PhilHealth Revised Provisions for the Recovery and Disposition of Unclaimed Refunds from Accredited IHCPs
Philippine Health Insurance Corporation (PhilHealth) announces the amendments to PC 42, s2009 (Revised Provisions for the Recovery and Disposition of Unclaimed Refunds from Accredited IHCPs):
1. Section A. Item 1
A Financial Statement (FS) as of 2008 and a duly notarized Report on Unclaimed Refund (RUR) from 1995 to 2008 shall be submitted by all currently and previously accredited IHCPs. IHCPs that do not have accumulated refunds are likewise obliged to submit a duly notarized RUR indicating that there are no fefunds to be returned to PhilHealth. Thereafter, all currently accredited IHCPs are required to submit the FS annually and the RUR as prescribed.2. Section A. Item 5
PhilHealth shall accept payment from IHCPs with or without the Billing Statement (BS), provided, that such payment shall be subject to verification vis-a-vis the submitted RUR and FS.3. Section A. Item 6.1
The total amount of unclaimed refund that is being requested to be paid on installment basis is more than P1,000,000.00 supported by the latest audited FS and/or cash flow or liquidity statement of the IHCP.4. Section A. Item 6.2
The IHCP should submit the request in writing addressed to the concerned PhilHealth Regional Office (PhRO) within five (5) working days from receipt of the billing statement of demand letter, as the case maybe. The written request must be submitted together with the supporting documents stated in Section A, item 6.15. Section A. Item 6.3
ILD shall send an approval letter to the IHCP through the PhRO concerned stating therein the schedule of installment payments to be fully paid within a period of six (6) months. If request is not granted, ILD shall likewise inform the requesting IHCP of the denial coursed through the concerned PhRO6. Section A. Item 6.4
Item 6.4 in Section A of PC 42, s2009 is deleted.7. Section A. Item 6.5
Only the names of members in the validated RUR list will be published and processed for payment.8. Section B. Item 4
Members shall claim their refund from PhilHealth within two years from the date their names are published in a newspaper of general circulation advising them of the refund. After the two year has lapsed, the fund will be reverted back to the Corporation's mother account.All concerned are advised to refer to other provisions in PC 42, s2009 that are not inconsistent with the changes herein as they remain in full force and effect.
This circular becomes effective fifteen (15) days after publication in the Official Gazetter or in a newspaper of general circulation.
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