10  Evaluate documents gathered None Investigator, Fact-Finding
Investigation And Enforcement
Department
None 2.11  Prepare and submit fact-finding investigation None Investigator, Fact-Finding
report Investigation And Enforcement
Department
None 2.12. Secure medical evaluation to substantiate the None Investigator, Fact-Finding
report, if necessary Investigation And Enforcement
Department
 None 2.13   File complaint affidavit if there is prima facie None within 10 days from the Investigator, Fact-Finding
evidence of violation issuance of fact-finding Investigation And Enforcement
investigation report Department
(RA 7875 as amended,
None 2.15  Forward complaint to Prosecution Department None Title VIII Rule II, Section Administrative personnel,
84. Complaints filed Fact-Finding Investigation And
before FFIED, Item C) Enforcement Department

Total: None 70 days, 2 hours and

40 minutes

(RA 7875 as amended, Title VIII, Rule II, Section 84. Complaints filed before FFIED, Item B. )
(RA 7875 as amended, Rule II, Section 84. Complaints filed before FFIED, Item C)
2. Processing of Complaints from Walk-In Clients
Attending to the complaints filed by walk-in clients by Fact-Finding Investigation and Enforcement Department.
ffice/Division: Fact-Finding Investigation and Enforcement Department - Investigation and Enforcement Division
Classification: Simple
Type of Transaction: G2C – Government to Client
Who May Avail: All
CHECKLIST OF REQUIREMENT WHERE TO SECURE
Documentary evidence that may serve as reference/attachments in the complaint (such as Walk-in client
certified true copy of the original benefit payment notice, billing statements and receipts)
(1 copy)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Coordinate with the 1.1  Receiving personnel to attend to the concern of None 5 mins Administrative personnel,
department's front desk/receiving the client Investigation and Enforcement
personnel Division
None 1.2 Coordinate with an Investigator to accommodate None 10 minutes Administrative personnel,
the complainant Investigation and Enforcement
Division
None 1.3  Prepare documents necessary in the interview None 15 minutes Investigator, Investigation and
(i.e. Domiciliary Visit Undertaking or Salaysay Form) Enforcement Division

2. Discuss/detail the 2.1  Conduct the interview on the client None 2 hours Investigator, Investigation and
circumstances Enforcement Division
None 2.2 Record the discussion in the Salaysay Form None Investigator, Investigation and
Enforcement Division
None 2.3 Finalize the discussion with the client None Investigator, Investigation and
Enforcement Division
None 2.4 Secure approval by signing the Salaysay form None Investigator, Investigation and
by both parties (investigator and client, and an Enforcement Division
administering officer)
3. Provide document/evidence 3.1 Secure certified true copies of documents from None 30 minutes Investigator, Investigation and
asked by the Investigator (based the client to substantiate the complaint Enforcement Division
on discussion)
None 3.2 Record the transaction with client and receipt of None 5 minutes Investigator, Investigation and
the documents through record logbook Enforcement Division
None 4.1.   Evaluate documents to recommend conduct of None 1 hour Investigator, Investigation and
investigation, if warranted Enforcement Division
Total: None 4 hours and 28 mins
1. Resolution of Appeals on denied or reduced benefit claims filed by the member and hospital appellant.
The decisions or notices of the PROs may be appealed by the aggrieved health care provider or member in writing to the PARD within fifteen (15) days from
receipt of such decisions or notices. The PARD may adopt, modify or reject the decisions or notices of the PRO on protests in whole or in part. Forthwith, the
PARD shall issue an order resolving the appeals, as far as practicable, within a period of thirty (30) days from receipt of the appeal, citing the facts and the law
or rules on which the same is based. The order of the PARD shall be final and executory.
Office/Division: Protests and Appeals Review Department (PARD)
Classification: Highly Technical
Type of Transaction: G2C - Government to Citizen; G2G - Government to Government
Who May Avail: PhilHealth member and Healthcare Provider availing the benefit claim
CHECKLIST OF REQUIREMENT WHERE TO SECURE
Standard Requirements Situational Requirements Standard Requirements Situational Requirements
1. Letter-appeal (1 Original copy) 1. CF3,CF4 if applicable (1 original copy) 1. Written by the appellant (either Member, 1. Healthcare Provider
Dependent, Institution or Professional)
2. MR/Order letter-denial (1 Original Copy) 2. MDR (1 original copy) 2. PRO CRC 2. any PhilHealth office
3. PRO Letter-denial (1 Original Copy) 3. Medical/Clinical Records & documents (1 3. PRO BAS 3. Healthcare Provider
certified photocopy)
4. CF1, CF2, CSF (1 Original Copy) 4. Healthcare Provider and Company filled 4. Healthcare Provider
out
5. SOA/Cost of services rendered (1 Original 4. Doctors Orders/Nurses Notes (1 certified 5. Healthcare Provider 5. Healthcare Provider
copy) photocopy)
6. PBEF (1 Original copy) 5. Hospital Cert of Eligibility/ Accreditation 6. Healthcare Provider - PhilHealth Section 6. Healthcare Provider
(1 certified photocopy)
7. Validation Report (1 Original copy) 6. Pre-cataract surgery authorization (1 7. Healthcare Provider 7. Member
original copy)
8. Waiver for members claim (1 original 7. PHIC Official Receipts/ Bank/ Bayad 8. Healthcare Provider 8. BIR, Post Office, DFA, PSA, LTO, SSS, GSIS,
copy) Centers (1 original copy) Pag-Ibig
None 8. Government Issued Identification Card of None 9. Healthcare Provider, other government
the member and/or dependent (1 certified institutions
photocopy)
None 9. Other pertinent medical and legal None 10. Healthcare Provider, other government
documents as may be required institutions
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. The Appellant files his/her 1.1 Receipt of the appeal and validate the None 2 days/50 appeal claims Receiving Clerk - Admin Support
appeal, including all original completeness of all attached documents by the Section
claim documents to PARD either Admin Staff
by personally submitting his/her
appeal or thru registered mail/
private courier.
None 1.2 Stamp date of receipt of the appeal None 1 day/50 appeal claims Receiving Clerk - Admin Support
Section
None 1.3 Assign docket number and encode in the None 2 days/50 appeal claims Administrative Service Assistant C-
database Admin Support Section
None 1.4 Preparation of the transmittal of docketed appeal None 1 day/50 appeal claims Administrative Service Assistant
and forward it including its supporting documents C/Administrative Officer II/Social
to Medical Review Division for medical review and Insurance Specialist- Admin
evaluation and Legal Division for legal review and Support Section
drafting of resolution.
None 1.5 Receive, encode and assign the docketed appeal None 3 days/50 claims Administrative Service Assistant C -
claim to Medical Officers for medical evaluation Medical Review Division
None 1.6 Medical Evaluation/Assessment of each appealed None 10 days/ 50 claims Medical Specialists - Medical
claim Review Division
None 1.7 Prepare and issue Letter of Deficiency, if None 5 days/5 RTH claims Administrative Service Assistant C -
additional medical record is needed to support the Medical Review Division
claim
None 1.8 Prepare the Medical Evaluation Report with None 5 days/50 claims Medical Specialists - Medical
recommendation Review Division
None 1.9 Approval of the Medical Evaluation Report by the None 7 days/50 claims Division Chief, Medical Review
Division Chief of the Medical Review Division Division
None 1.10 Forward appeal with approved medical None 3 days/50 claims Administrative Service Assistant C -
evaluation report and supporting documents to Medical Review Division
Legal Division for legal review and the drafting of
Resolution . Prepare the transmittal.
 None 1.11 Receive, encode, update database and assign None 3 days/50 claims Clerk III - Legal Support Division
the appealed claim to Attorney V/Legal Researchers
None 1.12 Legal review, validation, preparation and None 12 1/2 days/50 claims Legal Researchers - Legal Support
drafting of Resolution with recommendations Division
None 1.13 Review and recommend the approval of the None 7 days/50 claims Division Chief - Legal Support
draft Resolution to the SM Division
None 1.14 Preparation of transmittal/annex, check None 6 days/50 claims Clerk III - Legal Support Division
completeness and forward draft Resolution to the
Senior Manager for review, comment and approval
of Resolution along with its recommendation.
None 1.15 Receive,encode in the database and forward to None 1 day/50 appeal claims Administrative Service Assistant C -
Senior Manager for review,comment and approval Admin Support Section
None 1.16 Review and approval of the Senior Manager None Legal division (14 Legal Researchers - Legal Support
(includes return to the Legal Division for revisions of days/50 claims-receipt Division, Division Chief for LSD
the Resolution ) of reso, revision by LR, and Senior Manger Protests and
Review of DC) Appeals Review Department
Senior Manager - 3 days (PARD)
(if no meetings)
None 1.17 For signature by the authorized Officers the None Legal Division 2 days/50 Division Chief for LSD, Division
Final Resolution claims Chief for MRD & Senior Manager
Medical Division 10 - Protests and Appeals Review
minutes; Department (PARD)
Senior Manager 2 days
(if no meetings)
None 1.18 Forward duly signed Resolution and claim None 3 days/50 appeal claims Administrative Service Assistant C-
documents to the Admin for scanning, preparation Admin Support Section
of mailing transmittal and mailing of documents to
the concerned parties.
None 1.19 Update PARD database on the status of the 1 day/50 appeal claims Administrative Service Assistant C -
appeal Admin Support Section
Total: None 91 days, 4 hrs and 10
mins

* Within thirty (30) days as far as practicable, as provided under the Revised Implementing Rules and Regulations (RIRR) of RA 7875 (National Health Insurance Act of 2013) as amended by RA
9241and 10606
1. Coordinate EXTERNAL Events / Activities
Coordination with clients to accomplish the objectives of the EXTERNAL events / activities.
Office/Division: Member Management Group (All Departments)
Classification: G2G – Government to Government
G2C – Government to Transacting Public
G2B – Government to Transacting Business Entity
Type of Transaction: G2G - Government to Government ; G2B - Government to Business; G2C - Government to Citizen
Who May Avail: Concerned EXTERNAL CLIENTS pertinent to the Employed, Senior Citizens, Lifetime Members Program, OWP, Non-poor, NHTS, or PAMANA segments.
To wit: Officers and personnel of the Central Office, PhilHealth Regional and Local Health Insurance Offices.
CHECKLIST OF REQUIREMENT WHERE TO SECURE
One (1) Original and duly accomplished: End-user/Business Process Owner (BPO)
- Approved CPO
- TOR of the Lease of Venue
- Estimated Expenses
- Project Proposal
- DRAR
- Matrix of Canvass
- Purchase Request
- Table of Rating Factors
- Certificate of No.Gov.Facility
- Request for Quotations or Proposals (RFQ or RFP) From End-user to Supplier/Hotel Provider
- Approved ABC From End-user to Comptrollership to FMS
- Memo to SBAC End-user to SBAC
- BAC-GS Resolution From SBAC to End-user/BPO
- NOA/NTP
- Approved Contract
- Proof of Posting to the
- PhilGeps
- Approved Contract From End-user to Hotel to SBAC
- Attendance Sheet
- Programme End-user/BPO
- Certificate of Attendance and Appearances
- Presentation
- After Travel Report
- Memo to COO
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Request for External Meetings 1.1. Prepare and ensure approval of Corporate None 5 working days or more. Admin and Technical and Officers
/ Participation to Events or Personnel Order (CPO) with duly accomplished of the department.
Activities attachments (e.g., Estimated Budgetary Expenses,
Terms of Reference of the Lease of Venue, and 1-3 Team members
Project Proposal of the event)
1.2. Upon approval by the SM of the draft CPO and 5 working days or more.
its attachments, the personnel in-charge to the
event makes a DRAR for routing to the concerned
officers for their further review, inputs and
recommendations for the approval by President &
CEO.
1.3. Upon approval by the PCEO, Request for 1 working day(s)
Quotations or Proposals (RFQ or RFP) for canvassing
from at least 3 suppliers will ensue.
1.4. Conduct ocular visits on the supplier’s proposed 2 working day(s)
venue. And select the most advantageous quotation
with conducive venue for the selection of the lowest
calculated responsive quotation. “
1.5. Prepare all procurement documentation 1 working day
requirements for review and approval by the SM.

1.6. Upon approval by the SM, prepare the Approved 1 working day
Budget for Contract (ABC) and attach all pertinent
documents.
1. Request for External Meetings 1.7. Upon signing of the ABC by the SM, attach 1 working day Admin and Technical and Officers
/ Participation to Events or Budget Expense Form (BEF) and forward the of the department.
Activities documents to the EA for encoding to the DTS
logbook Excel of the EA and forward to Admin & 1-3 Team members
Record Unit Staff of the FS to log/encode to the
Outgoing Excel DTS Logbook and forward to Budget
Administration Sections (BAS) for processing of
documents.
1.8. Upon signing of the Approved ABC, prepare 1 working day
memorandum address to the Head of SBAC and
attach all documentary requirements 14 days before
the event.
1.9. Make follow ups with SBAC on the schedule of 1 working day
meeting for approval of BAC-GS Committee for the
Lease of Venue.

1.10. Upon approval of the Lease of Venue by the 2 working day(s) in

BAC-GS Committee, the BAC-GS Resolution, Notice consideration with the
of Award (NOA) & Notice to Proceed (NTP) are then availability of the PCEO
endorsed to the Office of the President for signing to review and sign the
by the President & CEO documents.
Total: None 20 working days 1-3 Team members
2. Evaluation of Billing Documents by the Head Collection Division
Billing the National Government for PhilHealth Subsidies
Office/Division: Member Management Group (All Departments)
Classification: Complex
Type of Transaction: G2G– Government to Government
Who May Avail: Concerned Internal /External CLIENTS of the Member Management Group, to wit:
Officers and personnel of the Central Office, Regional / Branch Offices and Stakeholders
CHECKLIST OF REQUIREMENT WHERE TO SECURE
One original copy of documents for evaluation (Memo, Issuances and/or policies, reports Concerned offices (internal and external clients)
and other correspondences.
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Incoming documents for Billing 1.1 Log Billing document and assign control 1 day Clerk III
from MMG Segment Offices

1.2 Forward received documents to concerned 2 Collection staff

collection staff for billing preparation.
2. Outgoing Documents to MMG 2.1 Forward Billing letters to VP-MMG for signature None 1 day Clerk III
offices and/or other concerned
offices
2.2 Forward signed Billing letters to FMS, COO, PCEO None 3 days
for approval and signature
2.3 Received signed Billing from OP for MMG action None 1 day

2.4 Log signed billing and forward to DBM None

3. Follow-ups/Pick-up of DBM 3.1. Follow-up Billing Status by coordinating with None 1 day Collecton Staff of OSD
Billings/ Releases DBM staff for release of SARO/.NCA

3.2 Prepare OBS and reserve Vehicle for pick-up of None Clerk III
SARO/NCA Releases from DBM

3.3 Pick-up SARO/NCA releases to DBM None

Total: None 7 days

3. Evaluation of Received Documents for Review/Action and Approval of Collection Head
Evaluate of received documents within MMG and /or from different offices, for review/action and approval.
Office/Division: Member Management Group (All Departments)
Classification: Complex
Type of Transaction: G2G– Government to Government
Who May Avail: Concerned Internal /External CLIENTS of the Member Management Group, to wit: -
Officers and personnel of the Central Office, Regional / Branch Offices and Stakeholders
CHECKLIST OF REQUIREMENT WHERE TO SECURE
One original copy of documents for evaluation (Memo, Issuances and/or policies, reports Concerned offices (internal and external clients)
and other correspondences.
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Endorsement of Documents 1. Receive endorsed documents (Memos, Policies, None 1 day
within MMG offices and/or from Reports, Correspondence, URS/SRF, JOROS, Systems
other offices for appropriate Access/Clearance etc.)
action
1.1. Log the document and Assign control number Clerk III of concerned Offices

1.2. Forward received documents to Collection Collection Head

Head for instruction

1.3. Log the document to note the instruction of 8 staff for Admin, Budget,
the Collection Head Philhealth Express, Collection,
Systems and Policy concerns
1.4 Forward documents to concerned staff for
actions
1. Forward acted memos, policies, reports 1 day Clerk III of OSD
correspondence etc. to concerned offices for
information and/or actions.
1. Endorsement of Documents 2. Forward URS & JOROS requests to ITMD for action 1 day Clerk III of OSD
within MMG offices and/or from
other offices for appropriate 3. Forward request for data extractions to TFI for 1 day
action action
4. Forward Monthly Collection Reports to concerned 1 day Collection Head and / or Collection
offices in the Head Office and also to PROs and Staff
Branch Offices via email

3. Responses Memoranda/Policies/Reports ect. 2 working days 7 staff both Technical and Non-
Technical
3.1 Preparation of responses for queries/
comments ect.
Total: None 7 working days
4. Formulation and Development of Programs / Policies and Activities pertinent to membership and contributions.
Formulation and Development of Programs / Policies and Activities pertinent to membership and contributions of PhilHealth members under the Employed,
Senior Citizens, Lifetime Members Program, OWP, Non-poor, NHTS, or PAMANA segments.
Office/Division: Member Management Group (All Departments)
Classification: Highly Technical
Type of Transaction: G2G – Government to Government
G2C – Government to Transacting Public
G2B – Government to Transacting Business Entity
Who May Avail: Concerned Internal and External Stakeholders in the Employed, Senior Citizens, Lifetime Members Program, OWP, Non-poor, NHTS, or PAMANA
segments. To wit:
- PhilHealth Board and Executive Committee;
- PhilHealth Regional and Local Health Insurance Offices
- Private and Public Offices and Agencies
CHECKLIST OF REQUIREMENT WHERE TO SECURE
One (1) Original and duly accomplished:
- Memorandum or Report for policy formulation or enhancements; To be provided by clients
- Form “A”: Policy Proposal Request Form CorPlan, MMG Segments or through: www.tinyurl/policydocs
- Form “B”: Policy Routing Slip
- Form “C”: PhilHealth Policy Review Checklist
- Form “D”: Summary of Policy Comments
- Form “E”: Meeting Summary
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Request or suggestion for policy 1. Conducts the necessary “Completed Staff Work” as None Technical and Managerial Officers
development or enhancement of part of the formulation and development of policy / of MMG
exiting policy programs / activities, as follows:
1.1. Identification of the Issue; * 22 working days 5 to 7 Technical Staff of MMG
to design the proposed policy,
1.2. Establish Work Process; program or activity
1.3. Collect and Analyze Data;
1. Request or suggestion for policy 1.4. Develop and Assess Options; None 5 working days 5 to 7 Technical Staff of MMG
development or enhancement of to design the proposed policy,
exiting policy 1.5. Recommendations and Draft Reports for 3 working days program or activity
Stakeholders Consensus;
1.6. Obtain Decision Maker (Board or ExeCom) 2 working days VP of MMG
Approval;
1.7. Implement Approved Decision through Technical Staff of MMG, the
issuance of PhilHealth Circulars or Corporate Management and the PROs
Orders; preparation and execution of
Communication and Operational Plans;
1.7.1. Drafting of PC or CO 5 working days Technical Staff of MMG
1.7.2. Email Routing of the Draft Policy to PROs 5 working days Technical Staff of MMG and PROs
for Comments and Inputs
1.7.3. Securing Risk Assessment Certification 5 working days Technical Staff of MMG and PMT
from PMT-Risk Risk
1.7.4. Securing Legal Certification from Legal 5 working days Technical Staff of MMG and Legal
Sector
1.7.5. Securing IT Support System Readiness 5 working days Technical Staff of MMG and IMS
Certification from Information Management
Sector
1.7.6. Document Review and Approval (DRAR) 25 working days (5 Concerned Offices of the ExeCom
Process days average for each (e.g., OCIO, FMS, CAG, HFPS, OCOO,
concerned Offices to Actuary and PMT RISK, etc.)
review)
1.7.7. Signing of the PC or CO by the PCEO 5 working days PCEO
1.7.8. Preparation of Communication and 5 working days Technical Staff of MMG
Operational Plans
1.7.9. Execution of Communication and 2 working days; Technical Staff of MMG / Operation
Operational Plans Units
1.7.10. Publication to Newspaper 2 working days; Personnel of CAG and Records
 1. Request or suggestion for policy 1.8. Monitor and Evaluate implementation None **132 working days Technical Staff of MMG and the
development or enhancement of Management
exiting policy
Total: None 228 working days (10 5 to 7 Technical & the
months) Management

* This is the very important part of the process. Appropriate amount of time is spent as deemed necessary to ensure quality of work.
** M&E is used to track changes in the implementation or performance of the adopted policy over time. Its purpose is to permit stakeholders to make informed decisions
regarding the effectiveness and efficiency of the option/alternative adopted.
1. Adjustment, Correction and Deletion of Premium Contribution (Walk-in and Through E-mail)
This service allows adjustment, correction and deletion of premium contribution (as the need arises)
Office/Division: Member Management Group (OFP)
Classification: Complex
Type of Transaction: G2C- Government to Citizen
G2B- Government to Business Entity
Who May Avail: Migrant Workers; Filipinos Living Abroad and Filipinos with Dual Citizenship
CHECKLIST OF REQUIREMENT WHERE TO SECURE
“1 original copy of duly accomplished DARF Any PhilHealth Office
1 photocopy of Official Receipt or any proof of payment (to be submitted)
At least 1 photocopy of valid ID of the member (to be submitted)

Additional requirements if through representative:

1 original copy of Authorization letter from member
At least 1 original of valid ID of representative (to be presented)
At least 1 photocopy of valid ID of member (to be submitted)”
1 scanned copy of duly accomplished DARF Through e-mail
1 scanned copy of Official Receipt or any proof of payment
At least 1 scanned copy of valid ID of the member

Additional requirements if through representative:

1 scanned copy of Authorization letter from member
At least 1 scanned copy of valid ID of representative
At least 1 scanned copy of valid ID of member
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. The member shall submit the 1.1 Print/Receive the required documents and check None Walk-in: Social Insurance Assistant I, OFP
required documents for walk-in. for completeness. 5 minutes per DARF Supervisor
7 days if under PRO
1.2 Endorse the documents to the concerned PRO. jurisdiction (to be
endorsed to concerned
PROs)
1. The member shall submit the 1.3 Checks for the correctness of the data. None Email: Social Insurance Assistant I, OFP
required documents for walk-in. depends on the number Supervisor
of e-mails received
1.4 Issue the Member Data Record. 5 minutes per DARF
7 days if under PRO
2. Make sure to secure a copy of jurisdiction (to be
the MDR. endorsed to concerned
PROs)

Total: None 5 minutes (walk-in);

7 days if under PRO
jurisdication
2. Amendment of Member Data Record (Walk-in and through e-mail)
This service allows amendment of member’s data information.
Office/Division: Member Management Group (OFP)
Classification: Simple
Type of Transaction: G2C- Government to Citizen
G2B- Government to Business Entity
Who May Avail: Migrant Workers; Filipinos Living Abroad and Filipinos with Dual Citizenship
CHECKLIST OF REQUIREMENT WHERE TO SECURE
Case-to-case basis but not limited to the following supporting documents may be Any PhilHealth Office
required from the applicant/s Through e-mail

To correct/ add dependents, Submit 1 photo copy (walk-in)/ scanned copy (e-mail) of any
of the following:
Marriage Contract for legal spouse
Birth Certificate or proof of adoption or guardianship (children below 21 years old)
Birth Certificate of the parents and the member to establish relationship with each other

To amend civil status, Submit 1 photo copy (walk-in)/ scanned copy (e-mail) of any of the
following:
Marriage contract (Married)
Death Certificate (widowed)
Legal documents to prove that marriage is nulled, voided or legally separated

Additional requirements if through representative

1 original (walk-in)/ scanned copy (e-mail) of Authorization letter from member
At least 1 photo copy (walk-in)/ scanned copy (e-mail) of valid ID of member (to be
presented)
1 original copy (walk-in)/ scanned copy (e-mail) of valid ID of a representative

1 original copy (walk-in)/ scanned copy (e-mail) of PhilHealth Form (PMRF)

 AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
(Walk-in) 1.1. Assigned staff shall check for the completeness None Walk-in Social Insurance Assistant I, OFP
1. The member shall submit the documents submitted and shall prompt client for 5 minutes per PMRF
required documents for walk-in or any missing requirements.
e-mail.
1.2.Assigned staff shall provide amended MDR 5 minutes
upon confirmation from the client that all data
information is correct.
2. Check correctness of data. Email
1-3 days (depends on
the number of e-mails
3. Make sure to secure a copy of received)
the MDR.
Total: None 10 mins for walk-in
1-3 days (depends on
the number of e-mails
received for email)
3. Enrolment Procedures (Walk-in and Through E-mail)
This service allows initial registration and enrolment to the National Health Insurance Program.
Office/Division: Member Management Group (OFP)
Classification: Simple
Type of Transaction: G2C- Government to Citizen
Who May Avail: Land-based Migrant Workers; Filipinos Living Abroad and Filipinos with Dual Citizenship
CHECKLIST OF REQUIREMENT WHERE TO SECURE
1 photocopy of Proof of Income Any PhilHealth Office
*For declaration of dependents see separate section on Declaration of Dependents
1 Original copy of PhilHealth Form: PMRF
At least 1 photocopy of valid ID of member (to be submitted)
1 original copy of valid ID of member (to be presented)
*Additional requirements if through representative
1 Original copy of Authorization letter from member
1 original copy of valid ID of representative (to be presented)
At least 1 photo copy of valid ID of member (to be submitted)
At least 1 scanned copy valid ID of member Through e-mail
1 scanned copy of Proof of Income
*For declaration of dependents see separate section on Declaration of Dependents
1 scanned copy of PhilHealth Form: PMRF
*Additional requirements if through representative
1 scanned copy of Authorization letter from member
1 scanned copy of valid ID of representative
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
(Walk-in) (Walk-in) No service fee (if Walk-in Social Insurance Assistant I, OFP
1. Present a copy of any valid 1.1. Upon receipt of requirements, assigned staff registration only) 5 minutes per PMRF
ID of the member and any shall verify record (if any).
proof of income. If through a Computed Premium
representative, representative 1.2. Assigned staff shall provide premium contribution for OFWs (if 5 minutes
shall submit authorization contribution for OFWs. with premium payment)
letter and a photo copy of the
member’s valid ID.
2. Member shall pay computed No service fee (if 5 minutes Social Insurance Assistant I, OFP
premium contribution at any registration only)
accredited collecting agents.
Computed Premium
(E-mail) (E-mail) contribution for OFWs (if No service fee (if
3. Client shall send through e-mail 3.1. Assigned staff shall verify the record upon with premium payment) registration only)
a copy of duly accomplished receipt.
PMRF and proof of income. Computed Premium
contribution for OFWs (if
4. Member shall pay computed 3.2. Assigned staff shall provide premium with premium payment)
premium contribution at any contribution for OFWs.
accredited collecting agents.

Total: None (if registration 10 mins for walk-in

only) 1-3 days (depends on
the number of e-mails
Computed Premium received for email)
contribution for OFWs (if
with premium payment)
4. Handling of Inquiries: Guidelines on Membership, Contribution and Benefit Availment and Claims Concerns
This service responds to member inquiries on the following but not limited to Membership, Contribution, Benefit Availment and Claims Concerns.
Office/Division: Member Management Group (OFP)
Classification: Simple
Type of Transaction: G2C- Government to Citizen
G2B- Government to Business Entity
Who May Avail: Migrant Workers; Filipinos Living Abroad and Filipinos with Dual Citizenship
CHECKLIST OF REQUIREMENT WHERE TO SECURE
1 original copy of transaction slip Walk-in
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. (Through E-mail) 1.1. Receives the inquiry and asks follow-up None Email Social Insurance Assistant I, OFP
Send message their inquiries questions for verification if needed. 3 days (depends on
on Membership, Contribution, the number of e-mails
Benefit Availment and Claims 1.2 Responds to client inquiries. received)
Concerns.
2. (Through Walk-in) 2.1.Receives the inquiry and asks follow-up Walk-in
Fill up Transaction Slip and write questions for verification if needed. 3-10 minutes per client
the inquiries.
2.2. Respond to client inquiries.
3. (Through Phone) 3.1. Receives the inquiry and asks follow-up Phone
Inquires via phone call re: questions for verification if needed. 3-10 minutes per client
Membership, Contribution,
Benefit Availment and Claims 3.2 Responds to client inquiries.
Concerns.
Total: None 3 days (e-mail);
3-10 minutes (walk-in/
phone)
5. Issuance of PhilHealth ID (Walk-in)
This service allows client’s request for a copy of their PhilHealth IDs.
Office/Division: Member Management Group (OFP)
Classification: Simple
Type of Transaction: G2C- Government to Citizen
Who May Avail: Migrant Workers; Filipinos Living Abroad and Filipinos with Dual Citizenship
CHECKLIST OF REQUIREMENT WHERE TO SECURE
1 Original copy of Transaction Slip Any PhilHealth Office
At least 1 original copy of valid ID of member (to be presented)
*Additional requirements if through representative
1 Original copy of Authorization letter from member
1 original copy of valid ID of representative (to be presented)
At least 1 photo copy of valid ID of member (to be submitted)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
(Walk-in) (Walk-in) None 2 minutes Social Insurance Assistant I, OFP
1. Fill-out transaction Slip. 1.1. Upon receipt of transaction slip, or a valid
authorization letter (if through a representative),
assigned staff shall verify PIN.
2. Present a copy of any valid 1.2. Assigned staff shall provide a copy of the 3 minutes per
ID of the member. If through a PhilHealth ID to the client. transaction
representative, representative
shall submit authorization letter
and a photo copy of the member’s
valid ID.
3. Make sure to secure a copy of
the PhilHealth ID issued.

Total: None 5 mins

6. Issuance of Member Data Record (Walk-in and Through E-mail)
This service allows client’s request for a copy of their Member Data Record.
Office/Division: Member Management Group (OFP)
Classification: Simple
Type of Transaction: G2C- Government to Citizen
G2B- Government to Business Entity
Who May Avail: Migrant Workers; Filipinos Living Abroad and Filipinos with Dual Citizenship
CHECKLIST OF REQUIREMENT WHERE TO SECURE
1 original Transaction Slip Any PhilHealth Office
At least 1 original valid ID of member (to be presented)
*Additional requirements if through representative
1 Original copy of Authorization letter from member
1 original copy of valid ID of representative (to be presented)
At least 1 photo copy of valid ID of member (to be submitted)
Request and provide the following member information: Through e-mail
Last Name, First Name, Middle Name
Date of Birth
Place of Birth
Address
At least 1 scanned copy of valid ID of member

Additional requirements if through representative

1 scanned copy of Authorization letter from member
At least 1 scanned copy of valid ID of representative
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
(Walk-in) (Walk-in) No Service Fee Walk-in Social Insurance Assistant I, OFP
1. The member shall submit 1.1. Upon receipt of transaction slip, or a valid 2 minutes
documents for walk-in. authorization letter (if through a representative)
assigned staff shall verify PIN.
2. Make sure to secure a copy of 1.2. Assigned staff shall provide a copy of the MDR to 3 minutes per
the MDR issued. the client. transaction
(E-mail) (E-mail) No Service Fee Email Social Insurance Assistant I, OFP
3. Client shall provide the member 3.1. Assigned staff shall check for the completeness 1-3 days (depends on
information for Issuance of MDR information and shall prompt client for any missing the number of e-mails
through e-mail. member information. received)
4. Make sure to secure a copy of 3.2.Assigned staff shall provide a copy of the MDR to
the MDR issued. the client.
Total: None 5 mins for walk-in
1-3 days (depends on
the number of e-mails
received for email)
7. PIN Verification (Walk-in and Through E-mail)
The Office of the Area Vice-President shall facilitate the processing of letter of requests, queries, issues and concerns of external clients.
Office/Division: Member Management Group (OFP)
Classification: Simple
Type of Transaction: G2C- Government to Citizen
Who May Avail: Migrant Workers; Filipinos Living Abroad and Filipinos with Dual Citizenship
CHECKLIST OF REQUIREMENT WHERE TO SECURE
1 Original copy of Transaction Slip Any PhilHealth Office
At least 1 original copy of valid ID of member (to be presented)
*Additional requirements if through representative:
1 Original copy of Authorization letter from member
1 original copy of valid ID of representative (to be presented)
At least 1 photo copy of valid ID of member (to be submitted)
Request and provide the following member information: Through e-mail
Last Name, First Name and Middle Name
Date of Birth
Place of Birth
Address
At least 1 scanned copy valid ID of member

*Additional requirements if through representative:

1 Scanned copy of Authorization letter from member
At least 1 scanned copy of valid ID of representative
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
(Walk-in) (Walk-in) None Walk-in Social Insurance Assistant I, OFP
1. Fill-out transaction Slip. 1.1. Upon receipt of transaction slip, assigned staff 2 minutes
shall verify PIN.
2. Present a copy of any valid ID of 2.1. Assigned staff shall provide PIN to the client. 3 minutes per
the member. transaction
(E-mail) (E-mail) Email
3. Client shall provide the member 3.1. Assigned staff shall check for the completeness 1-3 days (depends on
information asked for PIN of member information and shall prompt client for the number of e-mails
verification via e-mail. any missing member information. received)
(E-mail) 3.2. Assigned staff shall provide PIN to the client. None Email Social Insurance Assistant I, OFP
3. Client shall provide the member 1-3 days (depends on
information asked for PIN the number of e-mails
verification via e-mail. received)
Total: None 5 mins for walk-in
1-3 days for email
8. Posting of Premium Contribution (Walk-in and through e-mail)
This service facilitates posting of premium contributions that were not reflected in the MDR.
Office/Division: Member Management Group (OFP)
Classification: Complex
Type of Transaction: G2C- Government to Citizen
Who May Avail: Land based Migrant Workers; Filipinos Living Abroad
CHECKLIST OF REQUIREMENT WHERE TO SECURE
1 original copy of Transaction slip Any PhilHealth Office (walk-in)
At least 1 original copy of valid ID of member (to be presented)
Request 1 photocopy of Official receipt

*Additional requirements if through representative:

1 Original copy of Authorization letter from member
1 original copy of valid ID of representative (to be presented)
At least 1 photo copy of valid ID of member (to be submitted)
At least 1 scanned copy of valid ID of member Through e-mail
Request 1 scanned copy of Official receipt

*Additional requirements if through representative:

1 scanned copy of Authorization letter from member
1 scanned copy of valid ID of representative
CLIENT STEPS AGENCY ACTION PROCESSING TIME PERSON RESPONSIBLE
1. Submit the required 1.1. Print/Receive the required documents and check None Walk-in Social Insurance Assistant I, OFP
documents. If through a for completeness. 5 minutes per
representative, representative transaction (if posted in
shall submit authorization letter 1.2. Start processing the request. the Treasury database)
and a photo copy of the member’s
valid ID. 7 days (if not yet
1.3. If not yet posted in the database, staff verifies posted in the Treasury
the payment information. Database- for
verification
1.4. Issue the Member Data Record.
2. Make sure to check the None Walk-in Social Insurance Assistant I, OFP
correctness of payment 5 minutes per
information upon receipt of the transaction (if posted in
Member Data Record. the Treasury database)

7 days (if not yet

posted in the Treasury
Database- for
verification
Total: None 7 days (if not yet
posted in the Treasury
Database)
9. Receiving and Endorsement of Overseas Confinement Claims (Filed through E-mail)
This service receives and facilitate filing of overseas confinement claims.
Office/Division: Member Management Group (OFP)
Classification: Simple Internal Service
Type of Transaction: G2C- Government to Citizen
G2B- Government to Business Entity
Who May Avail: Migrant Workers; Filipinos Living Abroad and Filipinos with Dual Citizenship
CHECKLIST OF REQUIREMENT WHERE TO SECURE
Confinement abroad requirements (Certified True Copy): Through e-mail

1. 1 scanned copy of CTC Claim Form 1, properly and completely filled out
2. 1 scanned copy of CTC Statement of Account or its equivalent
3. 1 scanned copy of CTC Official receipt or any proof of payment of hospital bills and
professional fees from the hospital where the patient was confined
4. 1 scanned copy of CTC Certification from the attending physician as to the final
diagnosis, period of confinement and services rendered
5. English transactions from the hospital or Embassy for all documents.
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submit the required documents 1.1. Print/Receive the required documents and check None 1 day Social Insurance Assistant I, OFP
for overseas confinement filed for completeness. Supervisor
through email. Senior Manager
1.2. Start processing the request and prepares
documents.
1.3. Endorse the documents to the concerned PRO. 5 days (For
endorsement to
concerned PROs/
Branch Offices; depends
on the number of
e-mails received; until a
feedback is received)
2. Make sure to ask for a feedback 2.1. Communicates with the member on the details 1 day
and claim details for monitoring of the claim.
purposes.
2.2. PRO shall issue check if claim is good for
processing

3. Member shall receive the

reimbursement through check if
claim is good for processing.
Total: None 7 days
1. Management of Documents - Internal
This covers the receipts of incoming documents from internal clients
Office/Division: Office of the President and CEO
Classification: Simple
Type of Transaction: G2G - Government to Government
Who May Avail: PhilHealth Employees
CHECKLIST OF REQUIREMENT WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Admin staff of other PhilHealth 1.1 Check the nature and document completeness None 3 minutes Receiving Officer , Office of the
Offices submits documents President

1.2 Stamp received the transmittal, file copy and None 1 minute Receiving Officer , Office of the
return to the admin staff President
1.3 Encode in the documents tracking none 5 minutes Receiving Officer , Office of the
President

1.4 Assign reference number, segregates and None 5 minutes Receiving Officer , Office of the
forward for scanning President
1.5 Scan documents and forward to concerned None 15 minutes Admin Staff, Office of the President
Executive Assistant for review

Total: None 29 minutes

2. Management of Documents - External
This covers the receipts of incoming documents from External clients
Office/Division: Office of the President and CEO
Classification: Simple
Type of Transaction: G2G - Other Government Agencies, G2C - Government to Public
Who May Avail: PhilHealth Employees
CHECKLIST OF REQUIREMENT WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Admin staff of other PhilHealth 1.1 Check the nature and document completeness None 3 minutes Receiving Officer , Office of the
Offices submits documents President

1.2 Stamp received the transmittal, file copy and None 1 minute Receiving Officer , Office of the
return to the admin staff President
1.3 Encode in the documents tracking none 5 minutes Receiving Officer , Office of the
President

1.4 Assign reference number, segregates and None 5 minutes Receiving Officer , Office of the
forward for scanning President
1.5 Scan documents and forward to concerned None 15 minutes Admin Staff, Office of the President
Executive Assistant for review

Total: None 29 minutes

3. Review and Approval of Documents
This pertains to the documents that needs management actions (In relation to Universal Health Care Law)
Office/Division: Office of the President and CEO
Classification: Highly Technical
Type of Transaction: G2G - Government to Government
Who May Avail: All
CHECKLIST OF REQUIREMENT WHERE TO SECURE
None None
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Admin staff of other PhilHealth 1.1 Receiving Clerk forward documents to concerned None 29 minutes Admin Staff, Office of the President
Offices submits documents Executive Assistants (EA) and CEO
1.2 Conduct review, analysis and recommend None Simple - 15 minutes; Executive Assistant, OPCEO
Complex within 24
hours
Check documents, if with Complete Staff Work, None Simple - 15 minutes; Executive Assistant, OPCEO
recommend approval of Head Executive Assistant Complex within 24
(HEA) hours
Check documents, if without Complete Staff Work, None Simple - 15 minutes; Executive Assistant, OPCEO
return the documents to concerned office Complex within 24
hours
1.3 Head Executive Assistant (HEA) recommends None Simple - 15 minutes; Head Executive Assistant
approved or disapproved to PCEO/endorse Complex within 24
documents to other offices hours
1.4 President and CEO approve or disapprove None Simple - 15 minutes; PCEO
Complex within 24
hours
Total: None
4. Processing of External Data Requests (through eFOI Portal)
This process covers handling of external requests for records and data within the Corporation and ensure that all records/data releases by the Corporation
shall be in compliance with the mandates of the Universal Health Care Act of 2019 (RA 11223), Ease of Doing Business and Efficient Government Service
Delivery Act of 2018 (RA 11032), Freedom of Information Order (EO No. 2 s.2016), Data Privacy Act of 2012 (RA 10173), and the Department of Budget
Management (DBM and Governance Commission for GOCCs’ (GCG) Good Governance Requirements (e.g. Transparency Seal).

Per EODB Act of 2018, transactions are classified into the following:
1. Simple transactions – requests that are readily available (e.g., Standard Reports);
2. Complex transactions – requests that need to be sourced from more than one office (e.g. data from multiple offices within the Corporation) and requires
packaging of data using prescribed template or format; and
3. Highly technical transactions – requests that require technical analysis or cross-tabulations and database extractions (e.g. data for research).
Office/Division: Corporate Planning Department (CorPlan)
Classification: Highly Technical
Type of Transaction: G2G – Government to Government; G2C – Government to Citizen; G2B – Government to Business
Who May Avail: All
CHECKLIST OF REQUIREMENT WHERE TO SECURE
Registration through the eFOI Portal containing the following information: Freedom of Information Website: https://www.foi.gov.ph/
1. Date
2. Full Name
3. Office (if applicable; institution)
4. Description of Data Being Requested
5. Purpose of Request (e.g. use for data, etc.)
6. Reference Period of Data Being Requested
7. Data Needed
8. Format (e.g. table format, print-out, digital, etc.)
9. Other information that could help the concerned office that shall process the data (e.g.
script parameters, etc.)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Submit letter request or Receive letter/form from requesting party via eFOI None 1 Hour Administrative Staff
accomplished Data Request Form Portal and forward to Knowledge Resource Unit (Office of the Senior Manager /
(DRF) to the CorPlan OSM)
Receive acknowledgement Send acknowledgement receipt to requesting party None 1 Hour Administrative Staff
receipt from this office (Office of the Senior Manager /
OSM)
None Checking of letter/DRF as to completeness of None 2 Hours Planning Officer
necessary details in order to properly process the (Knowledge Resource Unit)
request
Receive letter/email from this If incomplete (e.g. unclear instructions, with None 2 Hours Planning Officer
office questions for verification, etc.), the requesting party (Knowledge Resource Unit)
if informed
Receive letter/email from this Checking if the requested information is available in None 2 Hours Planning Officer
office PhilHealth website, if so, the requesting party will be (Knowledge Resource Unit)
informed and the link will be provided.
Receive letter/email from this If the requested information is not in the custody None 2 Hours Planning Officer
office of the Corporation and any of its offices, if so, the (Knowledge Resource Unit)
requesting party shall be advised accordingly.
Receive letter/email from this If the requested information is the same as a None 2 Hours Planning Officer
office previous request which was already granted or (Knowledge Resource Unit)
denied, if so, proper information shall be provided to
the requesting party to this effect.
None Review and classify the request per internal None 1 Working Day Planning Officer
guidelines (e.g. restricted, confidential, with (Knowledge Resource Unit)
Personally-Identifiable Information/PII, etc.)
None Identify the source of the requested information (e.g.
Task Force Informatics)

None Locate, retrieve, and/or extract the required

information
None Properly document, record, and monitor the None 1 Working Day Planning Officer
request, including turn-around-time (Knowledge Resource Unit)

None If with Data Privacy Concerns, endorse the request

to the Data Protection Officer (DPO) for evaluation.

None If without any Data Privacy concerns, endorse

the request to concerned offices (e.g. Task Force
Informatics)
None Concerned office (e.g. Task Force Informatics, Sectors None 13 Working Days Data Analyst
concerned) extracts the data requested (Task Force Informatics / Office
concerned)
None Provide proper information to requesting party if the None 1 Hour Planning Officer
request for information will require extension. These (Knowledge Resource Unit)
reasons may include but not limited to examination
of voluminous records, the occurrence of fortuitous
events, coincides with voluminous requests, or other
analogous cases
Receive letter/email from this Should this be the case, provide proper information None 1 Hour Planning Officer
office to requesting party of the extension, explaining (Knowledge Resource Unit)
the reasons for such, for fifteen (15) working days,
but not exceed twenty (20) working days unless
in exceptional circumstances warranting a longer
period
None Upon receipt of data from processing / extracting None 1 Working Day Planning Officer
office (e.g. Task Force Informatics, Sectors concerned, (Knowledge Resource Unit)
etc.), this office further formats the data to the
specifications of the requesting party (e.g. table
formats, etc.)
None Determine applicable fees based on pricing None 1 Hour Planning Officer
guidelines, if any: (Knowledge Resource Unit)

None (For Government agencies, Policy-makers, Local ***

government / sponsoring institutions, prospective
PhilHealth Project / Program Donors/Sponsors and
as directed by judicial courts)
None Readily available data published in the corporate None 1 Hour Planning Officer
websites like philhealth.gov.ph, Knowledge (Knowledge Resource Unit)
Management Portal, for public or external use shall
be free of charge.
None For data that need to be customized in a manner or Labor Cost (e.g. man- Planning Officer
format that is not readily available, the Corporation hours): Php75.00 per hour; (Knowledge Resource Unit)
shall charge a fee covering minimal charges Computer Time and
Operating Costs: Php10.00
per hour; and Printing /
Duplication / Reproduction
Costs: Php2.00 per page
None Release of requests for databases (i.e. raw data) shall Php0.0375 per kilobyte Planning Officer
be subject to approval of Management plus the cost of CDs or USB (Knowledge Resource Unit)
drives to be used
None (For Research Organizations / Researchers / Students ***
and Agencies with Jurisdiction over institutions and
individuals)
None Published and readily available data/tables for Minimum Processing Fee Planning Officer
public or external use shall be charged (for 1-page document (Knowledge Resource Unit)
print): Php25.00; Additional
cost per table / page
document print: Php5.00
None For data need to be customized in a manner or Labor Cost Planning Officer
format that is not readily available, the Corporation (per number of man-hours (Knowledge Resource Unit)
shall charge a fee covering minimal incidental worked): Php 150.00 per
charges hour; Computer Time
and Operating Costs: Php
20.00 per hour; Printing /
Duplication / Reproduction
costs: Php 5.00 per page
None Release of requests for databases (i.e. raw data) shall Php 0.075 per kilobyte Planning Officer
be subject to approval of Management plus the cost of CDs or USB (Knowledge Resource Unit)
drives to be used to be
used.
 None (Urgent requests will be entertained but shall be (Rate: 10% more than the 1 Hour Planning Officer
subject to higher rate) computed cost of the data (Knowledge Resource Unit)
request)
None (Grant or Deny of the Request for Information) None 2 Hours ***

None If denied: Write a response letter to the requesting None 2 Hours Planning Officer
party informing them of the denial of the request. (Knowledge Resource Unit)
The letter should indicate the grounds for denial and
the circumstances on which the denial was based
on. Route for appropriate approval If no notice was
provided within fifteen (15) working days since the
submission of the request, this would indicate that
the request was denied
Receives letter/billing from this If granted: Inform or notify the requesting party; None 2 Hours Planning Officer
office of total amount to be paid including the amount of applicable fees, if any. This (Knowledge Resource Unit)
(if any) should comply with internal rules and procedures on
payment of applicable fees.
Requesting party pays the Processes the payment None 1 Hour Cashier Staff
determined amount with the (Cashier Office)
Corporation's Cashier office.
Receives official receipt from Provides official receipt to requesting party None 1 Hour Cashier Staff
Cashier (Cashier Office)
Requesting party presents copy Receives copy of the official receipt as confirmation None 1 Hour Planning Officer
of official receipt to this office as (Knowledge Resource Unit)
proof of payment

Requesting party receives the Sends the requested data via eFOI Portal None 1 Hour Technical staff
data requested. (Knowledge Resource Unit)

Total: (as applicable) 15 Days

Note/s: Processes indicated herein lifted from Corporate Order No. 2020-0053 and Freedom of Information Manual
5. Issuance of Minutes of Meetings
This is issued to the requesting party on a per request basis, subject to the provisions of Corporate Order No. 2020-0053, Data Privacy Act of 2012 and its IRR.
Office/Division: Office of the Corporate Secretary
Classification: Complex
Type of Transaction: G2G (external)
Who May Avail: Congress, PACC, DOJ, NBI, Judicial and other Quasi-judicial Bodies/tribunals
CHECKLIST OF REQUIREMENT WHERE TO SECURE
Letter Request stating the specific topic and purpose of requested document or Congress, PACC, DOJ, NBI, Judicial and other Quasi-judicial Bodies/Tribunals
Subpoena duces tecum ( 1 original copy)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Submit the Letter Request stating 1. Validate the appropriateness of the request None 1 day Division Chief
topic and purpose of requested Clerk of Board
document or Subpoena duces
tecum to the Office of the
Corporate Secretary
2.Recommend the Approval of release of document 2 days Corporate Secretary
3.Approve the release of document 3 days Chairperson of the Board
4. Photocopy the document 1 day Records Custodian
5.Release the requested document
Total: None 7 days
6. Issuance of PhilHealth Board Resolutions (PBRs)
This is issued to the requesting party on a per request basis, subject to the provisions of Corporate Order No. 2020-0053, Data Privacy Act of 2012 and its IRR.
Office/Division: Office of the Corporate Secretary
Classification: Complex
Type of Transaction: G2G (external)
Who May Avail: Congress, PACC, DOJ, NBI, Judicial and other Quasi-judicial tribunal/bodies
CHECKLIST OF REQUIREMENT WHERE TO SECURE
Letter request stating the specific topic and purpose of requested document (1 original Congress, PACC, DOJ, NBI, Judicial and other Quasi-judicial bodies/ tribunals
copy) or Subpoena duces tecum
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
Submit the Letter stating the 1. Validate the appropriateness of the request None 1 day Division Chief Clerk of Board
topic and purpose of requested
document or the Subpoena
duces tecum to the Office of the
Corporate Secretary
2. Recommend the approval of the request 2 days Corporate Secretary
3.Approve the release of the document 3 days Chairperson of the Board
4.Photocopy the document 1 day Records Custodian
5.Release the requested document
Total: None 7 days
7. BAC Secretariat Services
Securing Bid Documents
Office/Division: Secretariat for the Bids and Awards Committees
Classification: Simple
Type of Transaction: G2B, G2G
Who May Avail: Interested Bidders
CHECKLIST OF REQUIREMENT WHERE TO SECURE
1. Filled-up Order of Payment form (2 original copy) BAC Secretariat Section, SBAC
2. Bidding Documents (1 set photocopy with original markings and bidding document
number)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Supplier inspect Bid Documents Issues Order of Payment form for filling-up of None 30 mins. BAC Secretariat
(photocopy with original SBAC supplier
markings for bidding document
number) Signs the Order of Payment Form None 30 mins. Head, SBAC
(provided there is no
interruption in internet
connectivity)
2. Supplier signifies intention to Issues Order of Payment form for filling-up of None 5 mins BAC Secretariat
participate in the procurement supplier
opportunity and fills-up order of
payment form (original copy) Signs the Order of Payment Form None 5 mins Head, SBAC
3. Supplier pays Bid Document Accepts payment of Bid Document Fees Bid Documents Fee 5 mins Cashier’s Office / Unit
Fees (original copy of order of (Based on ABC range)
payment)
4. Supplier submits proof of Releases Bid Documents None 5 mins. BAC Secretariat
payment (original copy of Official
Receipt) List supplier as prospective bidder for the None 5 mins. BAC Secretariat
procurement project

Validate if prospective bidder is included in the None 5 mins BAC Secretariat

Document Request List at PhilGEPS, if not add name
of bidder

Total: None 90 mins

8. Procurement Services
Local Shopping
Office/Division: Secretariat for the Bids and Awards Committees
Classification: Simple
Type of Transaction: G2B, G2G
Who May Avail: Interested Bonafide Bidders/Suppliers
CHECKLIST OF REQUIREMENT WHERE TO SECURE
1. Properly Filled-up Purchase Request with supporting documents 1. Purchase Request (PR) from End-user
(3 original copy of the approved Purchase Request)

2. APR Preparation for PS-DBM Transaction 2. Consolidated Purchase Request (PR) from PRID-PSMD
(3 original copies)

3. Local Shopping Transaction if items are not available at PSDBM 3. Purchase Request (PR) from End-user
(3 original copies)
CLIENT STEPS AGENCY ACTION FEES TO BE PAID PROCESSING TIME PERSON RESPONSIBLE
1. Submission of properly filled-up Evaluation of Purchase Request None 30 mins. Buyer/Canvasser
PR with supporting documents
from End-user Posting of opportunities at PhilGEPS and Corporate None 30 mins. Buyer/Canvasser
Websites (provided there is no
interruption in internet
connectivity)

Preparation of APR for PSDBM and RFQ for Local None 30 mins. Buyer/Canvasser
Shopping
 2. Indorsement of APR to PSDBM Checking & Pick-up of Supplies Signed DV 8 Hours Buyer/Canvasser

Supplier signifies intention to Evaluation of received RFQ or Quotation None 5 mins Buyer/Canvasser
participate in the procurement
opportunity and fills-up RFQ or AOC, PO and JO Preparation None 15 mins Buyer/Canvasser
submits Quotation
(original copy) Signs the prepared AOC, PO and JO None 5 mins Buyer/Canvasser
Section Head, SBAC Head
3.Supplier signs/ accepts PO/JO Indorsement of signed PO/JO to PRID-PSMD None 30 mins. PRID-PSMD Personnel
(3 original copy)
End-user Personnel

Buyer/Canvasser
Total: None 10 hrs and 30 mins

Person Responsible: Administration Services Assistant C of SBAC

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HR FEEDBACK AND COMPLAINTS MECHANISM
How to send feedback? Feedback and complaints are sent directly to email addresses of the HRD Units concerned. There is an intranet website for the Human Resource
Department where the email addresses of HRD Units/Teams are published and accessible to employees.

How feedbacks are processed? Feedback that can be resolved within the jurisdiction of the employee concerned are acted upon immediately by the HR Staff concerned. Those that
needs to be elevated to the supervisor will be acted upon by the supervisor. Some items shall be elevated to the Section Chief, Division Chief, HRD
Head, MSS Head and ExCom Level, depending on the nature of the feedback/complaint.
How to file a complaint? Complaints can either be reported to the HRD/HRU through a face-to-face Transaction. It can also be documented through an incident report to be
submitted to the HRD. It can also be forwarded to the HRD through email. HRD also accepts anonymous complaints.

How complaints are processed? Complaints are processed by the HRD Head by referring the concern to responsible HR Unit for validation of the concern and root-cause analysis if
found valid, then a recommended course of action, subject to the approval of the HRD Head. The approved action shall then be acted upon until the
complaint is resolved.
Contact Information of (office) Human Resource Department Landline 8706-6735
CAC FEEDBACK AND COMPLAINTS MECHANISM
How to send feedback? All external clients, including government channels (i.e. 8888, CSC-CCB, e-FOI, PCC, ARTA, etc.) and media can send feedback (complaints, suggestions
and commendations) to PhilHealth through any of the following communication channels of the Corporate Action Center and regional counterparts:

Email:
- [email protected] or
- email address of PhilHealth Regional Offices (PROs), Branches, and Local Health Insurance offices (LHIOs) posted in philhealth website (www.
philhealth.gov.ph)

Call:
- hotline 8441-7442
- phone number of PROs, Branches and LHIOs posted in philhealth website (www.philhealth.gov.ph)
Social Media:
- ”@PhilHealthofficial” facebook page
Walk-In:
- CAC Walk-In Counter, PhilHealth Head Office, Room 707 CityState Centre, 709 Shaw Boulevard, Oranbo, Pasig City
- PhilHealth Regional and Local Offices with addresses posted at philhealth website (www.philhealth.gov.ph)
How feedbacks are processed? 1. Recieving and Initial Validation

The Responsible CAC Team managing the channel or assigned Action Officer Designates (AODs) in PROs and LHIOs:
a. Receives client feedback
b. Requests consent on use of personal information, then verifies concern with the client, evaluates client feedback and profile/records, previous
transactions of client through Customer Service Management System (CSMS)
c. Requests for additional BASIC information/documents required for processing.

Note:
Required documents may include:
- “Salaysay”, attached payslips and other proof, if client feedback is a complaint against non-remitting employer
- Usual basic information and documents required in PhilHealth processes, in accordance wih existing corporate policies and rules and Citizen’s charter
d. Identifies responsible office to handle transaction (based on function, jurisdiction and lodged authority)
e. Determines complexity of processing and corrsponding TAT in accordance with EODB Law.
- Simple (3 workinng days from receipt of PhilHealth) - if processing and final response is ministerial not requiring review and approval process.
- Complex (7 working days from date of receipt by PhilHealth) - if endorsement of transaction (if applicable), processing and final response require regular
review and approval process
- Technical (20 working days from date of receipt by PhilHealth) - if endorsement of transaction (if applicable), processing and final response require
teachnical/management review and approval process

2. Acknowledgment and Initial Response

The handling office (CAC or endorsee office):

a. Endorse the transaction to an appropriate office through CSMS (If Level 2)
b. Issues or communicates acknowledgment and initial response to client/government channel if the final response is not readily available.

Note: Initial response includes (1) ”concrete and specific action within 72 hours” in accordance with Executive Order No. 6, 2016; (2) transaction
reference number, (3) contact information of office for follow-up i.e. hotline 02-8441-7442 and [email protected]. or local hotline or
email of PRO or LHIO)
 3. Provision of Relevant Services

The handling office:

a. Requests client for additional TECHNICAL information/documents required for processing, if any (For technical transactions).

Note: If requiring the release of Personally Identifiable Information, require at least 3 correct information validated against client’s database records
for information security purposes.

b. Provides services as may be related to the client’s concern, in accordance with existing corporate policies and procedures.
c. Provides redress to the client for non-conforming services (i.e. correction of errors, giving of apology to the client, correction of other affected
processes or services)

The handling office:

a. Prepares, reviews, and approves (or pre-approve) final response to client
b. Releases approved/pre-approved response to client and government channel, if applicable, within the prescribed TAT.
c. In case the needed processes cannot be completed within the prescribed TAT, the CAC (for govt lodged tickets) or handling office (for clients)
informs the client before the deadline about the needed TAT extension which shall not exceed an additional 3, 7 and 20 working days for simple,
complex and technical transactions respectively.
d. If government-lodged, the CAC provides updates to government channels and facilitates closure.
How to file a complaint? All external clients, including government channels (i.e. 8888, CSC-CCB, PCC, ARTA, etc.) and media can send complaints to PhilHealth through any of
the following communication channels of the Corporate Action Center and regional counterparts:

Email:
- [email protected] or
- email address of PhilHealth Regional Offices (PROs), Branches, and Local Health Insurance offices (LHIOs) posted in philhealth website (www.
philhealth.gov.ph)

Call:
- hotline 8441-7442
- phone number of PROs, Branches and LHIOs posted in philhealth website (www.philhealth.gov.ph)
Social Media:
- ”@PhilHealthofficial” facebook page
Walk-In:
- CAC Walk-In Counter, PhilHealth Head Office, Room 707 CityState Centre, 709 Shaw Boulevard, Oranbo, Pasig City
- PhilHealth Regional and Local Offices with addresses posted at philhealth website (www.philhealth.gov.ph)
How complaints are processed?

The Responsible CAC Team managing the channel or assigned Action Officer Designates (AODs) in PROs and LHIOs:
a. Receives client feedback
b. Requests consent on use of personal information, then verifies concern with the client, evaluates client feedback and profile/records, previous
transactions of client through Customer Service Management System (CSMS)
c. Requests for additional BASIC information/documents required for processing.

Note:
Required documents may include:
- ”Salaysay”, attached payslips and other proof, if client feedback is a complaint against non-remitting employer
- Usual basic information and documents required in PhilHealth processes, in accordance wih existing corporate policies and rules and Citizen’s charter
d. Identifies responsible office to handle transaction (based on function, jurisdiction and lodged authority)
e. Determines complexity of processing and corrsponding TAT in accordance with EODB Law.

- Simple (3 workinng days from receipt of PhilHealth) - if processing and final response is ministerial not requiring review and approval process.
- Complex (7 working days from date of receipt by PhilHealth) - if endorsement of transaction (if applicable), processing and final response
require regular review and approval process
- Technical (20 working days from date of receipt by PhilHealth) - if endorsement of transaction (if applicable), processing and final response
require teachnical/management review and approval process
2. Acknowledgment and Initial Response

The handling office (CAC or endorsee office):

a. Endorse the transaction to an appropriate office through CSMS (If Level 2)
b. Issues or communicates acknowledgment and initial response to client/government channel if the final response is not readily available.

Note: Initial response includes (1) ”concrete and specific action within 72 hours” in accordance with Executive Order No. 6, 2016; (2) transaction
reference number, (3) contact information of office for follow-up i.e. hotline 02-8441-7442 and [email protected]. or local hotline or
email of PRO or LHIO)
3. Provision of Relevant Services

The handling office:

a. Requests client for additional TECHNICAL information/documents required for processing, if any (For technical transactions).

Note: If requiring the release of Personally Identifiable Information, require at least 3 correct information validated against client’s database records
for information security purposes.

b. Provides services as may be related to the client’s concern, in accordance with existing corporate policies and procedures.
c. Provides redress to the client for non-conforming services (i.e. correction of errors, giving of apology to the client, correction of other affected
processes or services)
 4. Respond to the Client (including Government Channel)

The handling office:

a. Prepares, reviews, and approves (or pre-approve) final response to client
b. Releases approved/pre-approved response to client and government channel, if applicable, within the prescribed TAT.
c. In case the needed processes cannot be completed within the prescribed TAT, the CAC (for govt lodged tickets) or handling office (for clients)
informs the client before the deadline about the needed TAT extension which shall not exceed an additional 3, 7 and 20 working days for simple,
complex and technical transactions respectively.
d. If government-lodged, the CAC provides updates to government channels and facilitates closure.
Contact Information of ARTA, PCC, Anti-Red Tape Authority (ARTA):
and CCB [email protected]
8-478-5093

Presidential Complaint Center (PCC):

[email protected]
8888

Contact Center ng Bayan (CCB):

[email protected]
0908-881-6565
 LIST OF OFFICES

OFFICES ADDRESS
CONTACT INFORMATION

PHILHEALTH HEAD OFFICE

Citystate Centre, 709 Shaw Blvd., 1603 Pasig 8441-7444 / 8441-7442
PhilHealth Central Office
City, Philippines Textline:0917-898-7442 (PHIC)
[email protected]
PHILHEALTH REGIONAL OFFICE - BRANCH
PRO NCR- North Manila 10th Commandment Building, Rizal Avenue,
Caloocan City
PRO NCR Central - Quezon
Corporate 145 Building, 145 Mother Ignacia,
City
Brgy. South Triangle, Quezon City
PRO NCR South - Pasig 8007 Pioneer Street, Kapitolyo, Pasig City
PRO III Branch A- San 2/F PhilHealth Bldg., Lazatin Blvd., San
(045) 961-0710 loc. 4321
Fernando Agustin, San Fernando City, Pampanga
PHILHEALTH REGIONAL OFFICE
VCP Building, Block 56, Lot 11, 68 Kalayaan
PRO NCR
Avenue
Teacher’s Village West, Quezon City (02) 8441-5673
Akia Building, Old De Venecia Highway (075) 515-3333; (075) 5229691 (fax)
PRO I - Dagupan
Dagupan City, Pangasinan [email protected]
The Builder’s Place, Del Rosario St. (078) 255-1342; (0917) 8357544
PRO II - Tuguegarao
Tuguegarao City, Cagayan 3500 [email protected]
 SNOBT Inc. Bulding, No. 19 Leonard Wood
PRO CAR - Baguio (074) 444-5345; 444-8361; 444-9862
Road Baguio City 2600
[email protected]
G/F PhilHealth Bldg., Lazatin Blvd., San
PRO III-A - San Fernando Agustin, San Fernando City, Pampanga C-
2000 (045) 961-1977; (045) 961-3949 loc. 4330
The Cabanas Mall of Malolos 2nd and 3rd
PRO III-B - Malolos floors N4 Bldg. Km. 44/45 MacArthur
Highway Longos, Malolos City, Bulacan (044) 796-1559; (044) 796-1560 loc. 4400
Lucena Grand Central Terminal, Brgy. Ilayang (042) 373-7554
PRO IV-A - Lucena
Dupay, Lucena City [email protected]
XentroMall Batangas City Diversion Road,
PRO IV-B - Batangas Brgy. Alangilan Batangas City 4200
[email protected]
PRO V - Legazpi ANST III Building Alternate Road, Legazpi City
Healthline: (052) 481-5596
Gaisano Capital Building, Luna Street, Lapaz, (033) 501-9160 to 62 loc. 100/102; (0998) 959-9487
PRO VI - Iloilo
Iloilo City [email protected]

Golden Peak Hotel & Suites,Gorordo Ave.

PRO VII - Cebu
corner Escario St., Cebu City 6000
(032) 233-3270; 233-3289; 233-7407; 233-7523
PhilHealth Building 167 P. Burgos St.
PRO VIII - Tacloban Tacloban City, Leyte (053)325-3563; (053) 523-1195 (Fax)
[email protected]
BGIDC Corporate Center, Gov. Lim Ave.,
PRO IX - Zamboanga Zamboanga City (062) 992-2739 (fax)
[email protected]
8F Gateway Tower 2, Limketkai Center, C.M. (088) 859-0225
PRO X - Cagayan De Oro
Recto Avenue, Cagayan de Oro City [email protected]
(085) 342-0900; (085) 816-0019;
Lynzee's Building, 766 J. Rosales
PRO CARAGA - Butuan (085) 225-7026 loc. 101-103
Avenue,Butuan City
[email protected]
 Trunkline: (082) 295-2133 local 6300;
Valgosons Building Bolton Extension, (082) 295-3382 (Public Affairs Unit)
PRO XI - Davao Poblacion, Davao City (0925) 7819987 (Local Healthline)
[email protected];
[email protected]
CSA I Building Cor. Zulueta Street, General (083) 228-9731 to 34 (fax); (083) 228-4733
PRO XII - Koronadal Santos Drive, Koronadal City [email protected]
[email protected]
Kouzbary Business Complex, Alibin Talib
PRO BARMM - Marawi Street, New Capitol HTs, [email protected]
Marawi Poblacion, Marawi City [email protected]
Local Health Insurance Office ( LHIO)
LHIO- Manila JARS Bldg., 1810 J.P. Laurel St., San Miguel, (02) 8521-7321
Manila [email protected]

LHIO-Caloocan 5th Floor, Victory Central Mall, Rizal Avenue

Extension, Grace Park, Caloocan City
(02) 8365-0464

LHIO-Valenzuela 4/F Puregold, Paso de Blas Road Cor. East

Service Road North, Valenzuela City (02) 8277-4863

LHIO-Mandaluyong 3rd Floor, 500 Shaw Zentrum Mall Shaw

Boulevard, Mandaluyong City (02) 8532-0449

LHIO-South Triangle, Quezon Lower Ground Floor, Corporate Building 145

City Mother Ignacia, Barangay South Triangle,
Quezon City (02) 8332-1557
 Our Workshop Sales (OWS) Building Lot 19
LHIO-Fairview
Block 237 Neopolitan 4 Britanny Subdivision,
Barangay Pasong Putik, Quezon City
(02) 8356-7461

Fibertex Bldg., cor. Don Mariano Subd.,

LHIO-Rizal
Ortigas Ext.,
Brgy San Juan, Cainta, Rizal (02) 8997-8377

LHIO-Taguig Global Satellite Office, 7th Floor

SM Aura Tower, Bonifacio Global City, Taguig

LHIO-Makati 2326 PTX Building, Chino Roces Ave.

Extension, Magallanes, Makati City

LHIO-Las Piñas 471 Editha Building, Alabang-Zapote Road,

Almanza I, Las Piñas City

HRDC Building, Km. 16 South Super Highway

LHIO-Parañaque Corner ACSIE Road, Severenian Industrial
Estate West Service Road, Bgy. Marcelo
Green Parañaque City

LHIO-Laoag G/F Valdez Building A, Valdez Center, Brgy.

(077) 600-0482; (077) 770-4945 (fax)
1,San Francisco, San Nicolas, Ilocos Norte
[email protected]

LHIO-Vigan 2/F Henady Bldg., del Pilar St., cor. Salcedo (077) 604-0008
St., Vigan City, Ilocos Sur [email protected]
LHIO-San Fernando G/F, CSI The City Mall Inc., Brgy. Biday, San (072) 607-7162
Fernando City, La Union [email protected]

LHIO-Western Pangasinan G/F Marmor Realty, Quezon Avenue, (075) 523-1860

Poblacion, Alaminos City, Pangasinan [email protected]

CBE Estrada Prime Holdings Inc., 3rd Floor CB

LHIO-Eastern Pangasinan
Mall, Mac Arthur Highway, Nancayasan (075) 600-5829; (075) 656-2030 (fax)
Urdaneta City, Pangasinan [email protected]

LHIO-Central Pangasinan 2nd BHF Family Plaza, Mayombo District, (075) 522-3122
Dagupan City [email protected]

LHIO-Tuguegarao Juliana’s Square Bldg., Rizal St., Centro 04 (078) 844-0271; (0917) 7028135
Tuguegarao City, Cagayan [email protected]

LHIO-Ilagan Abarca Building, V. Cureg St. Calamagui 2nd, (078) 624-0259; (0995) 6590670
Ilagan, Isabela [email protected]

LHIO-Cauayan 2nd Floor, LetJoelou Bldg., Canciller Ave. (078) 652-4166 ; (0917) 8659865
District 1 Cauayan City, Isabela [email protected]

LHIO-Santiago Ground Floor, MECC Bldg., National Highway, (078) 3050181; (0945)3201872
Villasis Santiago City, Isabela [email protected]
(0935) 3337886
LHIO-Solano OLMA Realty Bldg., National Highway, Brgy. [email protected]
Roxas Solano, Nueva Vizcaya [email protected]

LHIO-Bangued Ground Flr., VP Skyview Building, Magallanes

St., Zone 5, Bangued, Abra 2800
(074) 752-7924; (0999) 777-6100
LHIO-Baguio SNOBT Inc. Building, No. 19 Leonard Wood
Road, Baguio City 2600 (0929) 370-5617

LHIO-La Trinidad Dangwa Tranco Compound, Km. 2 Betag, La

Trinidad, Benguet, 2601 (074) 424-8937
LHIO-Lagawe
2nd Flr., JDT Bldg., Lagawe, Ifugao 3600 (074) 382-2173; (0917) 574-7485

LHIO-Tabuk 1st Flr. Richmond Bldg., Purok 4, Bulanao,

Tabuk City,Kalinga 3800 (0915) 779-6615

LHIO-Bontoc 1st Flr., Kedawen Bldg., Poblacion, Bontoc,

Mt. Province 2616 (074) 602-1510; (0921) 471-9848

LHIO-San Fernando, G/F PhilHealth Bldg., Lazatin Blvd., San

Pamanga Agustin, San Fernando City, Pampanga C-
2000 (045) 963-1155 loc. 4310

Ground Floor, ABC Bldg., Nepo Commercial

LHIO-Angeles
Complex, Doña Teresa Ave., Angeles City C-
2009 (045) 322-7162 loc. 4350

LHIO-Olongapo 1120 Rizal Ave., East Tapinac, Olongapo City

C-2200 (047) 222-9427 loc.4354
LHIO-Iba
ACM Bldg., Zone 6, Iba, Zambales C-2201 (047) 811-3690 loc. 4355

LHIO-Tarlac 3F My Metro Town Mall, Sto. Cristo, Tarlac

City C-2300 (045) 491 4696
LHIO-Balanga 2/F Zabala Bldg. II, Primrose St., Doña
Francisca Subd., Balanga City C-2100 (047) 237-1921

The Cabanas Mall of Malolos 2nd and 3rd

LHIO-Malolos
floors N4 Bldg. Km. 44/45 MacArthur
Highway Longos, Malolos City C-3000 (044) 796-1559; (044) 796-1560 loc. 4400; (044) 796-3481

LHIO-Sta. Maria A&E Bldg. 3, Gov. F. Halili Ave., Brgy.

Bagbaguin, Sta. Maria, Bulacan C-3022 (044) 288-2617 loc. 4457

LHIO-Cabanatuan 3/F NE Pacific Mall, Maharlika Highway,

Cabanatuan City, Nueva Ecija, C-3100 (044) 940-3723 loc. 4458

LHIO-Gapan 2F, Sta. Inez Bldg., Jose Abad Santos Ave.,

Sto. Niño, Gapan City, Nueva Ecija C-3105 (044) 486-9570 loc. 4459

LHIO-Baler NE Baler, 2nd Floor, Brgy Suklayin, Baler

Aurora C-3200 (0920) 538-9471

Cosico Avenue Brgy. Del Remedio, San Pablo

LHIO-San Pablo
City, Laguna (near Laguna State Polytechnic
(049) 562-7027 (fax); (049) 562-9242
University, San Pablo City campus)
[email protected]

LHIO-Trece Martires 1 FS Building, Governor’s Drive Brgy. Hugo- (046) 419-1686; (046) 419-0701
Perez, Trece Martires City, Cavite [email protected]

LHIO-Dasmariñas 2nd Floor Central Mall, Emilio Aguinaldo

(046) 472-0501; (046) 472-0468
Highway, Salitran, Dasmariñas City, Cavite
[email protected]
LHIO-Calamba CMC Annex Bldg. National Highway Crossing, (049) 502-5697; (049) 544-4551
Real, Calamba City [email protected]

Manuel Lorica Building, A. Bonifacio Street

LHIO-Gumaca
(Across NOVO) Barangay Pipisik, Gumaca, (042) 317-7754
Quezon [email protected]

LHIO-Lucena LGCTI Bldg., Diversion Road, Brgy. Ilayang (042) 3736703; (042) 373-6359
Dupay, Lucena City [email protected]

LHIO-Lemery 2/F Humarang Building Ilustre Ave. cor.

Noble St. Lemery, Batangas (043) 411-2048; (043) 411-1961

LHIO-Lipa The Only Place Business Center Marawoy,

Lipa City (043) 312-5325

2/F MBP Business Center President Laurel

LHIO-Tanauan
Highway, Poblacion Brgy. III
Tanauan City, Batangas 4232 (043) 778-6242; (043) 778-6080 (Fax)

Island LHIO- Boac Ground Floor Zenturia Hotel Isok I, Boac,

Marinduque (042) 332-2274

Island LHIO-Puerto Princesa National Hway cor. Tiansuy Go Road, Brgy

San Jose, Puerto Princesa City

Island LHIO-Mamburao ANTRAM Bldg. Seabreeze Subd., Brgy.

Tayamaan, Mamburao, Occidental Mindoro
(043) 711-1778
Island LHIO-Calapan Meck Bldg., Brgy. Masipit, Calapan City,
Oriental Mindoro

Island LHIO-Romblon 2/F GNI Bldg, Cocoville St, Brgy Dapawan,

Odiongan, Romblon

LHIO-Legazpi 2/F delos Santos Commercial Bldg. LandCo

(052) 481-55-96 (telefax); (052) 480-15-89
Business Park, Bitano Legazpi City
[email protected]

LHIO-Masbate Buna-Tusing Building, Danao Street Masbate (056) 333-6041

City 5400 [email protected]

LHIO-Naga (054) 473-5632; (054) 472-1483

Westpark, Magsaysay Ave., Naga City 4400
[email protected]

LHIO-Daet Cañeba Building, Gov. Panotes Avenue (054) 440 3380-81

Barangay VIII, Daet, Camarines Norte [email protected]

LHIO-Sorsogon LJA Bldg., Flores St., Burabod, Sorsogon City, (056) 421-5582
Sorsogon [email protected]

LHIO-Virac 2/F Riverside Building, Virac Town Center

Gogon Sirangan, Virac, Catanduanes 4800 [email protected]
(036) 268-9001; 500-7211; 262-8001; 500-7106; 500-7118;
500-8703; (0917) 722-4451
LHIO-Kalibo L. Kristen and OJ's Place D. Magma Street
[email protected]; it-
Kalibo, Aklan
[email protected]
 (036) 540-8052; 540-7209; 540-8023; (0917) 717-7135
LHIO-San Jose Ground Floor, St. Nicholas Commercial
[email protected]/[email protected]
Building, TA Fornier Street, San Jose, Antique
m

LHIO-Roxas SHJ Bldg, Gov. Gabriel Hernandez Avenue, (036) 522-4369; 621-0325; 522-8258; (0917) 7177183
Roxas City, Capiz [email protected]/[email protected]
(034) 708-5335; 709-0133; (034) 432-2319; 433-3694;
LHIO-Bacolod 426 Building, San Agustin Drive, Bacolod City, (0905) 273-0378
Negros Occidental [email protected]

Carpark Area, Gaisano Capital, Simeon

LHIO-Passi (033) 536-8301; (033) 311-6261; (0917) 390-8739
Aguilar Street, Pob., Ilawod Passi City, Iloilo
[email protected]; [email protected];
[email protected]

LHIO-Iloilo Ground Floor, Gaisano Capital Building, Luna (033) 501-9160 to 62 loc. 100/102; (0998) 959-9487
Street, Lapaz, Iloilo City [email protected]

G/F NNPAI Building, National Highway, Pob.

LHIO-Sagay
2, Sagay City (034) 722-0116; 488-0587; (0917) 717-7182
[email protected] / [email protected]

NZ Bldg, JY Perez Highway, Barangay

LHIO-Kabankalan Talubangi, Kabankalan City, Negros
Occidental (034) 746-8256; 471-2050; (0925) 874-5410
[email protected]

LHIO-Sara Cecilio Tady Street, Pob. Sara, Iloilo (033) 392-0520; 393-0262; (0917) 717-7184
[email protected]
 PhilHealth Members’ Assistance Center
(PMAC) G/F Golden Peak Hotel & Suites,
LHIO-Cebu
Gorordo Ave.corner Escario St., Cebu City 441-7444 local 5561
6000 [email protected]

Wireless Plaza, Hernan Cortes corner Lopez

LHIO-Mandaue
Jaena Streets, Subangdaku 032) 505-3022 (telefax)
Mandaue City 6014 Cebu [email protected]

Lower Ground, New Carcar City Hall,

LHIO-Carcar
Poblacion 3, Carcar City 6019 Cebu (032) 516-7544; (032) 487-8501 (telefax)
[email protected]

J. D. Almendras Building, National Road,

LHIO-Danao
Poblacion, Danao City 6004 Cebu (032) 324-7963; 09171475041
[email protected]

JGY Building, J.A Clarin Street, Tagbilaran City

LHIO-Tagbilaran
(Beside Motortrade and Colour Steel) 6300 (038) 412-0248; (038) 235-5622 (telefax)
Bohol [email protected]

LHIO-Talibon RHU Building, Municipal Hall Compound, (038) 515-5165 (telefax)

Talibon 6325 Bohol [email protected]

2nd Floor Poincare I Bldg., National Highway

LHIO-Dumaguete
corner E.J. Blanco Drive Extension,
(035) 422-3931; (035) 225-9297 (telefax)
Dumaguete City 6200 Negros Oriental
[email protected]
LHIO-vBais Vean Bldg., Roxas St., Bais City 6206 Negros (035) 402-3415; (0325) 402-8786 (telefax)
Oriental [email protected]

Primea Hotel, G. Abogado cor. San Francisco

LHIO-Borongan
Streets
Barangay C, Borongan City, Eastern Samar
(055) 261-3329; (055) 560-9065 (fax)

6A Building, Garcia corner Mabini Streets

LHIO-Catarman
Barangay Jose Abad Santos, Catarman,
Northern Samar (055)251-8240; (055)500-9281; (0917) 323-0036

LHIO-Maasin
Brgy. Mantahan, Maasin City, Southern Leyte
(053)381-3862; (053)570-8365

LHIO-Ormoc LAM Building., Rudy Revilla Avenue Barangay

Can-adieng, Ormoc City, Leyte (053)255-4859; (053)561-2809

LHIO-Tacloban Real Street, Fatima Village, Sagkahan,

Tacloban City (053) 888-0804

LHIO-Catbalogan San Bartolomew Street, Barangay Ubanon,

Catbalogan City, Western Samar (055)543-8090

LHIO-Zamboanga Wee Agro II bldg., Veterans Ave., Zamboanga

City (062) 310-3516

LHIO-Ipil NMJ Bldg., Gethsemani St., cor. Sucgang

Ave., Ipil, Zamboanga Sibugay (062) 333-5495
LHIO-Pagadian City Nesoricom Prime Arcade, Tiguma, Pagadian
City (062) 214-4303

LHIO-Dipolog City ABC Lessor Bldg., Malvar St., Barangay

Miputak, Dipolog City (062) 212-7860

LHIO-Cagayan De Oro Gateway Tower 2, Claro M. Recto Ave,

Cagayan de Oro

LHIO-Valencia, Bukidnon GF Candelaria Bldg., Sayre Hi-way, Hagkol

Valeciana City Bukidnon
LHIO-Ozamis City, Misamis
J-ME Building, Rizal Ave. cor Capistrano St.
Occidental
Ozamis City
LHIO-Gingoog City, Misamis
RRM Barro Bldg., Jadol-Tuto sts., Gingoog
Oriental
City Gingoog City, Misamis Oriental
LHIO-Iligan City, Lanao Del
GF Gonzales - Gimeno Bldg. 4 Macapagal
Norte
Avenue Tubod Iligan City
LHIO-PMAC (LHIO Butuan
Lynzee's Building, 766 J. Rosales Avenue, (085) 342-0900
City)
Butuan City [email protected]

LHIO-Bislig City, Surigao Del (086) 853-2262; (086) 628-2402; (0917) 702-4478; (0920)
2F MNBC Bldg., Abarca cor. M. Castillo
Sur 2180118
Streets, Mangagoy, Bislig City, Surigao del Sur
[email protected]
LHIO-San Francisco, Agusan
Alexandra Bldg., National Highway, Brgy. (085) 242-3883; (085) 343-9288 (fax)
Del Sur
Hubang, San Francisco, Agusan del Sur [email protected]
LHIO-Surigao Del Norte 2F Primeglee Bldg., San Nicolas St. corner (086) 231-9261
Diez St., Surigao City [email protected]

LHIO-Tandag, Surigao del Sur 2nd Floor JTP Bldg., Bagong Lungsod, Tandag (086) 211-4196; 211-4360
City, Surigao del Sur [email protected]

LHIO-Agusan del Sur Alexandra Bldg., National Highway, Brgy.

Hubang San Francisco, Agusan del Sur (085) 343-9288; 242-3883

LHIO-Davao City Valgosons Building Bolton Extension,

Poblacion, Davao City Trunkline: (082) 295-2133 local 6328 to 30

LHIO-Tagum City, Davao del G/Flr. F. Ramos Building, Lapu-lapu Street

Norte Magugpo, Poblacion, Tagum City, Davao Del Trunkline: (082) 295-2133 local 6363-64
Norte Direct Lines:(084) 655-9609; (084) 655-0834

De Leon Bldg., Roxas Ext. St. Brgy. San

LHIO-Digos, Davao Del Sur
Miguel, Digos City, Davao del Sur
Trunkline: (082) 295-2133 local 6365-66
LHIO-Digos Gonzales Building, Vinzon Street, Digos City
272-2018 ; 272-4488

Roche Building, Andravel corner Mabini

LHIO-Mati, Davao Oriental
Streets Trunkline: (082) 295-2133 local 6363-64
Barangay Central, Mati, Davao Oriental Direct Lines:(084) 655-9609; (084) 655-0834
LHIO-Nabunturan,
A. Ford Building, Purok 17, National Highway Trunkline: (082) 295-2133 local 6361-62;
Compostela Valley Province
Nabunturan, Compostela Valley Mobile No.: (0925) 5275048
LHIO-General Santos City, JM II Bldg., Pendatun Avenue, Dadiangas
South Cotabato North, (083) 305-1949
General Santos City [email protected]
LHIO-Kidapawan City, North
(064) 278-4360
Cotabato Apol-J Bldg., Quezon Blvd., Kidapawan City
[email protected]

LHIO-Koronadal City, South

Ground Flr., CSA I Building cor. Zulueta Street
Cotabato (083) 228-6389; (083) 228-9731 to 34 loc. 4506
and General Santos Drive, Koronadal City
[email protected]

LHIO-Cotabato City, Cotabato Door 3 F.A.Tan Bldg., S.K. Pendatun St., (064) 421-7292; (064) 471-0304
Cotabato City [email protected]

LHIO- Isulan, Sultan Kudarat R.E.R. Commercial Bldg. National Highway, (064) 201-5009
Isulan, Sultan Kudarat [email protected]

LHIO-Bongao, Tawi-Tawi Samsuya Building, Tubig Boh Highway, (0919) 874-2705

Bongao, Tawi-Tawi [email protected]

Ground Floor, Khouzbary Business Complex

LHIO-Marawi City
Ja'far Bin Abu Talib St., New Capitol Heights,
Marawi City (0938) 212-9134/ (0905) 574-5492

Ground Floor, A and N Business Center

LHIO-Datu Odin Sinsuat
Barangay Upper Capiton, Datu Odin Sinsuat,
Maguindanao (064) 557-1423

LHIO-Buluan Provincial Compound, Narra St., Poblacion,

Buluan, Maguindanao (0926) 391-9848
PHILHEALTH EXPRESS
Robinsons Otis 2/F Robinsons Otis, Guanzon Street, Paco,
Manila

Robinsons Place Manila Lingkod Pinoy Center, Pedro Gil Street,

Ermita, Manila
Lucky Chinatown, Binondo,
3/F City Place Lucky Chinatown Mall Annex
Manila
Regina, Binondo, Manila

LRT North Mall, Caloocan 4/F Caloocan LRT North Mall, Rizal Avenue
Extension, Caloocan City

Robinsons Malabon Governor Pascual Avenue corner Crispin

Street, Tinajeros, Malabon City

Robinsons Galleria Lower Ground Floor, Lingkod Pinoy Center,

Ortigas Avenue, Quezon City

Rodriguez, Rizal JP Rizal Street, Barangay Balite, Rodriguez,

Rizal
Antipolo, Rizal
2054 Robinsons Place, Antipolo City

SM North EDSA SM Annex, Government Services, Lower

Ground SM City North EDSA, Quezon City

Ali Mall 3rd Floor, P. Tuazon Avenue, Cubao, Quezon

City

Robinsons Metro East Level 4 Lingkod Pinoy Center, Marcos

Highway, Brgy. Dela Paz, Santolan, Pasig City
 Basement Level, Lingkod Pinoy Center,
Robinsons Place Las Piñas
Alabang-Zapote Road, Talon Dos, Las Piñas
City

Main Building, Ground Floor, Philippine

Muntinlupa City Hall
Business Registry, National Road, Putatan,
Muntinlupa City

Calasiao, Pangasinan (075) 632-0107

2/F Lingkod Pinoy Center, Robinsons Place
[email protected]

Robinsons Starmills Marquee Mall, Angeles City

Dinalupihan Municipal Hall, Bataan

San Nicolas, Ilocos Norte Level 1 Robinson's Place, San Nicolas, Ilocos (077) 772-2848
Norte (West side) [email protected]

Tuguegarao Cagayan Valley Medical Center

8:00am - 2:00pm - Daily

PhilHealth Express - Santiago Robinson's Place, Santiago City

10:00am - 6:00pm - Tuesday to Friday
PhilHealth Express - Nueva
Bambang Rural Health Unit
Vizcaya
8:00am - 5:00pm - Daily

NE Bodega Mall, Brgy. Abar 1st, San Jose City,

Nueva Ecija
NE Bodega Mall
 Annex Bldg., Municipal Comp., Baliuag,
Bulacan

Starmall- Bulacan 3F Starmall, Kaypian Road, Brgy. Kaypian,San

Jose Del Monte Bulacan (044) 797-0354
Robinsons Laguna
Robinsons Sta. Rosa City, Laguna
Robinsons Place Dasmariñas
Robinsons Place Dasmariñas City, Cavite
Robinsons Place Bacao
Robinsons Place Bacao, Gen. Trias, Cavite

Robinsons Place Lipa 2/F Robinsons Place, Mataas na Lupa, Lipa

City, Batangas
NuCiti Baymall
NUCITI Bldg., P. Burgos St., Batangas City

Robinsons Palawan Robinsons Place, Brgy. San Jose Puerto

Princesa City, Palawan
(054) 456-2174
Iriga City, Camarines Sur
City Public Library, Poblacion, Iriga City [email protected]

Sipocot, Camarines Sur LGU Annex Building, LGU Compound (054) 450-6054
Sipocot, Camarines Sur [email protected]

Tabaco, Albay Ground Floor, Municipal Building Tabaco (052) 203-0262

City, Albay [email protected]

Ligao, Albay Multipurpose Building, Barangay Guilid Ligao (052) 485-1898

City, Albay [email protected]
Robinsons Bacolod, Bacolod
3/F Robinsons Place BacolodMandalagan,
City
Bacolod City (0933) 629-6623

Robinsons Iloilo, Iloilo City Lingkod Pinoy Center, 3rd level Robinsons (0918) 553-3223
PlaceI Ioilo, Mabini Street, Iloilo City [email protected]

Iloilo - Jaro, Iloilo City Lingkod Pinoy Center, Ground Floor

Robinsons Place, Jaro, Iloilo City

2nd Floor, Lingkod Pinoy Center, Robinsons

Robinsons Roxas City, Capiz
Place Roxas (0917) 625-8999
Barangay Lawa-an, Roxas City, Capiz [email protected]

2nd Floor Jose V. Valmayor Public Market

San Carlos City, Negros Occ.
V. Gustilo Sreet, San Carlos City, Negros (034) 729-3897; (0939) 599-3788
Occidental [email protected]
(0916) 571-4471
Guimbal Poblacion, Iloilo
Poblacion Gerona Street, Guimbal, Iloilo [email protected]

Caticlan, Malay, Aklan Barangay Hall, Sitio Proper Caticlan, Malay,

Aklan

2nd Level, Government Services Express, SM

SM City Cebu City Cebu,
North Reclamation Area, Cebu City
Monday – Saturday; 10 am to 7 pm

3rd Level, Lingkod Pinoy Center, Robinsons

Robinsons Fuente Fuente,
Osmeña Blvd., Cebu City
Monday – Saturday; 10 am to 7 pm
 3rd Level, Lingkod Pinoy Center, Robinsons
Robinsons Galleria- Cebu Galleria,
Gen. Maxilom Avenue Extension, Cebu City
Monday – Friday; 10 am to 7 pm

2nd Level, SM City Consolacion, Cebu

SM City Consolacion National Road,
Cansaga, Consolacion, Cebu
Mondays - Fridays, 10am to 7pm

2nd Level, Galleria Luisa, Celestino Gallares

Galleria Luisa, Tagbilaran City Street,
Tagbilaran City, Bohol
Monday – Friday; 9 am to 6 pm

2nd Level, Lingkod Pinoy Center, Robinsons

Robinsons Place, Dumaguete
Place,
City
Calindagan,Dumaguete City, Negros Oriental
Monday – Saturday; 10 am to 7 pm

Zamboanga City Medical Center, Evangelista

St., Zamboanga City
Zamboanga City Yubenco Grand Mega Starmall, Putik,
Zamboanga City
KCC Mall de Zamboanga, Gov. Camins,
Zamboanga City
 Gaisano Capital Surigao, Surigao City
Surigao City
2nd Floor Gaisano Capital Surigao
Km. 4 Barangay Luna, Surigao City
New Van Terminal, Butuan
City New Van Terminal, Butuan City

Robinson’s Place, Butuan City 3rd Floor Lingkod Pinoy, Butuan City
(085) 815-5961

Calinan, Davao City Old Barangay Hall beside Police Station,

Aurora-Quezon St., Calinan, Davao City [email protected]

Toril, Davao City Urban Center B, Juan dela Cruz Street, Brgy.
Daliao, Toril Dist., Davao City [email protected]

Panabo City Multi-Purpose Tourism Cultural

Panabo City
and Sports Center, JP Laurel, Pan-Philippine
Highway, Panabo City, Davao del Norte
[email protected]

Robinsons Place, Tagum City 4th Level Robinsons Place, National Highway,
Tagum City, Davao del Norte
Sulop, Davao del Sur
Sulop Public Market, Sulop, Davao del Sur (082) 272-3705
Gensan Robinsons Gensan Gaisano, Kidapawan City

Cotabato City
ORC Complex, Cotabato City

Candon City Stern Real State Bldg., San Nicolas, Candon (077) 632-1188
City, Ilocos Sur (beside CSI Mall) [email protected]
 SATELLITE OFFICE

San Carlos City 2/F New Public Market, San Carlos City, (075) 203-0239; (075) 532-1111
Pangasinan [email protected]

Mangatarem 2/F Magic Mall, Romulo Highway, (075) 523-0845

Mangatarem, Pangasinan [email protected]

Agoo GSV Building, National Highway, San Agustin (072) 682-0297

Norte, Agoo, La Union [email protected]

Boracay Sitio Bantud, Manoc-Manoc, Boracay, Malay, (036) 506-3050

Aklan [email protected]

GEMPC Building, Provincial Capitol Grounds

Guimaras
San Miguel, Jordan, Guimaras (033) 396-1116; (0917) 799-5300
[email protected]

Hospital Site, Centro Poblacion Culasi,

Culasi
Antique
(036) 277-8543; (0999) 876-7027

2nd Flr, Festive Walk Parade, Iloilo Business

Mandurriao
Park, Megaworld Blvd., Barangay San Rafael,
Mandurriao, Iloilo City
(033) 315-4074
Pavia
3rd Floor, Robinsons Place Pavia, Iloilo (033) 315-4075

Siquijor Ground Floor, Multi-Purpose Center,

Poblacion, Siquijor 6225 Siquijor (035) 480-9844
 2nd Floor, Lingkod Pinoy Center,Robinsons
Tacloban City
Mall, Marasbaras, Tacloban City Sunday to
Friday 10:00am-7:00pm

Gaisano Central - Tacloban

2nd Floor, Gaisano Central, Tacloban City
City
Monday to Saturday 8:30am-5:30pm

Gaisano – Sogod Gaisano Sogod, Sogod, Southern Leyte

Monday to Saturday 9:00 a.m.-7:00p.m.
LGU Office Compound, Sta. Elena, Camarines
Norte ( SATELLITE OR SERVICE DESK)
LGU Compound, Nabua, Camarines Sur (
SATELLITE OR SERVICE DESK)
GLOBAL SATELLITE OFFICE
Philippine Overseas
Employment G/F Blas Ople Building, Ortigas Avenue, EDSA
Administration ( POEA) Mandaluyong City
BUSINESS CENTERS

San Carlos City 2/F New San Carlos City Public Market, San (075) 532-1111
Carlos City, Pangasinan [email protected]
(075) 546-1111
Mangatarem, Pangasinan
2/F Magic Mall, Mangatarem, Pangasinan [email protected]

Agoo, La Union 2/F Hypermarket, San Nicolas Central, Agoo,

La Union [email protected]

Aparri Business Center Hosana Bldg. MH del Pilar, Centro 5 Aparri,

Cagayan (0915) 2647573
Batanes Business Center Block 2, Lot 17, Cantor Street Barangay
Kayvaluganan Basco, Batanes (0919) 9951024

Apayao Business Center Apayao Business Center Poblacion, Luna,

Apayao (0915) 975-3365

Naval, Biliran (053) 500-9016

R.K. Bldg., Caneja cor Castin St. Naval, Biliran
[email protected]

Calbayog, City Nijaga Street, Barangay Central, Calbayog [email protected]

City (055) 533-9876

Baybay City G/F Legislative Building, R. Magsaysay Street, (053) 563-7283

Baybay City [email protected]

Malaybalay Old Provincial Hospital, Capitol Compound,

Malaybalay, Bukidnon

Maramag Stall 2&4, Perimeter Bldg., Integrated Bus

Terminal, Maramag, Bukidnon

Province of Camiguin Dychauco Arcade, Gen. B. Aranas Street

Barangay Poblacion, Mambajao 387-0353

Tubod LNPH Cmpd, Upper Sagadan, Baroy, Lanao

del Norte (063) 373-6267

Maranding, Lanao del Norte NCMC Building, Purok Lemontree Maranding,

Lala, Lanao del Norte (063) 388-7012

Carmen No. 105 G/F, Stary Building Max Suneil

Street, Brgy. Carmen Cagayan de Oro City
Oroquieta Sobong Building, Barrientos Street Layawan,
Oroquieta City (088) 545-3843

PhilHealth Business Center of Tangub Doña

Tangub
Maria D. Tan Memorial Hospital
Pertig Street, Mantic, Tangub City (088) 5450565

CHO Bayugan City CHO Bayugan City (Every 2nd and 4th
Tuesday) (0922) 8031877

RHU Trento, Agusan del Sur RHU Trento, Agusan del Sur (Every
Wednesday) (0908) 7675920
RHU Talacogon, Agusan del
RHU Talacogon, Agusan del Sur (Every 1st &
Sur
3rd Tuesday) (0918) 5893391

RHU Veruela, Agusan del Sur RHU Veruela, Agusan del Sur (Every 1st
Thursday of the month) (0910) 5427366
RHU Sta. Josefa, Agusan del
RHU Sta. Josefa, Agusan del Sur (Every 2nd
Sur
Thursday of the month) (0928) 6120147

RHU San Luis, Agusan del Sur RHU San Luis, Agusan del Sur (Every 3rd
Thursday of the month) (0910) 0904028

RHU Sibagat, Agusan del Sur RHU Sibagat, Agusan del Sur (Every 4th
Thursday of the month) (0949) 9961400
PHILHEALTH SERVICE DESK
 LGU Sta. Cruz, Zambales
LGU Subic, Zambales
Zambales
LGU San Antonio, Zambales
Harbor Point Mall, Subic Bay Freeport Zone

3rd Floor Robinsons Galleria South Km. 31

San Pedro, Laguna
National Highway, Brgy. Nueva, San Pedro,
Laguna Office hours: 10am-6:00pm
LGU Office Compound, Sta. Elena, Camarines
Norte ( SATELLITE OR SERVICE DESK)
LGU Compound, Nabua, Camarines Sur (
SATELLITE OR SERVICE DESK)

Guiuan Service Desk Municipal Hall, Guiuan, Eastern Samar -

Opens every Wednesday

Hilongos Service Desk Municipal Hall, Hilongos, Leyte

Opens every Tuesday to Friday (053)336-2254

Nasipit, Agusan del Norte MSWD Office, Municipal Hall, Nasipit, Agusan
del Norte
Cabadbaran City, Agusan del
Cabadbaran City Hall Lobby, Cabadbaran
Norte
City, Agusan del Norte

Municipality of Hinatuan, Old Service Desk

Surigao del Sur
RHU Building, Aquino, Hinatuan, Surigao del
Sur (Every Friday)
 Municipality of Lingig, Poblacion, Lingig,
Lingig, Surigao del Sur
Surigao del Sur
(Every Thursday)

Municipality of Tagbina, RHU Tagbina,

Tagbina, Surigao deL Sur
Poblacion, Tagbina, Surigao deL sur
(Every Wednesday)
Claver, Surigao del Norte
LGU Claver, Surigao del Norte
Province of Dinagat Islands
LGU San Jose, Province of Dinagat Islands
Siargao Islands, Surigao del
Norte LGU Dapa, Siargao Islands, Surigao del Norte

San Miguel, Surigao del Sur RHU San Miguel, San Miguel, Surigao del Sur
(Every Tuesday)

Lianga, Surigao del Sur Lianga District Hospital, Lianga, Surigao del
Sur (Every Wednesday) (0928) 3940190
Madrid District Hospital, Madrid, Surigao del
Madrid, Surigao del Sur
Sur (Every 2nd and 3rd Thursday) (0908) 8743038

Cantilan, Surigao del Sur MSWD Office, Cantilan, Surigao del Sur
(Every 3rd Friday) (086) 212-5543

Carrascal, Surigao del Sur Carrascal Diagnostic Bldg., Carrascal, Surigao

del Sur (Every 2nd Friday) (0930) 7612839