Glossary of PhilHealth forms and download links

Membership

PMRF: PhilHealth Member Registration Form - Download

Claims

Claim Form 1: Member and Patient Information - Download
Claim Form 2: Provider Information - Download
Claim Form 3: Patient's Clinical Record - Download

Employers

ER1: Employer Data Record - Download
ER2: Report of Employee-Members - Download
ER3: Employer Data Amendment Form - Download
RF1: Employer's Remittance Report - Download

Accreditation

Institutional

IAF: Institutional Accreditation Form - Download
MMHR: Monthly Mandatory Hospital Report - Download
SOI: Statement of Intent for Hospital, ASC and FSDC - Download
SOI: Statement of Intent for OPB, MCP and DOTS Providers - Download

Professional

PAF: Professionals Accreditation Form with Warranties for Accreditation and Checklist of Requirements - Download

Collecting Agents

CAAF: Collecting Agents Accreditation Form - Download

Payment

PPPS: PhilHealth Premium Payment Slip - Download

eClaims

HCPAP: Health Care Provider Account Profile application form - Download

Reference: http://www.philhealth.gov.ph/downloads/
 

Download the PhilHealth Premium Payment Slip (PPPS)

For employers and PhilHealth members who are paying their premium contributions or remitting their payments through accredited collecting agents of PhilHealth, the PhilHealth Premium Payment Slip is now downloadable.

The PhilHealth Premium Payment Slip is currently being used by accredited collecting agents. The employer/member would need to fill-out the slip, present the slip and the payment to the agent. You should ensure that the slip is properly filled-out as the details you have reflected will be recorded in PhilHealth's database.

To avoid the long lines and ensure availability of the form, PhilHealth is now allowing access to the form in softcopy format. You may download the PhilHealth Premium Payment Slip here.