PhilCare - Hospital / Clinic Affiliation Form

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Hi.

Thank you for your desire to join the PhilCare network of hospitals and clinics. We made our affiliation process easier. To help you get started, we have outlined our simple affiliation process below: 

1. Accomplish the PhilCare Hospital Clinic Affiliation Form (philcare.com.ph/provider/join)
2. Evaluation by PhilCare Network Management Department
3. Execution of the Hospital/Clinic Service Agreement
4. Orientation of the PhilCare End-to-End Process by PhilCare Network Management Department
5. Confirmation by PhilCare Network Management Department

Also, before proceeding, please make sure you have soft copies (pdf, jpg, png) of the following updated documents as we will be asking for these:

1. Letter of Intent
2. DOH License to Operate (If clinic, all applicable like: lab, x-ray, drug test, dialysis, ambulatory surgical, etc.)
3. PhilHealth Certificate (if applicable)
4. BIR Certificate of Registration (Form 2303)
5. SEC / DTI Registration (whichever is applicable)
6. Business Permit
7. Hospital/Clinic Profile
8. Vicinity Map (Google Map Link)
9. List of Services Available with HMO and cash basis rate
10. List of Active Physicians with specialization, clinic schedule and contact details (mobile and email)
11. Facility Photos (including facade)
12. Your Hospital/Clinic Contact Person and contact details (mobile and email)
13. Name/s and designation/s of your signatory/ies with attached valid ID

Re item 1, letter of intent, please address to:

EILYN E. AYUSTE, MD
Medical Director
PHILHEALTHCARE, INC. (PhilCare) 

In addition to item 10, for your physicians who wish to be affiliated with us, we would recommend that you please ask them in advance to accomplish philcare.com.ph/md/join and have them prepare the following documents as they will be submitting these:

• Diplomate and/or Fellow Certificate from your Specialty Society
• BIR Certificate of Registration (Form 2303)
• PRC ID
• Curriculum Vitae  

Please don't hesitate to reach out if you have any questions through nmd@philcare.com.ph.

Thank you very much.

Sincerely,

NICHOLAS OBA
Head, Network Management Department
Medical Services Division
PHILHEALTHCARE, INC. (PhilCare)

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Below are the important provisions from our service agreement we would like to highlight. Please discuss these provisions to your decision maker/s ahead of time for us to be efficient in our discussion.

• Secure Approval prior to availment
  Please make sure that a Letter of Authorization (LOA) is issued to the member prior to any availment. LOAs can be generated through calling our 24/7 hotlines or member self-service facilities such as our HeyPhil App, Kiosk, and our website.
• Billing Turn-Around-Time
  You should bill us within 30 days for NCR and 60 days for provincial providers from the date of availment or discharge.

• Affiliated Physicians
  Please only refer to affiliated Physicians. Otherwise, no LOA shall be issued and/or the billed claim is not valid for payment.

• Due Notice
  Please make sure to let us know in writing through nmd@philcare.com.ph at least seven (7) or thirthy (30) working days (whichever applicable) prior to the effectivity date:

1. Any changes in your affiliation such us but not limited to disaffiliation (30), suspension (7)
2. Any changes in your rates (30), otherwise we shall follow the existing rates
4. Any changes in your list of physicians

Any non-compliance with the above guidelines may result to delayed or non-payment.

• Payment Turn-Around-Time
  Our committment is to settle our payment within 30 working days upon receipt of your complete billing documents.

• PhilCare Coordinator
  Our affiliated hospitals have an assigned PhilCare Coordinator of our choosing which is selected from the affiliated physicians of the hospital. He/she has additional functions and responsibilities to help us with various functions such as but not limited to:
• Utilization management of members
• Physician related concerns (including affiliation of physicians)
• Visitation to our admitted patients
• Hospital related concerns
  
  

• Financial Discount
  We shall also be asking for a form of financial discount. This will be included in the service agreement we will be providing you once we are able to evaluate your documentary requirements.

For any concern or clarification, please contact our Network Management Department at nmd@philcare.com.ph. 

Please share the Google Map link of your facility. To do this:

1. Go to google.com/maps
2. Search for your hospital or clinic
3. Click Share
4. Then copy and paste the link to the field above.