To enable us to immediately return to our members their unclaimed refunds from accredited hospitals for their or their dependents’ confinements from Year 2007 to 2013, we are devoting this page to listing the names of PhilHealth members who may have benefit payment reimbursements during this period, and to guide them on how to claim the said refunds.
An unclaimed refund is a benefit payment that must be reimbursed by the accredited hospital to the member for a specific confinement period. The refund results from either an under-deduction or non-availment of benefits at point-of-service due to various circumstances at the time of hospitalization, and these have remained unclaimed by the members for some time now. The unclaimed refunds have been retrieved by PhilHealth from the accredited hospitals for immediate return to the concerned members.
1. Visit the nearest PhilHealth Regional Office (PRO) or Local Health Insurance Office (LHIO) in your locality. Bring two (2) valid identification cards.
2. Fill out the Request for Release of Unclaimed Refund Form completely.
3. Discuss with our frontline assistance personnel the preferred mode of release of the Unclaimed Refund.
4. Go back to the PRO or LHIO on the scheduled date of release of the refund, or await the notice of registered mail from the local post office (if mailing of cheque is preferred).
PhilHealth Call Center, (02) 441-7442 or contact numbers of any of our PROs or LHIOs nationwide.
1. The members list with unclaimed refund provided by health care institutions (HCIs) is only precise as of the date it is published and will be regularly updated. It is possible that refund may have been paid to members in the list at anytime prior to the next update.
2. PhilHealth shall not be liable for denied refunds arising from an inconsistency between the list provided by the HCIs and the claim for refund.
3. The burden of proof of relationship to member and knowledge of hospitalization details is incumbent on the claimant.
4. PhilHealth reserves the right to authenticate the identity of the claimant and the claim for refund prior to processing and releasing payment. PhilHealth shall not be liable for refunds released to false claimants.
An unclaimed refund refers to a benefit payment made by PhilHealth to a member through a healthcare institution (HCI), that the member had not been able to collect from. It usually results from an under-deduction by the HCI of the actual cost of hospitalization reimbursable to PhilHealth. HCIs with unclaimed refunds returned the funds to PhilHealth. As a result, PhilHealth endeavors to ensure that what it reimbursed for a member indeed reaches the member.
Not all members have a refund. Similarly, not all HCIs have refundable amounts to members. Only those members with which HCIs have declared unclaimed refunds are entitled to it.
The amount of refund varies per member, based on the lists reported by the HCIs. The lowest amount that can be refunded is one hundred pesos (P100).
Access www.philhealth.gov.ph/unclaimedrefunds. Click the tab showing the list of members’ and patients’ names. If your name is not on the list but you think you might have a refund from a previous hospitalization, kindly check with the HCI where you were admitted to.
If your name is in the list, proceed to the nearest PhilHealth office and present at least two (2) valid government-issued identification cards.
If the member is not available for reasons such as overseas worker, disability, etc., a representative may file the claim in his/her behalf. The claimant must bring the following documents:
a. Photocopy of valid ID card/passport of member
b. valid ID card of representative
c. authorization letter duly signed by the member
d. special power of attorney
The next of kin or heir may claim the refund. He/she must prove his/her relationship to the deceased. The following documents may be relevant to prove relationship:
a. valid ID card of member
b. death certificate
c. valid ID card of claimant
d. birth certificate
e. marriage contract
f. waiver letter from surviving heir.
Some of the lists forwarded by HCIs to PhilHealth only contain patients’ names. Under this circumstance, it is assumed that the patient will be the claimant.
All processing of payment for unclaimed refunds will be done at PhilHealth regional offices. Hence, if you file at a distant service office, processing time may be longer than if you filed at the regional office. However, the claimant may also opt to either personally pick up the refund, or have it mailed to his/her residence.