For those who don't have a choice but reimburse their PhilHealth benefits, I hope my experience below will help you or at least give you an idea on how to go about it.
Due to the unfortunate death of my first born, we were too messed up to think about anything else. All we wanted was to go home and give my son a proper burial. In the end, we decided to have him cremated.
After I got the discharge order from my OB-Gyne, there were a lot of things that needed to be taken cared of that we forgot to submit my PhilHealth documents when my hospital bill was settled. I don't remember anymore who reminded who, but because I was already discharged from the hospital, our only option was to have my PhilHealth benefit reimbursed.
I was still too weak then, so my husband was the one who went back to the hospital to secure all the necessary documents. He went to the PhilHealth window (in the hospital), asked for the list of requirements and went to the corresponding offices. After he got all the documents, he submitted them to the same PhilHealth window. He was given a name and phone number, and was told to contact the person after 2-3 months to inquire on the status of the reimbursement request.
On the third month, I contacted the person, who turned out to be a PhilHealth personnel. She told me that my reimbursed benefit was already available and the check has been forwarded to the hospital where I gave birth. In fact, it was already available 1 month after we filed the request (so call as early as 1 month). But she instructed me to get a BPN (Benefit Payment Notice) first before heading to the hospital to claim the check. I was told to go to the nearest PhilHealth office to get this BPN.
After securing my BPN, I went to the hospital thinking I'd be able to claim my benefits right away. But the check issued by PhilHealth was for both my hospital bill and my attending physician (doctors usually deduct the PhilHealth percentage from their professional fees). So the hospital has to cash out the check first, remove the amount allocated for my doctor, before reimbursing me the amount for my hospital bill. Because of this, I was told to go back after a week to claim my money.
The following week, I was able to get my money, a total of P11,000+. My PhilHealth benefit was P19,000, P7,000+ went to my OB-Gyne.
The procedure sounds simple, right? Well, it depends on the PhilHealth branch where you will get your BPN and the hospital where you were confined. We went at the PhilHealth Taft branch and queued for more than two hours just to get the BPN, a short information about my contributions which were printed at the back of a used bond paper. I commend the idea to recycle, but lining up for 2 hours for such a small amount of information? Is a faster, easier, more efficient way of obtaining these types of document from government agencies not doable?
I also gave birth in a government hospital (PGH) and this unfortunately means more lines, more inefficient systems of record retrieval and more frustrations. It took a total of 3 days before my husband was able to complete all the required documents. Usually, the persons who need to sign the documents were not present so he was asked to come back on another day.
On the day when I presented my BPN, we lined up for hours at the Billing window just to be told that the person in charge of reimbursement was not around and the guy at the window didn't know when she'll be back. We went out to have lunch, then back to queue again, only to be told the same thing again. My husband, partly irritated and party frustrated, decided to go inside the Billing office and look for that person.
Surprisingly, he found her, and also found out that she was there all along. The guy at the window just didn't bother to check if she's there or not. Imagine if my husband didn't go inside, we would probably go home empty-handed (and would need to go back the next day). What a waste of time.
But all is well that ends well. Given a different PhilHealth branch and hospital, your experience might be different from mine, but the procedure will be more or less the same. Also, some say that you'll get more amount by reimbursing your PhilHealth benefits than having it automatically deducted from your hospital. This is not true, at least for C-Section deliveries. My total reimbursed benefit is still P19,000, which is the allotted amount for CS delivery based on PhilHealth case-rate table.
Because of our experience, we learned our lesson. Unless it really, really, really can't be avoided, we'd rather stay a few hours more in the hospital and accomplish all the necessary PhilHealth documents and opt for outright deduction than go through the process of PhilHealth reimbursement again.
I had a very similar experience. Gave birth last June sa Rizal Provincial Hospital and was told to keep my receipts, return there after 6 months??? yes 6 long months to reimburse them. Clueless talaga kami both ng husband ko so today lang kami nag follow up sa hospital so ngayon lang din namin nalaman na kailangan pa pala namin kumuha ng BPN. I called Philhealth if bakit wala kaming nareceived na BPN while may nabasa ako ng ipinapadala siya sa address ng patient. The guy said na may times na nadedelay daw, sabi ko how long since 6 months na kami naghihintay, so mga 1 year ganon? Hindi daw niya masasagot. Much better daw na pumunta na lang ako sa office nila para makuha. Nakakadisappoint lang sobra. And after reading your post, lalo ako nadisappoint since you said na nakadivide iyong check sa hospital and sa doctor. We've already paid na kasi the professional fees and ang hospital bills pumapatak na 12k. If ibibigay pa ng Philhealth sa doctors iyong 7k, so wala naring silbi if ireimburse ko pang mga receipts ko kasi mag exceed na siya. Nakakatawa lang since nagtiwala ako sa OB ko, samantalang ang inissue lang niya sa amin eh receipt na wala namang nakalagay na amount. I don't know if iho-honor ba iyon or what.
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